My cats potassium levels are low after Liptosis -help?

[vince]

My cat is eighteen and had Liptosis 18mths ago-we recently noticed her back legs not working too well -the vet said her potassium levels were low.
All her blood results were o.k. except for one of the liver tests -I think it was the AlT? which was 900 instead of(the vet said)200-the normal.

But all her other liver tests were o.k.

Since the Liptosis she has had a good diet of fish,chicken,catfood and a few biscuits.

Reading between the lines,it seems she needs more and more protein to produce the potassium-is the fact she cant get enough protein accounting for her liver result.


She seems a little tired,not as active and a reluctance to jump because her back legs are weak-other than that,her coat is good ..her weight is 4.5kilos.
Anyone got any ideas? is there a link between the elevated liver count and the low potassium?

[Traci]

Generally, the ALT and postassium don't correlate....I'd suggest testing further and ruling out dietary deficiency of potassium, renal or urological problems, or gastrointestinal disorders. Has your kitty ever been diagnosed with a heart condition, or an arrythmia by chance?

The ALT could have been elevated simply due to stress at the time of the blood draw, but I'd recheck it in about two weeks just to monitor it. If anorexia or vomiting or dehydration has been a problem in the past or is currently, please ask your vet for further diagnostics to rule out the above mentioned.

If the potassium is mildly low and not terribly significant, you can supplement with Tumil K, but would also suggest that other rule outs have been done so that you're ahead of any potential health condition surfacing.

Can you elaborate on the diet.....are you feeding home-cooked, and what brand of cat food are you feeding? If you are feeding a significantly low carbohydrate diet, this could also contribute to low potassium.

[dolphin11star]

This may be related but also may already have been done; do they check blood pH when they do the tests? I don't know about cat medicine, but in human medicine, if the blood pH changes, the potassium levels change. Traci, do you know if that happens in cats, too?
Good luck, I hope your cat is well soon.

[Traci]

Blood markers are indicated in the CBC which I assume has been done. Dehydration, bacterial infection, immunological, allergic reaction, white and red blood cell counts, etc are all indicated in the CBC. Because potassium is a chemical enzyme, it is included in a chemical analysis, just as with the ALT and other major organ function enzymes.

[vince]

My cats potassium count was 3.6,the t4 test was 141.

She has been put on Tumil K and a thyroid drug for 2 weeks to stabilise,then they will look to taking out the thyroids/s.

But her back legs are still weak? and I cant understand why they have put her on Tumil K when her Potassium count is at the bottom end of the normal range?

[Traci]

If I understood you correctly, you're saying her potassium level was below normal, which means you need to supplement it in order to get it within safe level range. That's what the Tumil-K is for. Even low normal can be risky, so this is why your vet recommended continuing the Tumil-K, and will re-evaluate next time you get a recheck.

If she is continuously week after 2 weeks of potassium supplementation, ask your vet about temp IV fluids instead, rule out renal insufficiency, and rule out arthritic conditions (you said your kitty is 18 years of age, this would be a primary condition to rule out, with x-rays)

[vince]

Hi Traci,
Thanks for your reply,are you saying that the potassium supplementation could end after 2 weeks?

If she were to be found to be arhritic is there anything that can be done?..she was jumping fine up till a few weeks ago and now shes not jumping at all-she tried jumping on the table last week and fell off-poor thing!

Ive gotta say,I feel really uncomfortable about her being on all these tablets -especially the thyroid ones.

It seems the tablets treat the symptoms-not the cause,I mean her thyroid is 141 because I guess something else is failing and its the bodys regulator-slowing this down means something else bottle necks?

Im really worried,
Rgds,
Vince

[Traci]

Not exaclty, the Tumil-K supplementation could continue for quite some time, usually in relation to kidney failure, which is why I suggested you discuss that potential or recheck with your vet to make sure it's ruled out.

Another concern is the diet. You didn't elaborate on what exactly the sources were, so there could yet be a deficiency in the diet which you need to discuss with your vet. You mentioned chicken, fish, cat food and a few bicuits, but I don't know what the biscuit ingredients are, nor do I know if you are home-cooking the fish and chicken or otherwise. Home-cooked food for pets are not sufficiently supplemented, your vet has to instruct you on a properly supplemented home-cooked diet if that is part of the treatment plan. If you are doing this diet on your own, then you need to discuss it with your vet so he can rule out a potential deficiency.

Short of surgical removal or radioiodine treatment, the thyroid meds will have to be given for life. If there is an underlying secondary health concern, your vet would be telling you that. If for some reason he is not explaining things to you or is not thorough with you about your kitty's condition, or has not utilized full diagnostics to rule out other concerns, then get a second opinion immediately.

X-rays can be helpful in diagnosing arthritis by looking at joint inflammation, or degenerative joint/bone disease. If arthritis, Cosequin could be discussed with your vet, but I'm not sure if it can be used with thyroid meds, he would have to verify that for you. However, you said your kitty was jumping normally a few weeks ago, so I would venture a guess that it is the low potassium level that is contributing to the weakness. Again, a recheck on full bloodwork would be preferrable, as well as thyroid level testing (every three months or sooner if signs and symptoms suggest the meds need to be adjusted).

[vince]

Hi Traci,
In terms of diet,the chicken and fish are home cooked-fish is given every other day,chicken the weekend.
The biscuits are "I ams" for older cats-a handful every day.
Its interesting you mention the diet-because when she had the liptosis 18mths ago-I searched on the internet for causes-and one cause was put at starvation-now I know for sure she has never been starved-but what if she was hyperthyroid at that time-and was not taking in enough calories hence setting up the Liptosis?

Since over the Liptosis-before she was on the thyroid medication,she was eating like a horse-now much more sparingly.

We feed her in the morning and at night,if we leave food for during the day-(1) We are not sure SHE eats it(..we have two other cats) and (2) Because we have a catflap other cats come in!

If the weakness in the back legs is related to the potassium levels then why hasnt she reverted to normal after a week of the potassium supplement?

If arthiritic why was there a dramatic change from one minute shes jumping fine(..in the cold weather)-2 weeks later zero.(..in the hot weather..)

It seems more like shes damaged her legs somehow..or a nerve?

Interestingly,the week before she was diagnosed as needing the potassium and the thyroid supplementation,we had to take her to the vets because she seemed poorly-it transpired she was running a temp.and the vet thought that maybe she had been involved in a fight.

So Im really confused,I dont want to make the wrong decision with her-next week assuming her counts are o.k.-she will have the thyroid removed by surgery.

[Traci]

Not knowing the severity of the hepatic lipidosis at the time, I hesitate to comment, but I can tell you that it could very well have been secondary to the undiagnosed hyperthyroidism at the time, especially if she was anorexic and if the diet was insufficient in protein or calories. There are other causes to hepatic lipodosis, mainly stress and prolonged anorexia, but following those would include drug induced, or congenital, or other liver problem. You do need to be prepared to monitor her liver function periodically, because the thyroid meds can actually cause hepatopathy, usually this will be noted or caught within the first three months of treatment, in which the meds may need to be adjusted or ceased altogether. Anorexia and jaundice would be your red flags that a liver condition may be resurfacing.

As for the diet, if you are referring to giving chicken and fish as whole meals that are unsupported with cat food during the week or weekends, then it's not a sufficient diet, and she could be suffering malabsorption or too high metabolism of vital nutrients. Talk to your vet about her individual nutritional requirements, he may suggest she needs more protein or a better source of it.

I was unaware she had access to the outdoors or could have been in a brawl with another cat outdoors, this puts a whole new light on the subject. You need to rule out possible trauma as a result of an outdoor outing (a fall, hit by car, attacked by other animal, look for puncture wounds, etc)...which could be affecting her rear limb abilities (i.e., trauma to the pelvis or rear limbs)

The potassium can take some time to work, expect more time with this, but do get a followup blood panel including thryroid levels to monitor her potassium, liver function, as well as thyroid levels. I'd also opt for an x-ray to check for pelvic injury, luxating patellars, osteosarcoma, or joint disease/inflammation, any of which can occur suddenly. This may yet be related to low potassium levels, but play it safe and rule out the above.