Hypokalemia with no known causes

[Melcat4!!]

I will try to be as brief as possible with this long journey we have been on with my young precious kitty, Quinny.
Time table of events…
-Got him as a kitten (August 2022)
-At only 6 months he developed eye inflammation and high pressures. Ran a bunch of tests to determine a cause. None found.
-Was on prescription eye drops for 1 year, started to worsen
-Unfortunately, he was in so much pain his eyes had to be removed (January 2024)
- He spent one day at the vet eye surgeon, and then one afternoon in ER for bleeding around the eye socket.
He recovered well from surgery.
Here’s where the REAL problems began (at only a year and a half old…
A few days after the surgery we noticed Quinn slowly got lethargic, with a severe head drooping. We got him to the ER just in time, as he was suffering from Hypokalemia. Stayed in the ER for 5 days to get his potassium levels back up. Took him home continuing with RenaKare tablets. Cause of hypokalemia - UNKNOWN
There was one study done where they found a cat who has been on the same eye drops as Quinny, who developed Hypokalemia, but the cat wasn’t followed up with., and we got no answers.
My vet AND Internal medicine specialists are at a loss for the cause!!
**Please note: Quinny has undergone I think every test possible. Kidneys in normal range, had the Aldosterone test done and negative, ultrasounds negative. Blood pressure is fine. Thyroid test normal. Kidney function within normal range.
He has had to be on 5 tablets of RenaKare, just to get him in normal potassium range.
Today (Nov. 2024) his potassium has dipped below normal again, for an unknown reason. I am getting so scared!
We are upping the RenaKare to 6 tabs a day, and going to try to transition to renal canned diet ( just to see if by some chance the kidneys ARE involved - even though it doesn’t appear they are. I cannot get in to a kidney specialist for a few months!
They don’t know where else to send me (Internal medicine has no answers)
Are there ANY vets or specialists or anyone out there that have seen or heard of this happening?? PLEASE help, my kitty’s life depends on it
With extreme sadness, Melanie A

 

[FeebysOwner]

Hi and welcome to TCS, despite what brought you here. I am so sorry about what is going on with Quinn.

I don't know if you are located in the US, but your specialists should be contacting vet universities across the country looking for additional guidance/knowledge about Quinny's condition, as well as if there may be any correlation between it and the drops your little guy was given. I do know that hypokalemia can be genetic.

I don't know what drops he was given, but that might be helpful for other members who may have used them and could discuss if they had any similar issues. It would also enable us to do a search on this site for previous posts about the med.

 

[silent meowlook]

I’m sorry your cat is having so many problems. Is your cat a specific breed? The article below may be of some help.
How low has the serum potassium been?

Evaluation and Management of the Hypokalemic Patient

Patients with severe hypokalemia suffer from generalized muscle weakness; in cats, cervical ventroflexion may be noted.

todaysveterinarypractice.com

 

[Antonio65]

I was going to suggest you an aldosterone test, but saw you already had it done.
The cat in my avatar had a severe hypokalemia and the vets (I saw over a dozen of them in two months) could not find the answer until one vet thought about hyperaldosteronism, which was the correct answer.

Do your vets think that those eye drops might have anything to do with it? You mentioned a previous case with no follow up. Do your vets think it is possible or it may just be a coincidence?

 

[FriendofFerals]

I've got nothing intelligent to suggest. This is way beyond anything I've ever experienced but OMG hugs and welcome to the forum and I sincerely hope someone here can help!