Potassium? Lethargy, poor balance, trouble walking in CKD cat

[kitkat852]

16 y.o. cat, dx'd CKD 2016.
Last potassium number 3.8 (Canada reference 3.4-5.3) , increasing calcium 3.21 (ref. 2.2-3)
Sept., I switched renal food from canned Royal Canin Renal E to canned Purina NF. Then the trouble increased. Lethargy increased, balance worsened, so I thought maybe Purina had less potassium in it, so I switched back to Renal E. Contacted the manufacturers, only to discover that Purina has about twice the potassium in comparison to Renal E. So it probably wasn't the food.
I couldn't get a vet appointment, so I've been adding 1/3 dose of potassium to her food. NOW brands potassium. (full dosage is 1/5 tsp 2x day). She has had a slight improvement with walking but is still severely lethargic.

So, now I don't know what to do. I can go back and get electrolytes rechecked, but I suspect they will still be in the high 3's. Now I'm left with doing more tests (that I can't afford), or giving up and having her pts.

 

[FeebysOwner]

What else are you doing to treat her CKD? Does she get sub-Q fluids? How do her other numbers look (phosphorus, creatinine, BUN)? What about any heart issues? Is she eating and drinking OK? Is she on anti-nausea meds and appetite stimulants? More information is always better.

I presume you've researched information on Tanya's web site? Tanya's Comprehensive Guide to Feline Chronic Kidney Disease - Everything You Need to Know to Help Your Cat (felinecrf.org)

You are to be commended for getting her through 6 years with CKD! Even so, I wouldn't give up yet!

 

[kitkat852]

She gets fluids, b.p. meds (amlodipine, benazepril), b12, b complex, Clearlax. I've been syringe-feeding her since Oct. 2016. She used to eat a few treats, and dry kidney food, but she only eats a few Temptations these days. She's been off and on Cerenia, but I don't notice any difference on the days that she doesn't get it. Potassium was re-done in Sept. She's about 9 1/2 lbs, and losing weight and muscle mass.

 

[kitkat852]

eta, Potassium looks good here (Aug), but vet said she thought it was hemolyzed, based on how much of a struggle it was to get it. So I had it redone in Sept.

 

[FeebysOwner]

And so, did the Sept results show something different? In the results you shared, the potassium is well within range, and the calcium only slightly high.

Another anti-nausea med to try might be ondansetron. Some have better results with it than they do Cerenia. Didn't see anything about an appetite stimulant, which is usually given along with Cerenia or ondansetron.

In the meantime, give her baby food meat, if you can (Gerber Stage 2 or Beechnut). EZComplete can be added to any of them, other than the chicken, to make them complete for a cat. Alnutrin can be gotten for the chicken meats, but I am still working on that one myself.

 

[iPappy]

View attachment 432945
She gets fluids, b.p. meds (amlodipine, benazepril), b12, b complex, Clearlax. I've been syringe-feeding her since Oct. 2016. She used to eat a few treats, and dry kidney food, but she only eats a few Temptations these days. She's been off and on Cerenia, but I don't notice any difference on the days that she doesn't get it. Potassium was re-done in Sept. She's about 9 1/2 lbs, and losing weight and muscle mass.

Your dedication is fantastic!
I agree with having her heart checked. My vet told me once that the treatment for kidney problems can sometimes negatively affect the heart (and, the treatment for heart problems can sometimes negatively affect the kidneys, so it's a vicious cycle.) This doesn't mean your cat might be in heart failure, but she may need some medicine or some supplement to help support her cardiac health. Whatever it is, I hope it can be helped and again, your dedication is pretty awesome.

 

[kitkat852]

And so, did the Sept results show something different? In the results you shared, the potassium is well within range, and the calcium only slightly high.

Potassium was 3.8 in Sept., but she wasn't having trouble walking then. I'm trying to decide whether to stay on LR fluids or switch to Normosol.

Another anti-nausea med to try might be ondansetron. Some have better results with it than they do Cerenia. Didn't see anything about an appetite stimulant, which is usually given along with Cerenia or ondansetron.

I used cyproheptadine in 2016, and she ate for about 5 months, then quit. She's been syringe-fed ever since. The vet will only prescribe Cerenia here.

In the meantime, give her baby food meat, if you can (Gerber Stage 2 or Beechnut). EZComplete can be added to any of them, other than the chicken, to make them complete for a cat. Alnutrin can be gotten for the chicken meats, but I am still working on that one myself.

 

[kitkat852]

Your dedication is fantastic!
I agree with having her heart checked. My vet told me once that the treatment for kidney problems can sometimes negatively affect the heart (and, the treatment for heart problems can sometimes negatively affect the kidneys, so it's a vicious cycle.) This doesn't mean your cat might be in heart failure, but she may need some medicine or some supplement to help support her cardiac health. Whatever it is, I hope it can be helped and again, your dedication is pretty awesome.

The closest heart specialist is 200 miles away.

I don't know if I'm dedicated or nuts.

 

[iPappy]

The closest heart specialist is 200 miles away.

I don't know if I'm dedicated or nuts.

I didn't go the cardiologist route, my vet just noticed a murmur and we treated it.
You're not nuts. And if you are, so am I

 

[white shadow]

.
So, kitkat852 - I'm wondering if you've increased the potassium and what result you might have seen. [I'm just starting Rusty on a supp now...apparently positive results can be seen quickly]

I also wondered if you'd come across this list on the 'Tanya' site - that section has been quite helpful to me.
.

 

[Antonio65]

My Rainbow Bridge cat (photo in profile) had CKD since the age of 6, and ten years later she started showing weakness, lethargy, loss of muscle mass, difficulty at moving.
Her potassium went lower and lower, as low as 2.1 when the range was 3.8 to 5.4.
We had to give her supplements that corrected the issue in three days only.

The underlying problem, though, was an adrenal gland gone crazy, and the hormone it would produce was "eating up" all the potassium. We had to have that gland removed.