Disorders of Potassium

DiBartola, Stephen P.; Morais, Helio Autrán de

doi:10.1016/b978-1-4377-0654-3.00012-3

Cited by 50 publications

(9 citation statements)

References 143 publications

(111 reference statements)

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“…In particular, acidosis reduces while alkalosis increases the binding of calcium to albumin, causing consequently increased or decreased levels of ionised calcium, respectively. An alkaline environment lowers ionised calcium levels by exchanging calcium for hydrogen ions 44 . Whether the spontaneous resolution of hypercalcaemia in this case is attributed to the metabolic alkalosis remained unclear.…”

Section: Discussionmentioning

confidence: 80%

“…Unregulated mineralocorticoid activity promotes excess sodium retention, potassium excretion and hydrogen ion excretion due to increased activity and number of transmembrane ion pumps in the distal nephron. Tubular fluid electronegativity from avid sodium retention and high distal tubular flow rates from polyuria further promote urinary potassium and hydrogen ion loss, augmenting hypokalaemia and metabolic alkalosis 44 . Sodium and water retention leads to hypertension, although mineralocorticoid‐independent mechanisms also contribute to the pathogenesis of hypertension.…”

Section: Discussionmentioning

confidence: 99%

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A variant of multiple endocrine neoplasia type 1 in a dog?

Borgonovi

Scudder²

2022

Vet Record Case Reports

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A 9-year-old male neutered Cockerpoo dog was presented with pyrexia and was diagnosed with sterile idiopathic panniculitis. During initial investigations, advanced imaging revealed a suspected left-sided cervical paraganglioma and bilateral adrenal masses. The dog underwent immunosuppression and achieved remission of the sterile idiopathic panniculitis. Bilateral adrenalectomy and paraganglioma excision were then performed. Histopathology identified bilateral adrenocortical carcinoma and cervical neuroendocrine carcinoma. Three months later, the dog was diagnosed with primary hyperparathyroidism. Despite left total thyroidectomy and parathyroidectomy, mild hypercalcaemia persisted for several months. Eight months later the dog became persistently hypokalaemic refractory to potassium supplementation, with metabolic alkalosis and systemic hypertension. The dog was euthanised 5 months later due to clinical deterioration. On postmortem examination, right parathyroid hyperplasia and metastatic neuroendocrine carcinoma involving liver, jejunum, pancreas and tracheobronchial lymph node were identified. This is the first report describing the concurrent presence of these types of endocrine neoplasms in a dog.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

A variant of multiple endocrine neoplasia type 1 in a dog?

Borgonovi

Scudder²

2022

Vet Record Case Reports

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“…Furthermore, hyperkalemia itself increases potassium excretion 14, 19. In veterinary medicine, it has been postulated that an animal with HA may be able to maintain potassium balance if the sodium intake is sufficient to maintain extracellular fluid volume and distal tubular flow rate 21. We have no detailed information about the feeding habits of these dogs.…”

Section: Discussionmentioning

confidence: 95%

Evaluation of Aldosterone Concentrations in Dogs with Hypoadrenocorticism

Baumstark

Sieber-Ruckstuhl

Müller

et al. 2013

Veterinary Internal Medicne

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BackgroundSome dogs with primary hypoadrenocorticism (HA) have normal sodium and potassium concentrations, a phenomenon called atypical Addison's disease. The assumption that the zona glomerulosa and aldosterone secretion in these dogs are normal seems widely accepted; however, aldosterone measurements are missing in most published cases.ObjectivesTo measure aldosterone in dogs with HA with and without electrolyte abnormalities and to determine the time point of aldosterone peak concentrations during ACTH stimulation.AnimalsSeventy dogs with HA, 22 dogs with diseases mimicking HA, and 19 healthy dogs.MethodsProspective study. Blood samples were taken before and 60 minutes after injection of 250 μg ACTH in all dogs. Additional blood samples were taken 15, 30, and 45 minutes after ACTH in 7 dogs with HA and in 22 with diseases mimicking HA.ResultsBaseline and ACTH‐stimulated aldosterone was significantly lower in dogs with HA than in the other groups. Aldosterone was low or undetectable in 67/70 dogs with HA independently of sodium and potassium levels. In 3 dogs, sodium/potassium concentrations were normal; in 1 dog, sodium was normal and potassium decreased. In all 4, ACTH‐stimulated aldosterone concentrations were below the detection limit of the assay. Aldosterone concentrations were not different at 30, 45, or 60 minutes after ACTH administration.Conclusion and Clinical ImportanceCortisol and aldosterone secretion is compromised in dogs with HA with and without electrolyte abnormalities. The term atypical Addison's disease, used for dogs with primary HA and normal electrolytes, must be reconsidered; other mechanisms allowing normal electrolyte balance without aldosterone should be evaluated in these dogs.

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“…Administration of exogenous insulin stimulates the sodium–potassium ATPase pumps on cell surfaces, promoting the net movement of extracellular potassium into the cells. 5 The administration of dextrose without exogenous insulin is thought to stimulate the release of endogenous insulin from the beta islet cells of the pancreas, causing the same upregulation of the sodium–potassium ATPase pumps. 5 …”

Section: Discussionmentioning

confidence: 99%

“… 5 The administration of dextrose without exogenous insulin is thought to stimulate the release of endogenous insulin from the beta islet cells of the pancreas, causing the same upregulation of the sodium–potassium ATPase pumps. 5 …”

Section: Discussionmentioning

confidence: 99%

Treatment strategies for hyperkalemia secondary to urethral obstruction in 50 male cats: 2002–2017

Jones

Creedon

Epstein

2022

Journal of Feline Medicine and Surgery

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Objectives The aims of this study were: to describe the potassium-lowering treatment strategies used to manage moderate-to-severe hyperkalemia in male cats with urethral obstruction (UO); to determine how much dextrose was required per unit of insulin to prevent hypoglycemia; to determine whether early initiation of a dextrose continuous rate infusion (CRI) prevented hypoglycemia; and to determine whether in-hospital mortality was associated with presenting plasma potassium concentration ([K+]). Methods The medical records of male cats presenting with a [K+] ⩾7.0 mEq/l due to UO that had another [K+] measured within 6 h were reviewed retrospectively. All [K+] values within the first 6 h, blood glucose concentrations, treatments for hyperkalemia and survival to discharge were recorded. Analyses were performed to test for associations between dextrose:insulin ratios or method of dextrose administration and the development of hypoglycemia; and for presenting [K+] and mortality. Normally distributed groups of continuous data were compared with a t-test and categorical data were compared with a Fisher’s exact test. Results Fifty cats were included. Mean presenting [K+] was 8.9 ± 1.0 mEq/l, while the mean final [K+] within 6 h was 6.6 ± 1.4 mEq/l. Forty-two (84%) cats were treated with intravenous fluids and 40 (80%) were treated with dextrose and insulin. Median dextrose:insulin ratio was 2 g/u (range 0.4–100). No dextrose:insulin ratio was found to protect against hypoglycemia, and 3/8 cats that became hypoglycemic had received ⩾2 g dextrose per unit of insulin. There was no association between the early initiation of a dextrose-containing CRI and avoidance of hypoglycemia. No association was found between presenting [K+] and mortality. Conclusions and relevance While no specific dextrose:insulin ratio was found to protect against hypoglycemia, there is evidence that the commonly recommended dextrose:insulin ratio of 2 g/u may be inadequate in preventing hypoglycemia in every cat. Severity of hyperkalemia was not associated with mortality.

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Disorders of Potassium

Cited by 50 publications

References 143 publications

A variant of multiple endocrine neoplasia type 1 in a dog?

A variant of multiple endocrine neoplasia type 1 in a dog?

Evaluation of Aldosterone Concentrations in Dogs with Hypoadrenocorticism

Treatment strategies for hyperkalemia secondary to urethral obstruction in 50 male cats: 2002–2017

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