Hyper Kalemia Oct 13 2018 UGA CE

Selena Lane

Welcome to hell, little guy.
Welcome to hell, little guy.


Normally in AKI the K+ climbs.

High K+ widens all the ECG waves because repolarization with the calcium channels gets all fu_ked up. But it has to be pretty high to show changes in the EKG.

30% of dogs with Hyperkalemia are at risk for vtach, vpc’s and heart attack. Things get all tripped up because the heart isn’t relaxing / repolarizing – the impulses get shorter and shorter.

Hyperkalemia:  LMN weakness. Decreased reflexes.  (It’s all in the re polarization delays.)

Addressing the K+ elevations: Add Calcium (Calcium gluconate or Calcium Chloride) it doesn’t reduce K+ it corrects the RATIO of the two.

I.V. calcium only lasts a hour.   🙁

You can start dicking around with blood sugar (dextrose IV) and insulin shots. Uhhh. No. Albuterol or terbutaline, also a no from me. Dialysis machine. Continuous IV dextrose and insulin. For when the owner doesn’t see the writing on the wall and doesn’t mind a pet living with tubes and wires for days on end.

Sodium bicarb –  kind of a “no” from Dr Lane -> Side effects outweigh benefit.



Dr Erik Johnson is a Marietta, Georgia Veterinarian with a practice in small animal medicine. He graduated from University of Georgia with his Doctorate in 1991. Dr Johnson is the author of several texts on Koi and Pond Fish Health and Disease as well as numerous articles on dog and cat health topics.