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.
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