Veterinary Anesthesia & Analgesia Support Group
Practical Information for the Compassionate Veterinary Practitioner
line decor
HOME   
line decor
  Hyperkalemia Management Basics
  Bob Stein
  December, 2004
 
 

1)     RECOMMENDATIONS

a)      General Information

i)        Serum potassium levels are most likely to create electrocardiographic changes when levels reach or exceed 8 mml/L

(1)   Consequences include ventricular fibrillation and atrial standstill

b)      Corrective options

i)        Calcium gluconate or calcium chloride - 10% solution

(1)   Calcium Gluconate - 0.5 to 1.0 ml/kg slowly IV

(2)   Calcium Chloride – 0.5 ml/kg slowly IV

(3)   Duration of effect ~ 20 to 30 minutes

(4)   Does not lower serum potassium but helps normalize cell membrane potentials

ii)       Dextrose-insulin infusion

(1)   0.25 to 1.0 U/kg regular insulin with 2 grams of dextrose per unit of insulin

(a)    Use the low end of the insulin dose range for cats

(2)   Decreases serum potassium within 5 minutes

(3)   Duration of effect ~ 20 to 45 minutes

iii)     Sodium bicarbonate

(1)   0.5 to 2 mEq/kg IV

(2)   Ideally, bicarbonate administration should be based upon patient blood gas analysis

(a)    When unavailable, bicarbonate may be given if patient is unlikely to have pre-existing metabolic alkilosis

iv)     Follow all treatment sequences with a fluid diuresis

(1)   0.9% saline may be the best initial choice

(2)   Balanced electrolyte solutions are also an adequate option

 
 
 
 
 
 
 
 
 
 
 
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
     
     
     
     
     
    Page References:
     
     
    Return to top of page
     
     
    Questions or problems regarding this web site should be directed to DRSTEIN@VASG.ORG .
Copyright © 2003 ASAH. All rights reserved.
Last modified: April 6, 2011 .