title: Severe life-threatening hypokalemia in a cat with suspected distal renal tubular acidosis.
abstract: OBJECTIVE
  Description of the clinical presentation and management of a critically ill cat with profound hypokalemia associated with a suspicion of distal renal tubular acidosis (DRTA) and secondary hyperaldosteronism.
  
  
  METHODS
  A cat was presented with severe generalized weakness and acute ventilatory failure associated with severe hypokalemia. The acid-base analysis and complete analytical profile of the urine confirmed the presence of a normal anion-gap metabolic acidosis with a urine pH of 7, a disorder consistent with DRTA. The high plasma renin activity, high aldosterone concentration, and low normal plasma aldosterone concentration/plasma renin activity ratio suggested secondary hyperaldosteronism. The management of the patient in the ICU was successful. No identifiable cause could be determined as a cause for the DRTA, so the disorder was assumed to be the primary problem.
  
  
  CONCLUSIONS
  DRTA is a rare disorder occasionally reported in the veterinary literature; it is especially rare in cats. Complete diagnostic evaluation was necessary to identify the reported disorders as the cause of the clinical presentation. To the author's knowledge, this is the first case reporting DRTA, and a simultaneously documented mineralocorticoid response, as a cause of a life-threatening hypokalemia.
authors.affiliation: Emergency and Critical Care Service HCV-UPA, Veterinary Teaching Hospital, Veterinary Faculty UAB, Autonomous University of Barcelona, Barcelona, Spain. carlos.torrente@uab.es
authors.forename: Carlos
authors.initials: C
authors.lastname: Torrente
authors.forename: Paolo
authors.initials: P
authors.lastname: Silvestrini
authors.forename: Rafael
authors.initials: R
authors.lastname: Ruiz de Gopegui
mesh_terms: D000141:Acidosis, Renal Tubular / Q000150:complications / Q000662:veterinary*; D000818:Animals; D002371:Cat Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D002415:Cats; D005260:Female; D006929:Hyperaldosteronism / Q000150:complications / Q000662:veterinary; D007008:Hypokalemia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy / Q000662:veterinary*; D007552:Isotonic Solutions / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D007552:Isotonic Solutions