Feline vestibular disorders. Part II: diagnostic approach and differential diagnosis

Results of a neurological examination usually permit localisation of a vestibular disorder to either the central or peripheral parts of the vestibular system. Many different disorders located in the same part of the vestibular system will produce similar clinical signs. Therefore, additional diagnostic tests beyond a neurological examination are required in order to make an accurate diagnosis. The objectives of this review are to outline a diagnostic approach for disorders affecting the feline vestibular system, and to summarise the clinically important features of frequently diagnosed diseases affecting the vestibular system of cats.

Renal failure, laminitis, and colitis following severe rhabdomyolysis in a draft horse-cross with polysaccharide storage myopathy

A Thoroughbred-Percheron crossbred gelding developed a fulminant cascade of sequelae following a severe episode of rhabdomyolysis. Complications may occur with rhabdomyolysis of any etiology. In warmblood horses with Percheron bloodlines, rhabdomyolysis may be secondary to polysaccharide storage disease, and aggressive therapy should be undertaken promptly to avoid the complications.

Late-onset progressive spinocerebellar degeneration in Brittany Spaniel dogs

Eight Brittany Spaniel dogs, seven females and one male, between 7 and 14 years old presented with clinical neurological signs of spinocerebellar disease of about 6 months to 4 years duration. Clinically the dogs had a dramatic forward "saluting" movement of the thoracic limbs, hypermetria of the pelvic limbs, cerebellar ataxia and intention tremors. Terminally, dogs crawled in a crouched thoracic posture with neck extension. Lesions were confined to cerebellum, medulla oblongata and spinal cord. The most severe lesion was diffuse Purkinje cell loss with massive neurofilament accumulation in degenerating cells. There was some bilateral neuronal degeneration in the dorsal horns of the spinal cord and in the gracilis and cuneate nuclei. There was bilateral sporadic axonal degeneration in the dorsal columns and lateral and ventromedial areas of the spinal cord. The etiology of this syndrome was not determined.

Central nervous system disorders after renal transplantation in cats

OBJECTIVE

This study describes the incidence and severity of postoperative central nervous system (pCNS) disorders in feline renal transplant recipients.

STUDY DESIGN

A retrospective study based on the medical records of cats that received renal allografts from 1987 to 1996.

ANIMALS OR SAMPLE POPULATION

Fifty-seven client-owned cats received renal allografts for the treatment of renal failure.

METHODS

The frequency, duration, severity, and treatment of episodes of pCNS disorders were recorded from the medical records.

RESULTS

Twelve (21%) of 57 cats had pCNS disorders 1 hour to 5 days after the surgical procedure. Seven cats survived; four had single or multiple seizure episodes, and two had seizure episodes or disorientation followed by a period of coma. One cat became temporarily ataxic and blind after restraint for venipuncture. Five cats died; all had episodes of disorientation or seizures, or both, that progressed to a nonrecoverable comatose state, respiratory arrest or cardiac arrest, or both. There were no significant differences between the two groups in preoperative serum creatinine, blood urea nitrogen, or cholesterol levels, and intraoperative blood pressure measurements. There were no significant differences in the postoperative serum glucose levels, electrolytes levels, or osmolality between the two groups. The cats with pCNS disorders had a mean preoperative trough cyclosporine A (CyA) whole blood level of 429 ng/mL; cats without pCNS disorders had a significantly (P = .0116) higher mean preoperative trough CyA whole blood level of 736 ng/mL.

CONCLUSION

Central nervous system disorders are a common and often fatal complication of renal transplantation in cats.

CLINICAL RELEVANCE

Recognition of pCNS disorders, and possible causes, will help develop hypotheses to investigate the problem.

Magnetic resonance imaging and computed tomography characteristics of intracranial intra-arachnoid cysts in 6 dogs

Magnetic resonance imaging (MRI) and computed tomographic imaging (CT) characteristics of intracranial intra-arachnoid cysts in six dogs are described. Of the six dogs, three were less than one year of age and 4 were males. Five of the six dogs weighed less than 11 kg. Five cysts were located in the quadrigeminal cistern. On CT images, the intracranial intra-arachnoid cysts had sharply defined margins, contained fluid isodense to CSF and did not enhance following i.v. administration of contrast. On MRI images, the intracranial intra-arachnoid cysts were extra-axial, contained fluid isointense with CSF and did not enhance following i.v. contrast. While spinal arachnoid cysts of dogs have been reported in the literature, other than the six dogs contained in this report, intracranial intra-arachnoid cysts have not to our knowledge been described in animals. These six dogs have a similar age, sex, history, clinical signs, CT and MRI findings to those reported in people with intracranial intra-arachnoid cysts.

Sensory nerve conduction velocity of the caudal cutaneous sural and medial cutaneous antebrachial nerves of adult horses

Maximal conduction velocities of compound action potentials evoked by stimuli of 2 times threshold in the caudal cutaneous sural (CCSN) and medial cutaneous antebrachial (MCAN) nerves were determined by averaging potentials evoked and recorded through percutaneous needle electrodes. Mean maximal conduction velocities of compound action potentials were: CCSN = 61.3 +/- 2.0 meters/second (m/s) and MCAN = 56.4 +/- 2.8 m/s. To confirm accuracy of our percutaneous recordings, compound action potentials were recorded through bipolar chlorided silver electrodes from the exposed surfaces of fascicles of the CCSN and the MCAN. The maximal conduction velocities of these potentials were in agreement with the conduction velocities of compound action potentials that were evoked and recorded through percutaneous needle electrodes. The specificity of stimulating and recording sites was verified by recording before and after section of the nerves. Stimuli from 3 to 5 times threshold evoked a second, longer latency, compound action potential that consisted of a variable number of components in the CCSN and MCAN. The configurations and conduction velocities of the shorter latency potentials were the same as those of the single compound action potentials evoked by stimuli of 2 times threshold. Mean conduction velocities of the longer latency potentials were: CCSN = 24.4 +/- 2.6 m/s and MCAN = 24.5 +/- 2.2 m/s. Needle electrode and direct stimulation of either the CCSN or the MCAN at 3 to 5 times threshold failed to evoke contractions of limb muscles. Therefore, action potentials that contributed to the evoked compound potentials recorded in these horses arose, most likely, from afferent nerve fibers.

Comparison of computed tomography and radiography for detecting changes induced by malignant nasal neoplasia in dogs

The ability of computed tomography and radiography to detect changes associated with nasal neoplasia was compared in dogs. Eighteen areas or anatomic structures were evaluated in 21 dogs for changes indicative of neoplasia. Computed tomography was superior (P < or = 0.05) to radiography for detecting changes in 14 of 18 areas. Radiography was not superior for detecting changes in any structure or area. Computed tomography reveals vital information not always detected radiographically to assist in providing a prognosis and in planning treatment for nasal neoplasms in dogs.

Diagnosis of cauda equina abnormalities by using electromyography, discography, and epidurography in dogs

Electromyography (EMG), L7-S1 discography and epidurography were investigated in 15 dogs with clinical signs of cauda equina dysfunction and in 7 control dogs without such clinical signs. Electromyography of paraspinal and pelvic limb muscles was done in 13 of 15 affected dogs. An L7-S1 discogram followed by an epidurogram was performed in all 22 dogs using 20% iopamidol. Results of discograms, epidurograms, and gross necropsy examinations were normal in six of seven control dogs. The one dog in which these studies were abnormal had a mild L7-S1 disc protrusion that did not result in nerve root compression at necropsy. Electromyographic analysis was 100% accurate in predicting the presence or absence of cauda equina disease. None of the results of discograms were falsely negative. Twelve of 15 discograms in clinically affected dogs indicated dorsal disc protrusion, but 2 of these protrusions were found to be noncompressive at surgery (13% error). Abnormal epidurograms occurred in 9 of 15 clinically affected dogs. There was one false positive and two false negatives (20% error). Electromyography was a sensitive screening technique for the presence of cauda equina disease. Discography may be more sensitive for detection of L7-S1 disc protrusion than epidurography. An abnormal radiographic contrast study of the cauda equina may only be useful when combined with an abnormal EMG.

Intracranial meningioma with pulmonary metastasis in three dogs

Extracranial metastasis of primary central nervous system neoplasms is uncommon and has not been described in the dog. We report the clincopathologic features of intracranial meningioma with pulmonary metastasis in three dogs (case No. 1: 13-year-old castrated male Boxer dog; case No. 2: 14-year-old spayed female Dachshund; case No. 3: 6-year-old spayed female German Shepherd Dog). Case No. 1 presented with ataxia, lethargy, vomiting, and leaning and falling to the right, and had a transient remission following radiation and corticosteroid therapy; case No. 2 had a history of seizures that were unresponsive to primidone, left-sided postural reaction deficits, ataxia, and circling to the right; case No. 3 had only intermittent episodes of vomiting Computed tomography of case Nos. 1 and 2 revealed peripherally located homogeneous contrast-enhancing intracranial masses. Postmortem examination revealed intracranial masses with single or multiple pulmonary nodules in all three cases. Histologically, the intracranial and pulmonary masses were meningotheliomatous meningiomas with atypical features including brain infiltration, necrosis, nuclear atypia, prominent nucleoli, and moderate cell density. All of the primary meningiomas had low mitotic rates. The current interest in early diagnosis and aggressive clinical/surgical management of canine patients with meningioma and other primary central nervous system neoplasms will likely result in an increased detection of extracranial metastases.

Chronic cervical compressive myelopathy in horses: patterns of astrocytosis in the spinal cord

The distribution and morphology of fibrous astrocytes in the cervical spinal cord of normal horses and horses with chronic compressive myelopathy were demonstrated using immunohistochemical staining for glial fibrillary acidic protein. In the spinal cord from normal horses, astrocytes with stellate cell bodies and short processes were irregularly distributed in grey matter. In the white matter, their cell bodies were small and angular in areas adjacent to grey matter and larger and more stellate-shaped in the subpial area. Astrocyte processes were fine, and evenly distributed in a predominantly radial pattern in transverse sections of cord. Gliosis was marked in the spinal cords of horses with cervical compressive myelopathy. In the grey matter at the level of compression astrocytes were often enlarged and rounded, with short, blunt processes, but the gliosis was generally mild. In the white matter, gliosis was obvious in areas of nerve fibre swelling and degeneration at the level of compression and in areas of ascending and descending Wallerian degeneration. The fine radial pattern of astrocyte fibres was replaced by a dense, irregular arrangement. Gliosis persisted in the cords of chronically affected horses after active nerve fibre degeneration had subsided. The areas of gliosis coincided with the areas of Marchi staining for degenerating myelin and with areas of myelin loss in osmium tetroxide post-fixed tissue. Histological observations were consistent with astrocytes replacing areas of extracellular space that remained after nerve fibre degeneration. it is concluded that astrocytic gliosis is a prominent and persistent alteration of the spinal cord of horses with chronic cervical compressive myelopathy.

Muscle injury following experimental intraoperative irradiation

The paraaortic region of beagle dogs was irradiated to 15 to 55 Gy intraoperative irradiation, 10 to 47.5 Gy intraoperative irradiation following 50 Gy external beam irradiation in 25 fractions, or 50 to 80 Gy external beam irradiation in 30 fractions. Six MeV electrons were used for intraoperative irradiation, and external beam irradiation was done using photons from a 6 MV linear accelerator. The psoas muscle in the irradiation field was examined histomorphometrically 2 or 5 years after irradiation. The percentage of muscle fibers and capillaries decreased, whereas the percentage of connective tissue increased with increased dose for both intraoperative irradiation only and intraoperative irradiation plus external beam irradiation. The dose causing a 50% decrease in the percentage of muscle fibers was 21.2 Gy and 33.8 Gy at 2 and 5 years, respectively, after intraoperative irradiation alone, and 22.9 Gy and 25.2 Gy at 2 and 5 years, respectively, after intraoperative irradiation combined with 50 Gy external beam irradiation. The ED50 for severe vessel lesions was 19.2 Gy and 25.8 Gy at 2 and 5 years, respectively, after intraoperative irradiation alone and 16.0 Gy and 18.0 Gy at 2 and 5 years, respectively, after intraoperative irradiation combined with 50 Gy external beam irradiation. External beam irradiation alone caused a slight decrease in percentage of muscle fibers with increased dose, and vessel lesions were infrequent or mild. Radiation-induced muscle injury was characterized by loss of muscle fibers, decreased fiber size, severe vessel lesions, hemorrhage, inflammation, coagulation necrosis, and fibrosis. These histopathologic characteristics distinguish this muscle injury from that caused by neurogenic atrophy. These data indicate that radiation-induced muscle injury most likely was caused by injury of the supporting vasculature. The lesions produced were largely a function of the single intraoperative dose rather than the external beam fractionated doses. Furthermore, it appears that 20 to 25 Gy intraoperative irradiation combined with 50 Gy external beam irradiation may be near the maximum tolerated dose by sublumbar musculature and its supporting vasculature.

Trabecular bone remodeling and bone mineral density in the adult cat during chronic dietary acidification with ammonium chloride

Ammonium chloride (NH4Cl) is used as a urinary acidifier in the treatment and prevention of feline urologic syndrome. It is reported to cause alterations in calcium and bone metabolism in humans, dogs, and rats. Adult cats with normal renal function were fed 1.5% NH4Cl for 6 months to study the effects of chronic dietary acidification on trabecular bone remodeling of the iliac crest and bone mineral density (BMD) of lumbar vertebral trabecular bone and femoral cortex. Histomorphometric analyses of iliac crest biopsies were performed before and after treatment. Static and dynamic parameters of bone resorption and formation were determined. Single-energy quantitative computed tomography (SEQCT) was used to measure lumbar trabecular and femoral cortical BMD. There were no significant treatment effects in iliac crest trabecular bone remodeling or BMD of the vertebrae and femora. Bone remodeling activity decreased with time in both acidotic and control cats. Vertebral BMD increased with time in both groups of cats, whereas no change was seen in the femora. Thus, chronic dietary acidification for 6 months with therapeutic levels of NH4Cl produced no significant changes in trabecular bone remodeling or bone mineral density in adult cats.

Multilobular osteochondrosarcoma of the canine skull: 16 cases (1978-1988)

The medical records of 12 dogs with multilobular osteochondrosarcoma (MLO) and examined at the Veterinary Teaching Hospital, Colorado State University from August 1979 to January 1987 were reviewed. Medical records of 1 dog with MLO and 3 dogs with MLO examined at the Ontario Veterinary College, University of Guelph and the Veterinary Medical Teaching Hospital, University of California, Davis, respectively, were also reviewed and included in the study. The mean age of affected dogs was 7.5 years, a single breed did not appear to be overrepresented, and males were affected as frequently as were females. All of the primary lesions affected either the mandible, maxilla, or cranium. Excision was the only treatment in 11 dogs, 2 dogs had radiotherapy in addition to excision, and 1 dog had radiotherapy and chemotherapy after excision. Twelve treated dogs had follow-up information available. Of the 12 treated dogs, 7 (58%) had local recurrence, with median time to recurrence of 14 months. Seven dogs (58%) developed metastatic disease after treatment, with median time to metastasis of 14 months. The median disease-free interval was 12 months, and the median survival time was 21 months. Excision with histologically complete surgical margins appeared to offer good opportunity for long-term tumor control. The role of adjuvant chemotherapy and radiotherapy in the management of MLO remains unclear.

Clinical management of epilepsy of dogs and cats

A logical approach to the clinical management of a dog or cat with a history of seizures caused by epilepsy is presented. The definition of epilepsy, the classification of epileptic seizures, and the causes of seizures are discussed. A diagnostic approach to dogs and cats with seizure disorders is outlined. Anticonvulsant therapy for epilepsy is discussed, including the objectives of therapy, decision to start therapy, selection of an anticonvulsant drug, monitoring anticonvulsant therapy, and anticonvulsant drug failure.

Bone necrosis and tumor induction following experimental intraoperative irradiation

The bone of the lumbar vertebrae of 153 dogs was examined 2 and 5 years after intraoperative irradiation (IORT), fractionated external beam irradiation (EBRT), or the combination. Groups of dogs received 15 to 55 Gy IORT only, 10 to 47.5 Gy IORT combined with 50 Gy EBRT in 2 Gy fractions or 60 to 80 Gy EBRT in 30 fractions. Six MeV electrons were used for IORT, and EBRT was done using photons from a 6 MV linear accelerator. The paraaortic region was irradiated and the ventral part of the lumbar vertebrae was in the 90% isodose level. Two years after irradiation, the dose causing significant bone necrosis as determined by at least 50% empty lacunae in the vertebral cortex was 38.2 Gy IORT alone and 32.5 Gy IORT combined with EBRT. Five years after irradiation, the dose causing 50% empty lacunae was 28.5 Gy IORT only and 14.4 Gy IORT combined with EBRT. The ED50 for lesions of the ventral vertebral artery was 21.7 Gy IORT only and 20.1 Gy IORT combined with 50 Gy EBRT 2 years after irradiation and 27.0 Gy IORT only and 20.0 Gy IORT combined with 50 Gy EBRT 5 years after irradiation. All lesions after EBRT only were mild. Eight dogs developed osteosarcomas 4 to 5 years after irradiation, one at 47.5 Gy IORT only and the remainder at 25.0 Gy IORT and above combined with 50 Gy EBRT. In conclusion, the extent of empty lacunae, indicating bone necrosis, was more severe 5 years after irradiation than after 2 years. The effect of 50 Gy EBRT in 2 Gy fractions was equivalent to about 6 Gy IORT 2 years after irradiation and to about 14 Gy 5 years after irradiation. Based on these estimates, IORT doses of 10 to 15 Gy have an effect 5 times or greater than the amount given in 2 Gy fractions. Osteosarcomas occurred in 21% of dogs which received doses greater than 25 Gy IORT. Doses of 15 to 20 Gy IORT in combination with 50 Gy EBRT in 2 Gy fractions may be near the tolerance level for late developing bone injury.

Peripheral neuropathies following experimental intraoperative radiation therapy (IORT)

Injury to peripheral nerves in the lumbar para-aortic region was evaluated in beagle dogs 2 years following fractionated irradiation (EBRT), intraoperative irradiation (IORT), or a combination of IORT and EBRT. Time to onset of peripheral neuropathy was determined by means of serially completed neurological and electrophysiological examinations. Peripheral neuropathies were seen beginning as early as 6 months following 35 Gy (or greater) IORT only and 35 Gy plus 50 Gy EBRT. The incidence of peripheral neuropathies increased with increasing IORT doses beginning at 15 Gy. Onsets of peripheral neuropathies following IORT alone were clustered between 6 and 18 months, with onset in some dogs occurring as late as 24 months. The combination of IORT and EBRT resulted in an incidence and latency to onset of neuropathies similar to that seen with IORT alone. Neuropathies were not seen with EBRT alone at doses from 50 Gy to 80 Gy. Recovery of nerve function did not occur in affected dogs. Histological studies of nerves 2 years following irradiation demonstrated loss of axons and myelin, with a corresponding increase in endoneurial, perineurial, and epineurial connective tissue. Percentage of axon and myelin decreased to about 60% of normal at 15 Gy IORT, and additionally at higher doses. An insignificant decrease in percentage of axon and myelin was seen following EBRT alone. A significant lesion occurring in and around nerves at most IORT doses was necrosis and hyalinization of the media of small arteries and arterioles. The dose for a 50% probability for causing severe vessel lesions in the 2-year study was 19.5 Gy IORT only and 18.7 Gy when IORT was combined with EBRT. These lesions were not seen with any EBRT only dose. These studies suggest that peripheral nerve is a dose limiting normal tissue in IORT. Neuropathies appear to result from direct effects of irradiation on nerve and secondary effects to nerve resulting from damage to regional vasculature.

Central nervous system toxicosis associated with metronidazole treatment of dogs: five cases (1984-1987)

Metronidazole, administered to 5 dogs for periods ranging from 3 to 14 days, was associated with acute development of CNS dysfunction. Metronidazole dosage ranged from 67.3 to 129.0 mg/kg of body weight/d. Clinical signs of toxicosis began with anorexia and intermittent vomiting and progressed rapidly to include pronounced, generalized ataxia and vertical, positional nystagmus. These signs were consistent with lesions of the vestibular nuclei and/or cerebellum. High CSF protein content was detected in 2 of 3 dogs from which CSF was collected. Two dogs were euthanatized because of severe neurologic dysfunction. Three dogs improved slowly and recovered completely over several months. These findings suggest that currently recommended dosages of metronidazole may be too high for some dogs.

Hypokalemia in cats: 186 cases (1984-1987)

Retrospective review of serum biochemical data obtained from 501 cats over a 3-year period (1984-1987) indicated that 186 (37%) had hypokalemia (serum potassium concentration less than 4.1 mEq/L). After adjusting for disease diagnosis, cats fed either of 2 commercial diets were 4 times more likely to be hypokalemic than cats fed other diets. Odds ratios (OR; measure of association), adjusted for diet type, were calculated to determine the odds of hypokalemia for a given disease, compared with odds of normokalemia for the same disease. Chronic renal failure (OR = 14.4), hepatic disease (OR = 5.7), systemic infectious diseases (viral or bacterial; OR = 2.7), and neuromuscular or CNS disease (OR = 2.4) were all significantly associated (P less than 0.05) with the occurrence of hypokalemia. Significant differences in age or sex between hypokalemic and normokalemic cats were not found. Within the group of 186 hypokalemic cats, hypercholesterolemia (89 cats; 48%), hyperglycemia (88 cats; 47%), high serum urea nitrogen concentration (86 cats; 46%), hyperchloridemia (80 cats; 43%), and high serum creatinine concentration (73 cats; 39%) were the most common biochemical abnormalities. When disease diagnosis was compared among cats with severe hypokalemia (serum potassium concentration less than 3.0 mEq/L) and those with moderate hypokalemia, cats with severe hypokalemia were 3.5 times more likely to have chronic renal failure than cats with less severe hypokalemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Intraspinal epidermoid cyst in a dog

A 2-year-old female Rottweiler was examined because of progressive gait deficits consistent with transverse myelopathy between the T2 and L3 spinal cord segments. Myelography confirmed an intramedullary spinal cord lesion between T13 and L1, so the dog was euthanatized. At necropsy, an intramedullary epidermoid cyst was confirmed in the T13 and L1 spinal cord segments. The epidermoid cyst probably resulted from a congenital cause.

Central nervous system infection associated with anaerobic bacteria in two dogs and two cats

Central nervous system (CNS) infection caused by anaerobic bacteria (including Bacteroides, Fusobacterium, Peptostreptococcus, and Eubacterium) was diagnosed in two dogs and two cats. In one dog there was extensive meningomyeloencephalitis, presumably the result of hematogenous spread of bacteria from lung abscesses and bacterial endocarditis. Subdural empyema of unknown origin was found in a second dog and two cats. Clinical signs in all four animals included mental depression and focal neurologic deficits, without fever.

Neurotoxicity of amphotericin B methyl ester in dogs

Clinical and neuropathologic effects of chronically administered intravenous (iv) amphotericin B methyl ester (AME) were observed in 3 male dogs (2 German shorthaired pointers and 1 pit bull). Each dog received 6.2-7.3 g of AME (299-327 mg/kg body weight) over a period of 11-12 weeks. One dog developed neurologic signs of severe diffuse brain dysfunction and at necropsy all 3 dogs had a marked leukoencephalopathy, most severe in centrum ovale and subcortical white matter of frontal lobes. Brain histopathology included diffuse myelin loss, oligodendrocyte depletion, accumulation of macrophages filled with sudanophilic lipid, fibrillary astrogliosis, and swelling or fragmentation of many axons. Two control dogs administered iv glucose showed no neuropathologic abnormalities. These findings closely resemble the clinical and neuropathologic abnormalities that developed in patients during the first human trial of AME for treatment of fungal infections, but differ from those of animal studies that did not closely simulate the long-term drug administration required for antifungal therapy in humans. It was concluded that before human clinical trial is authorized, experimental protocols for animal studies of drug toxicity should reflect the anticipated human use of the drug, both in dose and duration.

Potassium depletion in cats: hypokalemic polymyopathy

Generalized weakness of acute onset, apparent muscular pain, and persistent ventroflexion of the neck were observed in 6 cats. These clinical signs were associated with a low serum potassium concentration and high serum creatine kinase activity. Generalized electromyographic abnormalities, together with normal motor nerve conduction velocity determinations, were detected in all cats. Muscle biopsy specimens from 4 of 5 cats were not abnormal on light microscopic examination. Mild necrosis and infrequent macrophages were evident in a muscle biopsy specimen from one cat. Signs of polymyopathy resolved in all cats, and creatine kinase activities returned to the normal range after parenteral and oral administration of potassium. Polymyopathy and hypokalemia recurred in 3 cats in which dietary potassium supplementation was not maintained after initial recovery from hypokalemic polymyopathy.

Potassium depletion in cats: renal and dietary influences

Excessive urinary potassium loss was diagnosed in 7 cats with persistent hypokalemia and high serum creatinine concentrations. Renal tubular acidosis (proximal or distal) was not evident in the affected cats. Plasma aldosterone concentrations and plasma renin activities in affected cats were not significantly different from control values. Potassium depletion and hypokalemia were attributed to the combined effects of decreased dietary potassium intake and excessive urinary potassium losses. It was concluded that increased urinary potassium excretion may represent a basic response to renal dysfunction in cats. Data suggested that dietary potassium supplementation improved renal function in most cats in this study.