Potassium Disorders in Pet Rabbits and Their Association with Glycemia, Azotemia, and Clinical Outcome

Potassium homeostasis is essential for maintaining membrane potential and normal neuromuscular function. Although potassium disturbances are clinically relevant in several species, their prevalence and prognostic significance in pet rabbits remain poorly characterized. This retrospective study evaluated plasma potassium concentrations at admission in 1773 venous samples from 1312 pet rabbits and assessed associations with mortality, glycemia, and renal markers (BUN and creatinine) using an i-Stat portable analyzer. Normokalemia (3.4-5.7 mmol/L) was observed in 78.1% of samples, while hypokalemia and hyperkalemia occurred in 13.9% and 8.0%, respectively. Overall, 7-day mortality was 21.3%, with most deaths (68.7%) occurring within 48 h. Both hypo- and hyperkalemia were associated with increased mortality, with hyperkalemia conferring the greatest risk (relative risk of up to 5.4 at 24 h; p < 0.0001). Potassium concentrations were higher in non-survivors at all time points. Hyperkalemia was also associated with hypoglycemia and azotemia (p < 0.0001), suggesting impaired renal potassium excretion and possible alterations in insulin-mediated cellular potassium uptake. No consistent association was observed between hyperglycemia and hyperkalemia. These findings indicate that plasma potassium disturbances are common in pet rabbits and are associated with short-term mortality and metabolic derangements. Early identification and correction of potassium imbalances and their causes may improve outcomes in critically ill rabbits.