Successful Management of a Rare Incidence of Potassium Chloride Extravasation in a Dog Receiving Intermittent Hemodialysis

Abstract

Aims: To ensure the safe administration of intravenous potassium chloride in patients with hypokalemia, emphasizing the prompt identification and management of extravasation to prevent serious complications. Presentation of Case: A 08 year-old male Labrador Retriever was presented with a 4-day history of anorexia, lethargy, severe vomiting, abdominal pain, weight loss, polyuria, polydipsia, and melena. Based on clinical findings and diagnostic evaluations, the dog was diagnosed acute kidney injury (AKI) and managed using intermittent hemodialysis (IHD). Following the first session of hemodialysis, the patient developed hypokalemia, and a constant rate infusion (CRI) of potassium chloride (Kcl) was initiated to correct the electrolyte imbalance. However, due to dislodgement of the intravenous cannula, a portion of the potassium chloride was                     inadvertently administered subcutaneously. This led to extensive swelling of the left                                                      hind-limb, indicative of extravasation. To manage the localized tissue reaction and minimize further damage, diluted lignocaine in normal saline was administered subcutaneously over the affected area. Discussion: Extravasation of potassium chloride is a serious complication that can result in localized tissue necrosis and significant damage to surrounding structures. In this case, inadequate monitoring of the intravenous site led to the accidental subcutaneous administration of potassium chloride, causing soft tissue swelling and a risk of necrosis. Conclusion: This incident underscores the critical importance of vigilant observation during intravenous infusions, especially when administering irritant solutions like potassium chloride. To prevent such occurrences, it is essential to implement strict monitoring protocols and ensure that all clinical staff is adequately trained in the safe handling and administration of intravenous medications.