The two main causes of hyperkalemia include failure of the kidneys to remove potassium (which gets excreted in the urine) and abnormal potassium release from cells. Horses with a history of hyperkalemic periodic paralysis (HYPP, a genetic muscle disorder of Quarter Horses), compromised kidney function, or massive cellular damage (due to injury or disease) are at greater risk of developing hyperkalemia, said Fielding.

 

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