ABOUT THE DIAGNOSIS
Feline asthma is a respiratory disease that can affect cats of any age. It is also known as feline allergic bronchitis, feline allergic lung disease, and feline lower airway disease. Cats with this disease have coughing (sometimes mistaken for “hairballs”) or even episodes of labored breathing (dyspnea) and wheezing. Some cats exhibit open-mouth breathing (pant like a dog), which is abnormal in all cats except under situations of anxiety such as traveling. Cats with asthma have trouble breathing because the tiny airways (bronchioles) in the lungs become obstructed or narrowed. This constriction decreases the amount of air that is allowed to enter and leave the lungs. Over time, these airways can suffer permanent damage and remain constricted. This can be a serious, life-threatening disease for some cats.
Feline asthma can be aggravated by environmental pollutants (allergens) such as cigarette or cigar smoke, dust from cat litter, carpet, household cleaners, and seasonal airborne allergies such as grasses. Stressful events can also trigger these episodes in some cats. The veterinarian may perform tests to look for other causes of respiratory problems. For example, cats can get heartworms, especially in warmer climates. The outward symptoms (clinical signs) of feline heartworm disease can mimic asthma. To test for feline heartworms, a small blood sample is taken.
Other possible impostors for asthma are parasites that can live in the lungs. These can be diagnosed by performing one or more fecal (stool) examinations. Parasites and other organisms such as bacteria and viruses can sometimes be found in the lungs by performing an airway wash (lavage). This can be done while using a special camera (bronchoscope) to visually examine the inside of the airways, or it can be done alone. For these procedures, the cat is anesthetized and a small tube is gently inserted into the windpipe (trachea). A small amount of sterile fluid is injected and removed. The fluid is then examined under the microscope and tested for various organisms.
LIVING WITH THE DIAGNOSIS
As with asthma in many humans, the cause (trigger) for asthma in cats may or may not ever be determined. Medication is available that can help to reduce the frequency and severity of coughing and wheezing. However, once the cat begins to take medication, the symptoms may improve greatly, but it can then be difficult to determine the cause of asthma because the medication masks the symptoms. Therefore, an important component of helping cats that have asthma is to seek out, and eliminate, the most likely triggers.
These include the following:
- Avoid exposing the cat to cigarette and/or cigar smoke.
- Change furnace filters regularly.
- Control molds, mildew, and dust.
- Do not use perfumes, hair sprays, or air fresheners.
- Consider using an air filtration system, ideally a HEPA-type system.
- Use hypoallergenic household cleaning agents.
- Use shredded paper or even sand instead of cat litter, provided the cat is willing to use the litter box normally with this new litter type.
Any cat that has a severe breathing problem should be taken to a veterinarian or to the local emergency clinic immediately. With severe symptoms, the cat is likely sensitive to surrounding stress, and an effort should be made to have the trip be as calm as possible under the circumstances to avoid life-threatening respiratory difficulty. Avoid lifting and moving the cat as much as possible, which can be stressful for the cat and can aggravate the breathing problem. The veterinary staff will place the cat in a calm, quiet environment. Oxygen may be given to help the cat to breathe more comfortably. Injectable medication may be given to reduce inflammation and dilate the network of airways (bronchioles) in the lungs. If this is the first time that the cat has had this type of problem and feline asthma has never been diagnosed, or if some features of the examination are inconsistent with asthma (such as unusual heart or lung sounds heard with the stethoscope), the veterinarian may take x-rays of the cat’s chest and perform other tests when the cat is calm. This is because labored breathing in cats may be caused by many different diseases, including those mentioned above, as well as heart diseases, certain types of tumors, fluid accumulation in the chest cavity, and many other types of serious and less serious disorders.
Ideally, treatment involves determining what is triggering the asthma (called the allergen) and removing it from the cat’s environment (see Living with the Diagnosis). If the cause cannot be determined, medication is usually necessary to help improve the cat’s quality of life. Asthma is not cured, but signs can be controlled in most cats.
For cats with frequent, severe respiratory distress, meticulously trying to identify and eliminate the triggering allergen becomes secondary to immediate symptom control. For these cats, therefore, medications are required to prevent (ideally) or at least reduce the severity of the episodes and to keep the cat as comfortable as possible. Corticosteroids, which are cortisone-like medications, can help by decreasing inflammation in the airways. Medication can also be given to further open the small airways in the lungs (bronchodilators).
Some cats may need to take both types of medication to feel better. Both corticosteroids and bronchodilator drugs can be given by mouth or through inhalation. Inhalers are used once or twice a day, the same way humans inhale medication using a device called a “metered dose inhaler”. A small tube or mask containing medication is gently held against the cat’s nose. As the cat inhales, the medication is inhaled. Most cats can learn to use an inhaler, and such devices offer advantages over pills including fewer adverse effects from the use of corticosteroids. Inhalers are, however, more expensive than oral medications. For cats with seasonal allergies, medications may only need to be given during a certain period of the year.
Your veterinarian can discuss various treatments with you after test results are known. It is often necessary to adjust the medication (types of medication and frequency of administration) several times to find the right schedule for your cat.
- Give medication exactly as directed.
- Discuss what to do if you cat becomes suddenly worse. Veterinarians will often prescribe “rescue” medications to be given athome before making a stressful trip in the car to a veterinary emergency clinic.
- Attempt to determine the cause of the asthma in the cat’s environment.
- Learn to recognize the early stages of respiratory difficulty. Many
- owners describe labored breathing in their cat as first being apparent from “belly-breathing”: increased depth of in-and-out movements of the chest and abdominal wall.
- Take your cat to your veterinarian or to the emergency clinic if breathing problems develop.
- Understand that asthma can be difficult to treat, and that a second opinion from a veterinary internal medicine specialist may be very helpful. You can discuss this with your veterinarian and a list of these specialists is available at www.acvim.org or www.vetspecialists.com for North America, or at www.ecvim-ca.org for Europe.
- Do not force any cat to take medications if it is too stressful. Instead, discuss alternative treatment with your veterinarian.
- Do not stop giving a medication if you suspect that you know the cause of your cat’s asthma until you have talked with your veterinarian. It can be dangerous to suddenly stop giving some medications (withdrawal effect causing relapse).
WHEN TO CALL YOUR VETERINARIAN
- If you cannot give a medication as scheduled.
- If you cannot keep a scheduled appointment.
- If your cat may be having an adverse reaction to a drug; signs include hives (bumps under the skin), loss of appetite, weakness, drooling, vomiting, diarrhea, or anxiety, but are very uncommon.
SIGNS TO WATCH FOR
- Open-mouth breathing, increased coughing, or wheezing. When these occur, it is useful for you to note what, if anything, changed in the cat’s environment in the previous 24 hours. This is an excellent way of narrowing down the list of possible triggers for an individual cat’s asthma.
From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.