Feline Asthma

The term feline asthma describes the clinical manifestations of several different conditions affecting the lower airways of the lungs. Symptoms of lower airway disease in cats can range from wheezing to coughing, to difficulty breathing or respiratory distress. In addition, some cats may be lethargic, or intolerant of exertion, or may breathe with their mouth open after minimal activity. These signs may be continuous, or they may come and go cyclically. They may occur in the short term (“acute”) or can last for weeks to months (“chronic”). Underlying conditions, which can lead to signs of lower airway disease include allergies, parasites, and infections. Some cases appear to be idiopathic, which means no one knows what the underlying cause is. The basic disease change is airway inflammation. Cats of any age and breed can be affected; the Siamese breed may be predisposed. Parasites called lungworms can inhabit the respiratory tract and cause signs similar to asthma. Heartworms, which are parasites that live in the heart and great vessels can trigger inflammation in the lungs, which can also lead to asthmatic signs.

DIAGNOSIS

If your cat is experiencing clinical signs compatible with asthma, some or all of the following tests might be recommended. A chest X-ray is commonly done to confirm the diagnosis and to eliminate other diseases which might have similar clinical signs, such as pneumonia or heart disease. The X-rays of asthmatic patients frequently show either over-inflation of the lungs or inflammation of the tissue surrounding the airways. A complete blood count (“CBC”) is often recommended to evaluate the white blood cell count and pinpoint changes which might indicate allergies or infection. Sometimes additional blood tests are also done to evaluate the overall health of the patient. A heartworm test may be done on the blood sample as well. A transtracheal wash is a test where cells are obtained from the airways by injecting, then withdrawing a small amount of sterile salt solution via the windpipe (trachea). This fluid can then be analyzed for cell type and can also be cultured to look for bacterial growth. Lungworms are also checked for.

TREATMENT

Treatment for patients whose tests point to asthma will usually involve a combination of therapies. For a patient in respiratory distress, oxygen and injectable medications that help dilate the airways (bronchodilators) are administered immediately, sometimes even before all diagnostic tests are completed. Once a patient is stabilized, longer term medications are utilized.

Many patients receive anti-inflammatory medications from the steroid family of drugs. These are potent medications which can rapidly reduce swelling and inflammation around airways as well as “calm” the underlying immune response in cases where allergies are involved. Steroids can be given by injection or orally, or inhaled via a human puffer. Occasionally, long acting steroid injections may be given to patients who are difficult to medicate. Many people worry about side effects associated with steroids. Cats are more resistant to these side effects than are humans, and frequently the beneficial effects can be life saving. Certainly, patients receiving these medications are monitored closely, and are often have their doses tapered off and even discontinued once their condition allows. Oral bronchodilators such as theophylline may be used in asthma management. Inhaler administration of bronchodilators are a newer approach to therapy. Some patients are placed on antibiotics . Mycoplasma infection requires a special class of antibiotic for treatment (examples include doxycycline and azithromycin).

Some cats are amenable to treatment with metered dose inhalers, similar those used by human asthmatics. Metered dose inhalers can deliver either steroid or bronchodilator medications directly into the lungs. This route avoids some of the side effects associated with oral or injectable medications. A small chamber is used to connect the inhaler to a face mask that is placed over the cat’s nose and mouth for several breaths.

PROGNOSIS

Although some cats may experience a single one-time episode of asthma, many cats experience recurrent episodes or chronic disease. Some will require periodic courses of medication and some may require ongoing treatment to prevent clinical signs. Each individual is different and it is difficult to predict at the onset which category a patient will fall into in the long run.

PREVENTION

Several preventative measures can be taken to help patients diagnosed with asthma. Some of these steps may also prevent development of asthma in the first place. Being overweight or obese can impair respiratory function. Therefore, in an overweight patient who has experienced lower airway disease, controlled weight loss may prevent future episodes or lessen their severity. Cigarette smoke can definitely worsen signs of asthma, as can dusty conditions, and sometimes even litter fragrances or people’s perfumes. Some drugs used to treat high blood pressure can worsen asthmatic conditions so be sure to discuss all medications being given to your asthmatic cat with the attending veterinarian.

SUMMARY

Asthma is a serious and occasionally life threatening problem in cats. Many factors complicate this condition. Most cats with asthma can be successfully treated and once the acute episode is controlled. One expects a good quality of life even when ongoing medications are required. Frequent monitoring by a veterinarian is imperative for cats receiving ongoing medications.

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