Feline Asthma: Lower Airway Disease

Feline asthma is a condition in which a cat coughs and has trouble breathing on a semi-regular basis.

What Causes Asthma in Cats?

There is some debate as to the primary cause of feline asthma, but most experts believe that the majority of cases are victims of allergens or irritants in the air that stimulate the cat's immune system to overreact.

Such allergens include:

• Smoke, either cigarette or fireplace
• Scented aerosol sprays such as air fresheners, hair spray, and cleaning products
• Perfume
• Environmental allergens like pollen, grass, or dust mites
• Dust from cat litters, especially clay-based varieties

Some other potential causes of lower airway disease in cats that aren't airborne allergens include:

• Food allergies
• Parasitic reactions to parasites either primarily living in the lungs or others migrating through the lungs as they complete their life cycle
• Heartworm infection
• Bacterial or mycobacterial infections

How Are a Cat's Airways Affected by Feline Asthma?

Once the airways are irritated or inflamed from any cause, the cat will experience a dramatic narrowing of the lower airways or bronchioles in the lungs. When this happens, the narrowed airways cannot handle the necessary flow of oxygen, and the cat will show signs such as coughing, labored breathing, or increased respiratory rate.

What Signs of Feline Asthma Should I Look for in My Cat?

In more mild and chronic cases, cats will assume a crouched position with their heads and necks extended, followed by a hacking and non-productive cough. This may continue for several minutes. The cat's breathing rate or effort may not change during these episodes, and owners may mistakenly interpret it as the cat trying to cough up a hairball.

In more serious episodes, the cat may have sudden and severe narrowing of the airways that leads to true respiratory distress with labored breathing, open-mouthed breathing, rapid breathing rate, and cyanotic or bluish color developing in the gums. This requires immediate transport to the veterinarian for emergency treatment of the airway disease crisis.

What Should I Expect When I Arrive at the Veterinarian's Office?

If your cat is experiencing a respiratory crisis, treatment will be started immediately and will probably include oxygen, a steroid to decrease the inflammation, and a bronchodilator to open the airways.

Oxygen is ideally administered through an oxygen cage which contains a much larger concentration of oxygen than the outside air. Cats do well in this setting because they do not have to be restrained or experience additional stress while receiving other medications. If this is not available, veterinarians can supply oxygen via a face mask, a small tube of flow-by oxygen, or a small tent.

Steroids are an important part of the treatment plan to quiet the inflammation causing the airways to narrow. There are several ways to administer steroids. In an emergency situation, either injections are given or an inhaler can be used for aerosol administration.

The third arm of emergency treatment is a bronchodilator medication to open the airways and decrease the work of breathing. Ideally, these are initially given by injection or via an inhaler and are followed up with oral forms later on.

What Tests Will Need to Be Run by My Veterinarian to Diagnose Feline Asthma?

Once your cat has received the initial medications and is considered to be stable, chest x-rays may be taken to look for causes of respiratory disease. In feline asthma, there are classic changes in the airways and lungs that will clue the veterinarian in on this diagnosis.

Blood tests, urinalysis, fecal exam, and a heartworm test are also recommended to look for other causes of your cat's condition. Generally, blood tests and urinalyses are normal in cats with airway disease. Fecal tests could show evidence of parasites, and a heartworm test will identify if feline heartworm disease is the cause for your cat's respiratory signs.

Sometimes, further imaging such as a CT or MRI scan or cytology of cells collected from the airway may be needed for a proper diagnosis.

What Medications Will I Need Long Term for My Cat with Feline Asthma?

Once a cat is discharged from the hospital, assuming there are no parasites or heartworms present, he may be prescribed long-term steroids and bronchodilators. Many times, these are oral medications.

More recently, veterinarians and cat owners are becoming aware of the long-term side effects of steroids. In many cases, your veterinarian will recommend considering inhalant medications, using a specifically designed feline inhaler, to decrease the likelihood of these side effects.

Is Feline Asthma Curable?

Most cases of airway disease in cats can be controlled by medications but are rarely cured. This is due to the changes in the lungs over time that can eventually lead to chronic scarring and eventual emphysema. Most cats do well and have a good quality of life on medications as needed at home but will have occasional episodes or recurrences depending on the underlying cause of their airway disease.

New research is investigating the use of stem cell treatment for feline asthma. Early results indicate that it can help relieve the chronic scarring associated with the condition. More research is required.

What Can I Do to Prevent My Cat from Developing Airway Disease?

There are some steps you can take to help limit the likelihood of your cat developing airway disease. These include avoiding obesity in your cat, limiting the use of aerosol products such as air fresheners, household cleaners, and perfumes in your home, avoiding dusty, clay-based litters, and eliminating smoke, both cigarette and fireplace, in your cat's environment.

Siamese cats are predisposed to developing airway disease, so owners of this breed should take extra care to limit exposure to the potential airway irritants listed above.

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