Cat asthma?

Sometimes I wonder if Mephit has asthma. She had another of her coughing fits today. They don't last very long, a minute at best, but it doesn't sound like a hairball or a sneeze or any other noise I've ever heard a cat make. I looked it up and found this article on catchannel.com, the link for it is

http://www.catchannel.com/vetlibrary/article_13267.aspx

Very interesting article, I laugh every time I think of a kitty with a little gas mask on though hehe :P


Muffy had always been a healthy cat. For years, the diminutive, longhaired calico was a fixture on the desk of Steve Beerstein, editor of a New York newspaper. However, Beerstein noticed that Muffy's breathing seemed slightly labored, and he could hear a gentle wheeze as she napped. He wasn't concerned, though, as her appetite and activity remained normal, and she continued to act like her usual self: queen of the newsroom.

Then one day when Beerstein arrived at work, he found Muffy crouching in the corner, coughing. Neck extended, she glanced up at Beerstein with a panicked look in her eyes. Beerstein tried to comfort her, to no avail. Between coughs, Muffy's chest was heaving.

"I'd grown accustomed to the occasional sound of her coughing up a hairball," Beerstein said. "But this was clearly no hairball."

In five minutes, Beerstein was hailing a cab and heading to his vet's office. "There are several possible reasons for coughing and labored breathing in cats," his vet said. "At the top of the list, though, is asthma."

What Is Asthma?
Feline asthma is a clinical condition characterized by recurrent bouts of coughing, wheezing, and labored breathing. The condition affects "approximately one percent of the general cat population, and over five percent of Siamese cats" said Rhonda Schulman, DVM, assistant professor of small animal medicine at the University of Illinois College of Veterinary Medicine.

Cats exhibiting these clinical signs usually behave normally between episodes. Some cats have only a brief history of coughing episodes before presented with an acute, severe respiratory compromise - the so-called "asthma attack."

Asthma is a type of allergic bronchitis. The allergen acts as an irritant, triggering a hypersensitivity reaction, and the airways respond with constriction, mucus and cough. If the environmental factors triggering the asthma can be identified and eliminated, the coughing and wheezing usually resolves. But, in most cases, no underlying allergen can be identified.

"People should not smoke or apply perfume around asthmatic cats, or use dusty cat litters," Schulman said.

A diagnosis of feline asthma is usually made based on the history, physical examination findings and chest X-rays. Increased bronchial markings on an X-ray are highly suggestive of asthma. Other helpful tests include a complete blood count and a heartworm test.

"Bronchoscopy, which involves using a tiny fiberoptic camera to actually examine the inside of the lungs and collect specimens, may also be useful in some cases," Schulman said.

Treatment Options
The most effective long-term treatment consists of high doses of oral steroids. Steroids lessen the inflammatory response, reducing the severity of symptoms.

Steroids are given twice daily for 10 to 14 days, and then the steroid dose is tapered slowly over several months. Most newly diagnosed asthmatic cats will feel and act much better within the first two weeks. Even though cats are fairly resistant to the undesirable side effects of steroids, a few have adverse reactions, making treatment a challenge. Steroids inhibit the action of insulin. While most cats can tolerate steroids with minimal ill effects, some fall victim to the side effects.

Bronchodilators are drugs that reverse airway constriction, allowing the air passages to open. Because steroids have potential side effects, it is tempting to choose bronchodilators as the initial treatment option. Since chronic inflammation is the root of the problem, treatment of this inflammation using steroids is the cornerstone of therapy. Bronchodilators may be used as adjunct therapy. Antihistamines and another class of drugs called anti-leukotrienes have been used in asthmatic cats with varying success.

Muffy's chest X-rays and blood tests confirmed the diagnosis of asthma. Oral prednisone was prescribed. On re-examination 10 days later, Muffy's cough had disappeared, and she seemed to breathe easier during sleep.

However, a new problem arose. "I found myself having to refill her water bowl twice as often as before," Beerstein said. "She even began to drink water out of my drinking glass." Steve told this to his veterinarian, and a urinalysis and blood sugar measurement confirmed that Muffy had become temporarily diabetic from the steroids.

Discontinuing the steroids caused her asthma symptoms to return. Fortunately, a new treatment that has essentially no side effects is available: inhaled medications.

A New Approach
Philip Padrid, DVM, associate professor at the University of Chicago, began investigating the possibility of using inhaled medications about 4 1/2 years ago. Steroids and bronchodilators can now be given effectively by inhalation to asthmatic cats.

Both types of drugs are available for humans, as metered dose inhalers (MDIs). In the human world, adults quickly learn to coordinate the inhaling of the medication. However, this is much more difficult for children and impossible for infants or cats. An alternative was developed to allow children, infants, and cats to use the MDIs without having to coordinate their breathing. A spacer - a plastic chamber roughly the size of a toilet paper tube - is attached to the MDI, and a facemask is attached to the other end. The spacer acts as a temporary storage area for the misted medication to sit, until the individual breathes it in.

"The original idea was to copy the way infants were treated," Padrid said. We then modified it when we found that it worked, but [it] was very expensive since the inhaler apparatus and mask used for humans was very inefficient, causing the drug to be wasted and increasing the expense."

Cat owners are taught to attach the MDI and the facemask to the spacer, and then to actuate the MDI twice, filling the spacer with the mist. The facemask is gently placed over the cat's mouth and nose, and the cat is allowed to inhale and exhale seven to 10 times with the mask in place.

Inhaled steroids are the most potent inhaled anti-inflammatory drugs available. Fluticasone is a steroid of large molecular size, preventing it from passing into the bloodstream when inhaled. "Inhaled steroids do not cause the unwanted side effects that the pills or injections do," Padrid said. Many cat owners find that giving inhaled steroids is faster and seems to bother the cat less, than trying to administer oral medication.

Bronchodilators are also available as MDIs. Albuterol is the one most commonly used in asthmatic cats. It acts more rapidly than oral or injectable forms. It can be used daily, or as needed for asthmatic cats that are already on daily steroids, yet still have occasional episodes of coughing, wheezing or increased respiratory effort at rest.

Muffy's Reaction
Muffy hated being pilled, and side effects precluded the use of oral steroids. Beerstein agreed to have Muffy try the inhaler and spacer. After demonstration of the proper technique, Beerstein quickly mastered the application of the inhaler and spacer to Muffy's muzzle. "She really resented the pills, but didn't mind the facemask," he said. "I think she realized that it was making her feel better."

Feline asthma is not a curable disease, but recent advances in our understanding of the disorder have allowed veterinarians to devise more effective treatment plans, and cats are breathing with greater ease as a result.