Smidget is an active and full figured 15 pound cat with asthma.  I received a phone call the other day from her owner, Mrs. Motley, who had moved to Connecticut.  She called to talk to me about the treatment options for managing Smidget’s asthma, because when it flares the cat gags, wheezes, and becomes lethargic.  Mrs. Motley faces two challenges with Smidget—safely managing asthma, and trying to get medication into the cat.  As far as Smidget is concerned, no one at home is going to medicate her orally, so her asthma is treated with long acting cortisone injections given by her local veterinarian.  These injections rarely cause side effects in cats, but occasionally they trigger the development of diabetes mellitus—especially in overweight cats.  Since Smidget falls into this high risk category, her owner wanted to know what else she could do to manage the condition.  Smidget’s response to injectable cortisone has become shorter, so the frequency of injections has increased.

Asthma is inflammation of the bronchi, which are airways in the lungs.  The airways swell and become full of secretions, limiting the amount of air that is able to pass, and creating respiratory distress.  Untreated asthma can progress and become life threatening.  Cats with mild asthma cough and gag, and owners frequently report that they think their cat is trying to spit up a hairball, but nothing comes up.  More advanced asthma causes audible wheezing, abdominal press breathing, and even open mouth breathing.  Treatment focuses on trying to decrease inflammation and constriction of the bronchi with cortisone and bronchodilators.  The antihistamine, cyproheptadine, and the human asthma medication, zafirlukast, are useful in some feline patients.

Managing chronic asthmatics becomes more complicated, especially in cases like Smidget’s.  Protocols utilizing human inhalers are proving successful in many cases.  Inhalers deliver drugs directly to the lungs where they work locally and without the side effects of drugs that enter the circulation either orally or by injection.  Cortisone inhalers are used initially, and bronchodilator inhalers are added if needed.  The drawbacks of using inhalers are that they are expensive, and they need to be used in a manner that ensures the cat inhales the product.  Asking your cat to breathe in deeply after you squirt an inhaler is not feasible, so there is a product called AeroKat with a special chamber and mask.

The chamber contains a one-way valve that keeps the aerosolized drug inside until the cat takes a few breaths and inhales it.  The technique takes some practice, but willing owners can be taught and their cats will comply.  I discussed using inhalers with Mrs. Motley and she was very interested.  I faxed a protocol to her local veterinarian, and hope that they are able to treat Smidget successfully.

Unless a specific allergen or environmental irritant is identified and removed, most cases of asthma recur.  Allergy testing and hyposensitization are other ideas for helping asthmatic cats.  Cigarette smoke, cat litter, and home remodeling projects have all been implicated as causes of asthma.  Cats are as sensitive to the things they breathe as we are.

Asthma cannot be properly diagnosed without chest x-rays.  Other conditions that have a similar presentation to asthma are heart disease, heartworms, pneumonia, diaphragmatic hernias, and fluid in the chest cavity.  Many asthmatic cats have fairly normal appearing chest x-rays, but it is important to rule out the other conditions that do have different radiographic appearances, because their treatments are dramatically different.  Early recognition of asthma is extremely helpful, because response to treatment will be better and the cat will be comfortable faster.  If your cat has a couple episodes of an unproductive cough or gag, don’t ignore it, the cause could be due to feline asthma.

Written by Dr. Wexler-Mitchell of The Cat Care Clinic in Orange, CA
Copyright © 2011 The Cat Care Clinic