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Putnam North Animal Hospital
Feline Asthma
The Basics
Feline asthma (also known as feline allergic bronchitis) is an airway disease that can be sudden or on-going in nature. In the disease, there is airway inflammation associated with over-responsiveness to various stimuli, such as allergens. It can affect cats of any age but is more commonly seen in cats between 2 – 8 years of age. Siamese cats appear to be predisposed to this disease and one study has shown that female cats are overrepresented; however this is not a consistent finding. Cats with this disease have episodes of coughing, sneezing, labored breathing or wheezing. Severely affected cats may exhibit open-mouth breathing or even dark grey or blue discoloration to the gums and tongue (cyanosis). Cats with asthma have trouble breathing because the airways in the lungs become constricted or narrowed. This constriction decreases the amount of air that is allowed to enter and leave the lungs. Affected cats will typically have a much more difficult time exhaling than inhaling. Over time, these airways can suffer permanent damage and remain constricted. This can be a serious, life-threatening disease for some cats.

Triggers of the disease are largely unknown but exposure to cigarette smoke, dusty cat litter, hair sprays, air fresheners and seasonal airborne allergies can possibly exacerbate the disease. Stressful events can also trigger these episodes in some cats.

Diagnosis
There are several other diseases that can have similar symptoms to feline asthma. These include infectious pneumonia, heartworm disease, cancer and heart disease. After a thorough physical exam, several diagnostic tests may be performed to try to reach a diagnosis. These may include a stool check to look for internal parasites, a complete blood count (CBC), blood chemistries and a heartworm test. Radiographs (x-rays) are an important diagnostic tool and will typically show a specific pattern in the lungs that is consistent with feline asthma. In some cases, further testing is recommended such as a transoral tracheal wash (TTW) or bronchoscopy (looking in the airways with a small camera) with branchoalveolar lavage (washing). These tests allow us to evaluate the appearance of airways visually and samples are taken so the airways and their cells can be evaluated microscopically.

Treatment
Emergency Treatment
Any cat having difficulty breathing is an emergency and should be brought in to us or the emergency veterinary hospital immediately. The cat should be kept as calm as possible and stressors should be avoided to try minimize a life-threatening event. Avoid lifting and moving the cat as much as possible. Oxygen is typically given to help the cat to breathe more comfortably. Injectable medication may be given to help open the airways up and reduce the inflammation that is present. The cat may need to be hospitalized until its’ breathing returns to a more normal state.

Long-term management
Feline asthma is a disease that will be managed, rather than cured. Therefore, an important component of helping cats that have asthma is to seek out, and eliminate if possible, the most likely triggers. These include the following:

Avoid exposing the cat to cigarette smoke.
Change furnace and air-conditioning 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 accepts to sue the litter box normally with this new litter type.

Medications are typically needed at some point to manage an asthmatic cat. Some patients require daily medications while others may do well with only periodic treatments. Corticosteroids are typically used to help manage the disease. They accomplish this by reducing inflammation and decreasing the body’s response to offending stimuli. Steroids may be administered orally or inhaled (using a form-fitting mask). A longer-acting injectable steroid may be used in milder cases or in cats that refuse to take the medication orally. We will try to minimize the amount of steroids given to your cat to the lowest effective dose as steroids can lower the body’s immune system response and can lead to weight gain, increased risk of diabetes and complicate underlying heart disease. Bronchodilators may also be given orally or inhaled. They are used to help open up constricted airways and allow better airflow. Some cats may only require one medication while others may need a combination of medications. If certain infectious organisms are suspected, antibiotics may need to be given, although this occurs very uncommonly. It is often necessary to adjust your cat’s medication, including type and frequency, several times depending upon response and time of year. For cats with seasonal allergies, medications may only need to be given during a certain period of the year.

DOs
Give medication exactly as directed.
Attempt to determine the cause of the asthma in the cat’s environment and eliminate or minimize it as much as possible.
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
Bring your cat in to us or to the emergency clinic immediately if breathing problems develop.

DON’Ts
Do not force any cat to take medications if it is too stressful.
Do not stop giving a medication until you have talked with us. It can be dangerous to suddenly stop giving some medications.

When to Give Us a Call
If you cannot give a medication as directed.
If your cat is exhibiting any signs listed below or is showing other signs of illness.

Signs to Watch For
Open-mouth breathing, coughing or wheezing, dark or bluish discoloration of the gums or tongue, hiding, vocalization, tiredness, exercise intolerance, vomiting or diarrhea, or any other signs of general illness.