Take A Deep Breath

Well, the radiologist's consultation of Stella's chest x-ray's came back yesterday-diffuse bronchial thickening consistent with feline asthma. Other less likely rule-outs are bacterial bronchitis and aelurostrongylosis (lung worms.) Whew. No mention of cancer. Since her blood work didn't really show evidence of infection, and because she is an indoor cat with very little risk of exposure for lung worms, I am going to start treating her for asthma first and see how she does. It only figures that this cat, who disappears under the bed, far, far from reach the second you just think about medicating her, will be the one who needs life long maintenance medications. Oh joy. I certainly feel the pain of all my clients who swear up and down they just can't medicate their pets-Stella does not make it easy. I can only imagine the U-Tube video of me crawling under the bed, (always when I'm late for work!) grabbing her tail and dragging her out hissing and spitting at me. Thank goodness the actual pilling act isn't hard-I've had plenty of practice medicating cats!

Thank you, everyone, who expressed your concern for Stella and for me. I appreciated the kind comments, Nicki, and the moral support-you do understand what it is like to be "mom" and doctor at the same time.

So, just what does this diagnosis of feline asthma mean for Stella...and for me? The problems start because of changes in her lungs. The airways actually constrict because of the formation of mucus, the inflammation of the airway and subsequent ulceration, and finally actual spasms of the airway muscles. When the airways are constricted, the cat can not take a deep breath, won't be able to exercise or play for long periods, will have coughing episodes, (as Stella does)and they may wheeze when they breathe. So far we have been lucky in that Stella has just had the low-grade, chronic cough as her only symptom, but an acute or sudden asthmatic crisis can occur at any time and could actually be life threatening as I have seen in other patients. There may be no obvious reason for the crisis, or it may be triggered by allergies or stressful events.

It is likely that the airways of affected cats are diseased all the time and actually flare up and worsen during the crisis episodes. This is very similar to what occurs with human asthmatics. That is why treatment is likely needed all the time, not just during those respiratory emergencies. Our goal, of course, is to try and prevent those emergencies. So, darn it, Stella will need long term medication. Looks like I'll be crawling under the bed with her quite frequently.

Since the primary cause of the airway constriction in asthmatic cats is inflammation, it makes sense that treatment revolves around anti-inflammatory medications. Corticosteroids are the gold standard for reducing inflammation and can be administered orally, by injection and even by inhaler. Don't laugh! Cats can and do receive inhalant medications for asthma just like humans do, although specially fitted masks need to be used. Other medications that can be helpful are airway dilators such as terbutaline. Because allergies often trigger severe asthma symptoms, antihistamines can be helpful for many asthmatic cats. Cyclosporine is an immunomodulator that is relatively new in its use for asthma cats. It is particularly useful for those cats who can not tolerate corticosteroids because of their side effects, concurrent diabetic cats, cats with calcium oxalate bladder stone histories, etc. It can be expensive, but cats are small so dosing shouldn't be prohibitive.

Environmental control is imprtant in these asthmatic cats. Remember we talked about second hand smoke causing respiratory problems in pets? Never smoke around an asthmatic cat. Try to use dust-free cat litter, and regularly replace air filters in your home. I have seen some cats who develop sensitivities to laundry detergents or fabric softeners, perfumes, even carpet cleaners, so evaluate your home for sources of possible irritants to your cats respiratory tract. Remember, they are much closer to the ground and very, very sensitive to environmental changes.


If Stella becomes too wiley or difficult to medicate every day, I may have to resort to an injection of a long-lasting corticosteroid to control the inflammation in her airways. It isn't without its risks, however, but could be a good alternative to fighting with her every darned time she needs a pill. Stress can trigger those crisis episodes-definitely something we want to avoid!

So, feline asthma is a crummy diagnosis because it is a disease that is rarely "cured." We can only hope to manage it and avoid the terrible respiratory emergencies, gasping for breath, tongue turning blue episodes that can be life threatening. Leave it to a vet's cat to come down with it-thanks a lot, Stella. Actually, I am quite relieved her cough wasn't anything more serious, and am hoping her new medication will help her take that deep breath and stop her coughing real soon. She has to be fit to be able to run away from Spartacus when he attacks her, after all.

Peace,
DrReneigh