Asthma In Cats
Cats with feline asthma typically cough several times a day, although this is often mistaken for bringing up a hairball or trying to vomit. A coughing cat will stretch its neck out low to the ground, and sharply expel air with a noticeable movement of the chest and abdomen. This may happen multiple times in a row but is almost never a “coughing fit” as seen in people or dogs. Cats will often sit up between coughs, and may gulp or lick their lips. To confuse matters further, sometimes repeated coughing can lead to vomiting.
Cats with feline asthma may sound wheezy, both when coughing and at rest. If severely affected, they can develop difficulty breathing and need emergency treatment. Due to the fact that most indoor cats lead inactive lifestyles, it is rare to notice reduced activity levels or difficulty tolerating exercise.
There is no specific test for feline asthma; instead, diagnosis is based on compatible findings and ruling out other similar conditions. Often, investigation starts with general blood tests to rule out other problems and confirm the cat is fit to have an anaesthetic.
X-rays of the lungs are essential for diagnosis of any respiratory disease. These are performed under anaesthesia, so the cat’s breathing can be controlled. Commonly, three x-rays are required to fully examine the chest cavity. Feline asthma commonly causes changes on an x-ray, however, early disease can show no changes at all. X-ray is useful to rule out other problems in the chest cavity. Ultrasound may also be used to screen for changes in the heart and chest.
The final step in a diagnosis of asthma is demonstrating increased levels of a specific white blood cell, called eosinophils, in the lungs. This is achieved using a process called bronchoalveolar lavage (BAL), in which a catheter is placed into the lungs, a small sample of sterile fluid is instilled, and the fluid is suctioned back out for analysis. It can be performed using an endoscope, though this is not always necessary, but the cat must be under general anaesthetic. There is a small risk that irritating the lower airways can cause them to constrict, so cats are monitored closely for a few hours afterwards. A BAL is the last piece of the puzzle for diagnosis, however not all cats are stable enough so sometimes the diagnosis is assumed without this step.
Cats who present very unwell and struggling to breathe will need to be admitted for intensive care. This involves supplemental oxygen as well as medications to open the airways and slow the breathing, such as bronchodilators, steroids and sometimes light sedation.
Cats who are stable will need lifelong treatment at home to manage the condition. This is most often a combination of bronchodilators, to open the lower airways, and steroids, to reduce inflammation and supress any allergic response. Both of these medications can be administered as tablets, or by inhalation. Similar to inhaler use in people, this method allows the drugs to be delivered directly to the lungs and reduces side effects from taking them orally. This is especially relevant for steroids, where long-term use can cause an increase in appetite and thirst. Not all cats will tolerate the use of an inhaler, however, the Aerokat™ aerosol chamber is specially designed for cats to make administration easier. It will need to be introduced slowly, and your vet can advise on this. There are also many videos online demonstrating use of these inhalers.
Changes to the home environment can also make a big difference to managing feline asthma. Anything that can irritate the airways should be avoided, including dusty cat litter, aerosol use, air fresheners and smoking. Frequent vacuuming of carpets is advisable. A HEPA (high efficiency particulate air) filter is particularly beneficial for house cats.
