Feline Asthma: That Hacking Cough Might Not be a Hairball

By Franny Syufy, About.com Guide

A severe attack of feline asthma may sometimes be discounted as just another hairball attack, or possibly choking on a bit of food. The cat will cough for awhile, the concerned caregiver will comfort him, then he will appear to be fine. But symptoms like these need to be checked out by a veterinarian, to eliminate asthma. You may be sent home with a bottle of hairball remedy, but if asthma is the diagnosis, you will learn ways of managing it.

What is feline asthma?

Much like human asthma, feline asthma is an allergen-caused upper respiratory condition that causes distressed breathing. It is also called bronchitis or feline bronchial disease. Bronchial spasms cause the individual bronchi to constrict or tighten, and the resultant swelling of surrounding tissues puts the cat into a full-blown asthma attack.

Human victims of asthma will know exactly what an asthma attack feels like, as coughing quickly ensues, in an effort to expel the excess mucous.

What allergens are more likely to trigger an asthma attack in cats?

Again, these are many of the same allergens responsible for human asthma attacks:

• Smoke
• Mildew or Mold
• Household Chemicals
• Dust
• Pollens
• Cat Litter
• Cold, Moist Air

Asthmatic cats are also subject to exercise-related attacks, and stress can either cause or exacerbate a feline asthma attack. For that reason, you should always try to remain as calm as possible when your cat suffers an attack, because you can "telegraph" your stress to your cat.

How can I recognize an asthma attack in my cat?

Early symptoms may be difficult to detect. You may hear a faint wheezing, which is more audible after vigorous exercise. Your cat may seem to tire easily. Labored breathing may proceed a serious attack.

A full-blown asthma attack may at first resemble a cat trying to cough up a hairball, or possibly choking on food. However, the body posture is somewhat different. With asthma, the cat's body will be hunched lower to the ground and his neck and head will be extended out and down in an effort to clear the airway of mucous. The "gagging" may also be accompanied by a typical coughing sound, and possibly sneezing. The cat may or may not expel foamy mucous.

These serious attacks may not happen frequently, which makes it easy to write them off as "just a hairball." Actually, they can be life-threatening, and a cat in a full-blown attack should be taken to a veterinarian immediately. Even a cat showing one or two of the early symptoms should be examined. Once diagnosed, there are things you can do to help your cat during one of these attacks.

How does the veterinarian diagnose feline asthma?

Other diseases share many of the same symptoms as feline asthma, including Heartworm Associated Respiratory Disease, a serious disease in itself. Your veterinarian will use several diagnostic tests to eliminate those conditions. The most common diagnostic tools are:

• Blood Tests
  These are the quickest and easiest, and will detect infection, which often accompanies asthmatic bronchitis. They will detect macrophages, esoinophils, neutrophils, and mast cells, which are types of blood cells that help constitute the immune system. And blood work is also useful in eliminating other diseases with the same symptoms.
• Chest XRay
  Also called a thoracic, xray, it will disclose abnormalities, such as areas of chronic irritation, as caused by infection, a flattened diaphragm, or unusual fluid accumulation. Evidence of heart disease may also be seen. This would not necessarily eliminate asthma, as the two sometimes go hand-in-hand. Your veterinarian may want to send the xray to a specialist for consultation. The xray is done in two stages: Lateral, with the cat on his side, and ventrodorsal,lying on his back with limbs extended out of the way. Although many cats may accede to these positions, others may need a small dose of anesthesia to perform an xray. Otherwise, it is harmless and painless.
• Bronchoalveolar Lavage
  This is an extremely useful procedure and in itself, perfectly safe. BAL, as it is called, is performed by inserting an endotracheal tube into the trachea under general anasthesia, then fluids present in the airways of the lungs are extracted through this tube for examination.

Aside from asthma, the BAL may diagnose other conditions of the lungs. In a study done in Barcelona of 26 cats, two were found to have Toxoplasma gondii cysts, two showed evidence of carcinoma, and 18 were determined to be related to asthma or infectious bronchitis. The down side of BAL is that it requires a general anesthesia, counter-indicated in a cat with severe respiratory distress.

How is feline asthma managed?

Once your cat is diagnosed with feline asthma, you have several options for treatment, depending on the severity of the case. The first, and most obvious thing you'll need to do is to try to eliminate the environmental allergens that are causing respiratory distress in your cat. Some will be easy; others more complicated or expensive.

1. Smoke
   If you are one of the dwindling minority of people who smoke, you'll need to do it outdoors in the future. Better yet, consider quitting, for your own health and for all those creatures who share your home. Fireplace smoke can also be a problem for asthmatics. We have not burned our own fireplace for years, but may someday convert it to a gas log version. Scented candles and plug-in air fresheners are particularly bad for both human and feline asthmatics, as is incense.
2. Mildew and Mold
   These can exist in homes in any climate. Mold can develop in damp basements, crawl spaces, or in steamy areas like bathrooms. Shower curtains and glass bath enclosures are magnets for mildew. Central air ducts are a perfect harboring for mold and mildew spores that float through the air, then are blown throughout the home by the heater or air conditioner. Part of your work here involves deep cleaning. Although it may sound contraindicated, a steam cleaner does a good job of cleaning mold and other allergens from solid surfaces like tile floors, shower enclosures, and walls. Professional services are indicated for cleaning central air ducts.
3. Dust and Dust Mites
   First, step up your use of the vacuum cleaner. Consider replacing curtains with attractive blinds. Think about hardwood floors or tile instead of wall-to-wall carpeting. Although expensive, Hepa air purifiers are excellent for removing both dust mites and mold spores from the air. If you cannot afford a whole-house installation, or live in a rental, consider a room purifier in the room your cat most frequently occupies.
4. Household Chemicals
   Try to keep their use to a minimum. Think "Clean Green" for your cats' benefit, your own health, and your home environment. Unfortunately, this includes eschewing most plug-in air fresheners and stove potpourris, which often cause respiratory distress in cats.
5. Pollens
   Pollens exist almost year-round in my area. A Hepa air purifier will also help clean the air of pollens. During pollen seasons, keep your windows closed, and keep your cat indoors.
6. Cat Litter
   Because of the dust that rises from clay litters, most of them are anathema to asthmatic cats. Some owners have used Feline Pine with good results, although some cats are allergic to the odor of pine. The same applies to scented silicone crystal litter. You definitely want to stick with unscented litter, and trial and error may be your last resource. Remember that cats are often fussy about litter changes, so introduce the new litter gradually.

What medications will my vet prescribe for my asthmatic cat?

Hopefully, your cat was diagnosed in the early stages of asthma, and not after a panicky trip to the emergency vet clinic in a full-blown asthmatic attack. Depending on the severity of your cat's lung involvement, he most likely will be treated with a combination of a daily steroid, either by inhaler or pill, and a bronchodialator inhaler for use as needed.

Daily Steroid Options

Conventional veterinary practice is the administration of prednisone, in pill form, and spaced out three times a day. It can also be administered with transdermal gel, or through injection. All three of these methods have their drawbacks. The newest form of administration is with a metered dose inhaler, often Flovent, given through a special mask. The Aerokat Feline Aerosol Chamber was developed for this purpose, and is highly regarded by veterinarians who are familiar with it. The advantage of aerosol steroid administration over pills and injections, is that it goes directly into the lungs, rather than throughout the body, thus there are fewer side effects. The web site of Fritz the Brave, has a full section on the use of the Aerokat, including videos demonstrating its use.

Bronchodialator

The most commonly-prescribed bronchodialator is albuterol, which can also be administered through a feline aerosol container, such as Aerokat. Albuterol is only given as needed, when an asthmatic cat starts coughing and wheezing, and should not be used routinely. Excessive use can actually cause bronchial spasms. If your cat is having more severe attacks than you consider normal, he should be taken back to your veterinarian for reevaluation and possible adjustment of his medications.

As with most feline health issues, the key to successful management of feline asthma is to know your cat well, keep your eyes and ears open for changes in his breathing, give him his medications as prescribed, and get veterinary care when indicated, either routine checkups or emergency intervention.