Feline Asthma: A Deep Dive into Our Cats' Respiratory Health
Have you ever seen a cat panting similar to the way that dogs do? This is generally a sign that your cat is in distress and may have feline asthma. In this episode, we discuss the facts about this chronic respiratory ailment that plagues our feline friends, exploring its diagnosis, treatment plans, and the environmental changes that can help alleviate their suffering.
From coughing and wheezing to difficulty breathing, feline asthma poses a threat, silently progressing over time. Discover the crucial signs that pet parents should watch out for, the role of allergens in triggering attacks, and why immediate veterinary attention is vital during a respiratory crisis. We also delve into the unique nuances of feline asthma management, including the use of inhalers and other medications, and unveil the environmental adjustments that can create a safer haven for our furry companions.
What You’ll Learn:
What feline asthma is.
Common signs of feline asthma.
What triggers feline asthma.
What to do if you see your cat panting like a dog.
How feline asthma is diagnosed.
Treatment plans for feline asthma.
How to avoid your cat getting worse.
Environmental changes we can make to help our cat.
The difference between human and feline asthma.
Ideas Worth Sharing:
“It is unnatural for your cat to pant like a dog. This is a good indication that they are in distress and need to go into hospital as quickly as possible.” - Tyler Sugerman
“Please always make sure that you are getting prednisoLONE for cats, not prednisone. Cats cannot break down prednisone as easily as dogs do.” - Tyler Sugerman
“Environmental changes can be very helpful in managing feline asthma. Reducing exposure to dust, pollen, and other irritants can help to prevent asthma attacks. This can be done by using air purifiers and dust-free litter.” - Tyler Sugerman
Resources Mentioned:
ASPCA 888-426-4435 or pet poison helpline 855-764-7661
The Original AEROKAT* Feline Aerosol Chamber Inhaler Spacer for Cats and Kittens
Read The Transcript:
Welcome to Vetsplanation. I'm your veterinary host, Tyler, or you can call me Suggs. This podcast is about educating pet parents about what is going on with their furry little loved ones. As an emergency veterinarian, I understand how hard it is to explain complex diseases in terms that are understandable for pet parents in a few short minutes before the next critical case comes in.
In this podcast, we can dive deeper into understanding of what our pets are going through and break down those complex medical terms into easier to understand chunks of information.
Just a quick disclaimer: this podcast is for informational purposes only. This is not meant to be a diagnosis of your pet. If you have questions about diagnostics or treatment options, please talk to your veterinarian about those things.
Remember, we are all practicing veterinary medicine, and medicine is not an exact science. Your veterinarian may have different treatment options. The information I provide here is to help pet parents, and it's not related to my place of work. I'm here for you guys to provide free information and knowledge.
If you like our podcast, consider sharing this podcast with at least one friend or someone else who has pets and could benefit from this.
Now, let's jump into this week's episode.
Tyler Sugerman: Hi guys, welcome back to Vetsplanation. So, today, we are going to be talking about Feline Asthma. This is a really important topic for cat owners to understand, as this can be really serious health issue for our feline friends.
So, what is feline asthma? To put it simply, it's just a respiratory condition in cats that causes inflammation and narrowing of the airways. This can make it difficult for cats to breathe normally, especially during times of high stress or exercise.
Most clinicians and researchers believe that feline asthma is actually caused by an allergic reaction to something that the cat is inhaling.
Feline asthma is a really chronic progressive disease that affects many cats, meaning that the asthma is there for a long period of time, and it slowly gets worse over time. They usually get diagnosed somewhere between ages two to four years, like their first diagnosis. But this can happen at any age, just the most common first diagnosis are around two to four-years-old.
The signs that pet parents will see at home are going to be coughing or wheezing, sometime difficulty breathing, and then they'll do this posture where they lay on the ground and stretch their neck out really far when they do a cough, that's to try to get as much air in and stuff out of their lungs as possible.
It can be triggered by a lot of environmental factors like dust, pollen, candles, plugins, incense, and especially cigarette smoke. So, in severe cases, cats may suffer from a respiratory distress. This looks like the cat is really breathing very hard or they may be breathing with their mouth open almost like they're panting.
But cats are actually obligate nasal breathers, meaning that they have to breathe through their nose. Unlike dogs who naturally will pant, it is not a normal thing for the cats to pant. If a cat is breathing with their mouth open, then it's a pretty good indicator that they're in distress and do need to go into the hospital immediately.
And I know that seeing these things can be a really scary thing for our pet parents, but let's talk about what's actually happening inside the body now. So, when the cat breathes something in, the cat's body makes something called antibodies.
These are little fighter cells that target that very specific thing that the cat is allergic to and tries to fight it off. The thing that the cat is allergic to is what's called the antigen. So, you have antibodies and antigen.
Now, I’m going to complicate it slightly more. The antigen or the thing that the cat is allergic to, makes the body create antibodies or cells to fight off the antigen. When the antibodies or fighter cells recognize the antigen or the thing that the cat is allergic to, the immune system starts triggering all sorts of things in the body. Most importantly, inflammation that occurs in the airways.
Think about inflammation like when you hurt yourself, you smash your thumb or something, and your thumb becomes really large. That's the inflammation I'm talking about, but this is actually end of the airways.
So, that tissue becomes larger, which is what happens when the cat's lungs try to get rid of that allergen or the antigen from the lungs. But it also decreases the amount of room for the cat to use their lungs to breathe.
Let's talk about some anatomy. You go from your trachea where you're breathing in, that's your windpipe, goes down to the lungs and in each lungs, they branch off for these bronchi and bronchioles and all sorts of things.
But they go from this really large structure to where they can get lots of air through and it becomes really small and now, they just can't get enough air through there so they can't breathe very well.
So, let's talk about how we diagnose it. The important thing to know is that there's no single test that's used to definitively diagnose asthma. Instead, we have to rely on our physical exam, multiple diagnostics, and our response to treatment. First, let's discuss the physical exam.
When a cat is first diagnosed with asthma before they're in crisis, we can often hear a wheezing sound from their lungs when we're using our stethoscope. Sometimes you can even hear it without the stethoscope, depending on how bad they are.
If the cat is in an asthmatic crisis, then it can be harder to pick up, but often, we could hear wheezing still. So, otherwise, we are listening for things that might tell us that there's some sort of different problem, such as listening to the heart to see if there's a heart problem or listening for noises that are coming from the upper respiratory system like in the nose instead of the lungs because those other things can produce things that sound like wheezing as well.
Then the next diagnostic is usually going to be more commonly known as X-rays, but we call them radiographs. On radiographs, we're looking for subtle changes indicating the lungs have inflammation in them. So, we call these railroads and donuts. And for anybody who's going to be watching this, I will show you an X-ray at the end of this to describe what I'm talking about.
But essentially, we're looking for these lines and circles in the lungs. So, this can be really subtle even when they're so bad that they're having an asthmatic attack. Radiographs can even look normal when the cat is having an asthmatic attack. It's been reported that about 23% of cats actually have normal radiographs.
Therefore, we have to put together our physical exam and the radiograph findings to determine if we think that the cat has asthma, if that's the cause of this respiratory distress. So, I would also like to note that not all veterinarians utilize these last two options, but there are also CT and bronchoscopy that can be performed.
CT or is otherwise known as CAT scan to most people, it essentially shows us a 3D image of the patient's lungs. Whereas bronchoscopy is where you put a camera down into parts of the lungs. We can't get all the way down to the very bottom, but parts of it so that we can look for signs of inflammation.
A lot of times, that person will take samples of the cells in the lungs as well because we're looking for those inflammatory cells, those things that I was telling you that are making inflammation, causing the asthma to be worse. There are other diseases I said that need to be ruled out. Things like chronic bronchitis, lungworms, which they can see a lot of times on bronchoscopy.
And then other weird parasites too sometimes that migrate to the lungs or even pneumonia, which when we're taking that sample of bacteria (if there's bacteria in there), then we know that there's pneumonia.
Now, that we've diagnosed the kitty with asthma, what kind of medications do we need to treat feline asthma? So, our goal of treatment is to decrease the inflammation and open up the airways. There are several types of medication that can be used including bronchodilators which are used to open up the airways and reduce the inflammation.
The most common long-term bronchodilators are inhalers. We use albuterol, which people who have asthma will know about, but albuterol is like a rescue inhaler. When the cat is starting to have trouble breathing, that's a really good one to give.
The most common one for everyday use to help prevent asthma attacks for our cats is Flovent or fluticasone. This is a corticosteroid and I'm going to talk about those really quickly first as well.
We use corticosteroids to reduce inflammation and prevent asthma attacks. The most common corticosteroids, that's not that fluticasone inhaler I was talking about, but things that they take orally are going to be prednisolone.
And that's a pill sometimes you can find it in a liquid. I've also heard of ones that you can put as a topical in the ear, but I don't know how well those work. There's also the injectable steroids that they last for about two weeks, it's called methylprednisolone.
But just as a side note for steroids for cats specifically, please always make sure if you especially go to an outside pharmacy that it says prednisolone. Please always make sure, especially if you go to an outside pharmacy that you get prednisolone, not prednisone. So, it should say L-O-N-E at the end.
That's because cats cannot break down prednisone as easily as dogs do. Steroids do good things and bad things. These corticosteroids, those are also known as steroids, so they do bad things as well. The good things are that it helps decrease the inflammation.
The bad thing is that they cause increases in drinking, increases in urination, and even increases in hunger. And sometimes it makes them more vocal so they'll walk around the house meowing constantly. But I've found that usually that subsides after a couple of weeks.
The long-term complications are that it can make our kidneys more prone to infection. We're decreasing the immune system which allows more infection to potentially occur, and it can also increase the chances of diabetes, like it pushes them into a diabetic state. So, we don't really want to do them as a long-term option if we don't have to.
One really cool thing is that we can use the inhaled steroids though. We usually use something called Flovent or fluticasone. As I mentioned earlier, these utilize the good properties of our steroids, so they decrease inflammation and go straight to the lungs.
But since it's focused directly in the lungs, you're inhaling it, we don't have all of those bad side effects. So, that's my preferred method of giving steroids to cats is giving them the inhaler of the steroids to bring down inflammation.
Usually, the fluticasone or Flovent will be used twice a day. And then like I said, albuterol, is more for just when they're having some sort of flare up essentially. Other medications may be prescribed as needed depending on the severity of the cat's symptoms.
Treatment does usually involve a combination of medication, and then also environmental changes and regular monitoring. So, therefore it's important to work with your regular vet for checkups and managing symptoms and to make sure that they're not going to get worse.
So, let's also talk about what I normally see, which is when the cat is having an asthmatic attack, a really bad flare up of asthma. It's usually having trouble breathing, the pet parent usually bring them in to the vet and we see them open mouth breathing a lot of the times as well. But you'll see that their chest is just moving really quickly, they are really having trouble breathing.
When that is the case, they need to come into the hospital immediately. That means that they're in distress, they need to be placed into oxygen cage so it can deliver a really high percentage of oxygen more than what's in the room air.
For cats, unfortunately, their shock organ is the lungs. That means that when they become more stressed, they can't breathe even more, and that's even more life-threatening. So, asthma for cats is not just life-threatening because they can't breathe, now that stress is adding to the fact that they can't breathe, it becomes even more life-threatening.
Once they've been diagnosed with asthma, usually the veterinarians start treating with injectable medications and the inhalers to try to open up those airways. We're using injectable bronchodilators and we're also using those inhalers and other things like sometimes we'll give a corticosteroid shot, but something to try to help open up those airways and decrease inflammation for the kitties.
Sometimes, they recover in a couple of hours and sometimes they have to be hospitalized for about 24 to 48 hours. It really depends just on how bad they are.
Now, let's talk about some of the environmental changes that you can do for your kitties at home. Environmental changes can be very helpful in managing asthma. Things like reducing pollen, dust and other irritants can help prevent asthma attacks.
This can be done by using air purifiers or even dust-free literally is really helpful. And avoiding smoking indoors. We don't want to smoke around them, try to smoke outside because even after you're done smoking, all that stuff lingers in the air.
Try not using plugins or anything with a really strong fragrance. Even strong cleaners can produce asthma attacks. I've had people cleaning their floor and that sent cats into an asthma attack. When you clean, just put the asthmatic kitty in another room until all of that is dry.
And then keeping cats indoors is really helpful as well because it reduces all the exposure to the outdoor pollens. All those pollens that are happening throughout the year, smoke that could be outside, and even dust that's outside as well. We can't really control the dust that's outside, so the easiest way is to keep them inside.
Let's talk about follow-up visits. So, like I said, regular monitoring is super important. Cats with asthma should be monitored for changes in their breathing and overall health. So, one thing you can do to try to figure out changes in the cat's breathing is trying to learn if that cat is having an increased respiratory rate.
When that cat is at rest, they're just laying there, they haven't been running around, they've just been laying there, you can count their breaths. They're a couple ways to do it, but I think the way that it makes the most sense that you aren't getting confused, it's going to be that you count how many breaths that cat takes in a minute. So, as soon as you see that chest rise, that’s one breath.
We like them to be somewhere between 30 to 40. If it's less than, that's fine. And if it's more than that, but we're not having trouble breathing at the moment, it's just higher respiratory rate. That's a good time to talk to your regular veterinarian to determine if they need to be brought in or if you need to have changes in your medications, maybe you need to increase the amount of fluticasone that you're giving.
They give metered amounts, so it might be that we have to go on a bigger dose, not just necessarily giving more of it throughout the day, just a bigger dose of it. As I said that's a really good indicator to try to talk to your vet to make sure that you're on the right track before we get into that crisis.
Additionally, regular checkups with your vet can help ensure the management plan is working. We do have to remember though that this is a progressive disease, which means we'll never cure the disease, we're essentially putting a band aid on it. We are managing it the best way we can with the materials that we have available.
So, even in people, there's no medication that's going to cure asthma. It's really just trying to help prevent those asthmatic attacks and keep our cats as safe as possible. Let's discuss some of the common questions I get.
One of the most common questions, “Is feline asthma the same thing as human asthma?” So, they do share a lot of the same features, same properties. They do have the same clinical signs, they have the same criteria for diagnosing both of them. And we do know in human asthma that there is inflammation that's there all the time and just have episodes of flareups, those asthmatic attacks.
We can extrapolate that to cats. We know that they have these asthmatic attacks and based on the X-rays, we assume that they do have inflammation there all the time, but that's not 100% known, we just assume that from humans.
But there's not a definitive thing even in humans as to what exactly is causing asthma or what exactly is making it worse. So, same thing with our cats, we don't always know what that inflammation is coming from, like which pollen or which antigen, we don't know.
The second common question I get is, “How do we administer the inhaler?” If I'm telling you to give your cat an inhaler, you're not going to be able to stick it in its mouth and do a puff, the cat will not tolerate that.
So, there are these really cool devices, they're called an AeroKat. I'll link this in the show notes. You’ll find them on Amazon and essentially, you put the inhaler on this little chamber. So, it's like this round chamber that you use. You put it into the inhaler and has a mask on the other end. So, that mask then goes over the cat's nose, that way you can do a puff.
One of the things that the cats get scared of is first of all, that puff, so that's why you can't really even stick it in a cat's mouth and have it just inhale. First, they also don't breathe through their mouth, they breathe through their nose.
But even that little puff can be a scary thing. So, it decreases the noise of that, and then sends all of that medication from the inhaler into this little chamber so that when you put the mask over the cat's nose, you do your little puff and then you have them breathe.
They're going to breathe in, ideally you want about 7 to 10 breaths that they take. That does take time for the cat to get used to and sometimes it's just doing it for one or two breaths, and then increasing it to three or four breaths and then all the way until you get to 7 to 10 breaths.
And doing things afterwards to try to help encourage them that this was a good thing that you did, by giving them treats, if they really like treats or giving them wet food, playing with them, just something that they really like to do. That way, you're encouraging them, it shows them that they did something really good and they're getting a reward for it.
And that'll help with trying to get them acclimated to this mask. Because the last thing we want is for them not to be able to make their breathing worse by stressing them out. They can't get those steroids in directly to their lungs. And then now, we have to give pills, which are also really hard to give or liquid of the prednisolone, and now, it increases our chance of diabetes. So, ideally, we want to get them used to this mask if at all possible.
We also don't want them stressed out and then throwing them into a worse asthmatic attack after that. And the last most common question I get is, “Are there any other treatment options for those who don't want to give steroids, or they can't have steroids?”
So, yes, there are other treatment options that may be helpful. Since we think this is an allergic reaction or it's allergies that are causing this, you can do allergy shots. So, anybody who has asthma or has allergies and notice that you can do these little tests underneath the skin to try to determine what you're allergic to. And then they put those little tiny bits of whatever you're allergic to in an injection. These are really tiny, microscopic things.
What happens is that we give these tiny particles back to the cat, they're injected back into them, and then we slowly increase the amounts over months so that they're getting a full dose by the end of a couple of months. The idea is that the cat's body will stop reacting to the allergens. This isn't a cure, remember — this is really just trying to help the lungs that are already damaged decrease those asthmatic attacks.
So, we're trying to help decrease them by trying to get the body used to that allergen and stop producing more inflammation.
Another medication is called cyclosporine. It is a medication used to suppress the immune system. So, we're trying to decrease what the immune system is doing, telling it to stop making inflammation.
But it is usually used in our patients that cannot have steroids for some other medical reason. Let's say that they have certain bladder stones, you can't use steroids, and for heart problems, we can't use steroids. It can be costly though, and it does require blood testing, I believe it's every six months if I remember correctly.
So, it is a pretty consistent thing that you have to go back to regular vet for to make sure that they're okay on the cyclosporine dosage that they're on.
Alright, so let us talk real quick about our animal facts.
So, do you know how long a tortoise can live? This is insane. So, we really think about them being around for a while, you're like, “Oh, they'll live for a while.” But did you know that the longest living land animal — I might mess this up, sorry. Seychelle's giant tortoise, his name was Justin and he lived to be 189-years-old when he died in 2021.
That's pretty crazy, 189-years-old. That means you basically have to will him to your great-grandchildren, so that somebody would be able to take care of him. And then the oldest living animal ever has been a quahog clam. It had been estimated to have lived for 507-years-old based on the rings around the clam shell.
This clam was accidentally found about the coast of Iceland by researchers. They called him Ming because he was named after the Chinese dynasty, which was in power during the clam’s birth year 1506. That's nuts.
Alright, that's all for today's episode on our feline asthma. Thank you again for listening, and if you have any questions or topics you want me to cover, please contact me, suggs@vetsplanationpodcast.com. Until next time, I wish your pets health and happiness, thank you guys.
Thanks for listening this week. If you have any questions, comments, suggestions, or you just want to say hi, feel free to email me at suggs@vetsplanationpodcast.com.
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Thank you all again for listening and we'll see you back here next week.