Check out our other interviews with Dr. Brandon:
- Essential Oils and Cats
- Cat Dental Care
- What Should Cats Really Eat? An Interview about Feline Nutrition
- Feline Asthma
- Vaccines Cats Need
What causes feline asthma?Feline asthma is a type of bronchopulmonary disease caused by an allergic reaction to inhaled allergens which results in excess mucus production and narrowing of the airways. Allergens are often the same which cause human asthma and reactions are highly individual. For example, one cat may react negatively to perfume, candles, and essential oils, while another may benefit from essential oils but have an extremely difficult time with wood smoke. It is often exacerbated by dry air, obesity, and history of other cardiopulmonary diseases.
How do you know if your cat has asthma? What are cat asthma symptoms?A definitive diagnosis is often not possible unless one happens to find high numbers of certain white blood cells on a tracheal wash. This procedure requires full anesthesia and is not 100% -- a negative or normal result does not rule out feline asthma.In general, we diagnose feline asthma based on ruling out other conditions and assessing all laboratory and clinical symptoms together. Blood work to rule out infections and chest radiographs to assess bronchial patterns are considered minimum laboratory tests … and are usually enough when combined with examination findings, to provide a diagnosis of feline asthma.Exam findings range from normal to changes in bronchial sounds and mucous membrane color, depression and dehydration.Symptoms include an episodic hacking cough, usually dry though can be mucoid, which occurs with specific stimuli or times of year. Cats may remove themselves from normal play activities and lay in different positions to ease constricted breathing.In severe cases, symptoms include blue gums (tongue, nose, lips -- anything normally pink can appear blue-tinged), foamy spittle, and even death. Acute and chronic asthma are possible, and some cats only have a single event, while others cough daily for years.
Are there such things as cat asthma inhalers?Yes and they are surprisingly well tolerated, and like humans, usually work better than oral medications.This video shows a few different types of asthmatic coughing and details administration of a common delivery mechanism, AeroKat. Because we cannot ask cats to hold their breath, allowing the aerosolized medication to sit within airways, they need to have a rebreathing system which keeps the medication in suspension while the cat breathes a few seconds.AeroKat is an adaptation from infant inhalers for the same reasons.
What are cat asthma treatment options?Like most treatment options, cats respond best to a multimodal approach. Treatment changes based on acute/emergency vs chronic care, age, presence of other health issues, and normal fluctuations of the immune system / disease itself.
- Environmental -- in short, remove anything which produces dust, noticeable scent, or smoke. While some can be added later, it’s best to be aggressive during this step.
- Remove all candles (soy or wax, scented or not)
- Remove plug-ins (scented or pheromone)
- Hold off on essential oils …
- Yes, I know this seems contradictory to comments made previously. Many cats do respond exceptionally well to essential oils, but others respond negatively.
- While diffused products like OpenAir are good treatment options, I prefer to remove all oils first; add them in with veterinary direction
- Provide low/no dust litter in an uncovered litter box. Some cats do well with pelleted liters while others need crystal types. Automatic litter boxes are also good options.
- If any perfumes are used in the home, make sure to put them on behind a closed bathroom door; leave the door closed when you leave to reduce diffusion of potential allergens in the home.
- If possible, remove carpets and rugs. Surfaces like tile and laminate flooring, which are easily cleaned of dust and fur, are preferable. Remove what you can and clean the rest at least weekly.
- Wash cat bedding at least weekly.
- Pay attention to anything else which triggers your cat’s asthma; remove it as well.
- Reduce household (human and feline) stress as best as possible.
- Inhaled medications & supplements (Inhaled refers to AeroKat systems rather than nebulization, though the latter is an excellent option for severe patients or those who will not allow masks to be held in place.)
- Steroidal inhalers: a mainstay of controlling the immune system response in feline asthma, steroids are potent anti-inflammatory drugs. They range greatly in strength and price, and are generally safe. Some cats will develop upper respiratory tract illness secondary to suppressed immune systems and feline herpes viral flares. Rarely cats can exhibit systemic symptoms of steroid administration (increased appetite, increased urination/thirst, poor skin/coat quality, etc.).
- Bronchodilator inhalers: medications like levalbuterol are suspended in moistened air and cause relaxation of bronchial muscles, opening airways in short time. Typically referred to as ‘rescue inhalers’ they are relatively safe, low cost, and commonly used in cats. Negative effects seen with this class of drugs in oral form are generally absent when inhaled.
- Essential oils: 1-4 drops of an equal parts blend of copaiba, frankincense and grapefruit, diffused in a room where your cat can come/go freely, is a good choice. These oils are generally well-tolerated and unlikely to trigger any reactions; eucalyptus or evergreen oils are good additions I might add later as needed. They can trigger bronchoconstriction in some mammals, so I avoid them at first.
- Oral medications & supplements
- Steroids are commonly prescribed to reduce overall inflammation of airways. They are not without risk as systemic steroid administration often creates a host of other issues. That said, most cats who require long term steroid administration typically do not need high doses, limiting negative effects.
- Bronchodilators help open airways via relaxation of bronchial muscles. Low doses are typically used to avoid negative systemic effects, and these drugs are generally considered well-tolerated.
- Oral antibiotics: it is not uncommon to place feline asthma patients on a course of doxycycline or other antibiotic. Secondary infections are not uncommon, especially when first diagnosed, and they can be present even with a normal systemic white blood cell count.
- Acupuncture & TCVM herbs can help balance the body’s energetic patterns. The patterns which are often found in feline asthma are the same as in humans: Wind Cold, Lung Heat, Lung Yin or Qi Deficiency, & Kidney & Lung Qi Deficiencies.
- Ayurvedic herbs like ashwagandha and curcumin can support the body’s anti-inflammatory efforts, as can full spectrum hemp products. The latter supports the feline endocannabinoid system which aims to resolve all cellular stress, no matter where it’s located.
- Diet is also important as one high in moisture and animal-based protein supports the body’s immune system and overall ability to maintain healthful homeostasis. Such as diet also supports a healthy body weight and can sometimes be tweaked to encourage energetic flow aimed at tonifying Yin and expelling Wind.
If a cat has an asthma attack, what do you do?Let’s go step by step on this one …Step One: take a deep relaxing breath yourself. If you’re panicked, it will only add to your cat’s stress. Remaining calm helps her remember that you’re going to help, and she can remain calmer as well.Step Two: look at your cat. Is she coughing and annoyed because her play was interrupted, or is bug-eyed and unable to get enough air?Step Three: if the latter, grab her carrier, and your wallet and car keys. Get to your local emergency veterinary hospital immediately. Asthma attacks can and do kill cats; don’t wait as early intervention can save her life.Step Four: let’s presume your cat either has chronic asthma or the first attack is mild, with your cat playing like normal within a minute or two.
- Chronic asthma: get your AeroKat and levalbuterol inhaler. Administer per prescribed directions, which may include administering a steroidal inhaler once the airways are open.
- First time attack or if your cat doesn’t respond as expected to prescribed medications: call your regular veterinarian and schedule a visit.