Cough, Cough, Wheeze, Wheeze: Is it a Hairball or Does Your Cat Have Asthma?

May is Asthma Awareness Month and just like their human family members, our cats can suffer from this potentially life-threatening disease that causes tightness in the chest and difficulty breathing.

It’s important that a coughing cat be properly diagnosed and that treatment for asthma not be initiated until other problems have been ruled-out.

Feline asthmatic bronchitis is caused by inflammation of the small airways of the lungs. Environmental pollution (including cigarette smoking, candle and incense burning), pollens, molds and grasses all can trigger asthma in a susceptible cat. Some cats have problems with asthma during the Winter, in climates where forced-air heating is used. Others begin to cough in the Spring, when the windows are opened. Still others are affected year-round.

Coughing is typically the foremost clinical sign of asthma in cats. Unlike dogs and humans, cats rarely cough from heart disease. The astute human guardian may detect wheezing from their asthmatic cat and these kitties tend to have a pronounced breath on expiration. They may be lethargic and either stop eating or drastically reduce their food intake.

Asthmatic cats need prompt evaluation and treatment. Radiographs (x-rays) of the chest are generally done first, although in an emergency situation, the kitty may need to be stabilized for a few hours in an oxygen cage before this can happen. Cats with asthma typically have small “doughnuts” throughout their lungs that represent inflammation around the small airways (as well as in them). Your cat’s veterinarian may suggest additional tests, including a complete blood count (CBC) and biochemical profile, a heartworm test, a special fecal (Baermann) test to rule-out lungworms, and either a transtracheal wash (TTW) or bronchoalveolar lavage (BAL). With either the TTW or BAL, the kitty is anesthetized and a small volume of saline is placed directly into the lungs to sample the types of cells present, as well as collect fluid for a bacterial culture and sensitivity.

Steroids, such as prednisolone, and a bronchodilator, like albuterol, are the mainstays of asthmatic treatment in cats. Because oral prednisolone can have serious, long-term effects, most asthmatic cats are now treated with inhalers—just like humans use. With cats, the inhalers are administered using a spacer, which is a long, plastic tube with a small mask that comfortably fits over the cat’s face. The kitty’s guardian depresses the inhaler one or two times into the spacer and the patient breathes in the treatment.

Even fractious, “scaredy” cats can be trained to accept the inhalers. Often times, the sound of the inhaler being depressed that causes the most problems and most cats can be acclimated to the soft—but often startling—noise.

It’s important that a coughing cat be properly diagnosed and that treatment for asthma not be initiated until other problems have been ruled-out. Lung tumors, some parasitic diseases (including lungworms), diaphragmatic hernias and fluid in the chest cavity (pleural effusion) all can cause coughing in cats. Asthmatic cats can have a concurrent bacterial infection, such as Mycoplasma. Your cat’s veterinarian will culture the TTW and BAL fluid separately for this.

Some cats with heartworm disease have respiratory disease (feline associated heartworm disease) that cannot be distinguished from asthma, based on clinical signs or radiographs. If you live in an area where heartworm is found in dogs, discuss with your veterinarian the benefits of beginning heartworm preventative medication in your cat or kitten (even if he or she is indoors-only). We’ll talk about heartworm disease in greater detail in an upcoming Cat Chat column.

If your kitty has asthma, the good news is that with proper diagnosis, treatment and some simple at-home environmental control, chances are good that he or she will do well long-term. However, very old homes, which may have increased amounts of dust and molds, as well as brand- new houses or apartments, which can contain many volatile chemicals, may exacerbate feline asthma. A few changes that can be made in the home to help our asthmatic cats include:

(1.) Use HEPA room cleaners and HEPA furnace filters and change the furnace filters regularly.
(2.) Eliminate indoor cigarette smoking, as well as the use of aerosols, such as room deodorants, and discontinue the burning of candles and incense.
(3.) Keep your asthmatic kitty out of rooms that have heavy upholstery, carpeting, bedding, plush toys, etc.
(4) Use Feline Pine cat litter for low dust and all natural alternative to clay litters.

Some asthmatic cats can be weaned down from (and sometimes off of) their medications, depending upon clinical signs and response to treatment. However, some cats with chronic disease need to receive medication several times a week or even daily.

As always, your cat’s veterinarian is your best source of information on dosing of asthma (as well as other) medications. Because abruptly stopping these medications can have life-threatening effects, never decide to stop treatment for asthma without first consulting with your kitty’s doctor.