Persistent coughing is a tell-tale sign of feline asthma, but despite one in eight cats having asthma, but it’s often overlooked as veterinarians rule out more serious diseases.

We found out the hard way as Little Yellow has finally diagnosed with asthma. It was misdiagnosed, as we will talk about more in a post detailing our journey through the medical maze. Today, we want to explain what the disease is.

General symptoms of feline asthma include:

• Coughing and wheezing
• Persistent cough
• Squatting with shoulders hunched, neck extended and rapid breathing or gasping for breath
• Gagging up foamy mucus
• Open mouth breathing
• Blue lips and gums
• Labored breath after exertion
• Overall weakness and lethargy

When an asthma attack occurs, the passageways in the lungs thicken and constrict, making it very difficult for the cat to breathe. As Paws reflects, we do believe that fateful day of June 13, 2013. Little Yellow was having a full-blown asthma attack. At only 5 years old, he was too young to have these health issues.

Persistent coughing is a tell-tale sign of feline asthma

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 even sneezing. The cat may or may not expel foamy mucous. Open mouth breathing or panting not associated with exercise in the cat is a sign of severe respiratory distress.

Asthma in cats usually develops between the ages of two and eight years old, but it can develop earlier or much later. As there are no specific tests to diagnose asthma, X-rays, ultra sound, blood work, evaluation of bronchial secretions and parasite tests typically are performed to rule out other diseases. This is important because the symptoms can mimic those of heartworm, lung worm, a parasite that can live in the feline bronchi and cause asthmatic symptoms; pneumonia, congestive heart failure, or heart disease.

Dust, pollen & other allergens trigger asthma attack

Factors contributing to increased severity of an asthma attack include:

• Allergens, including pollen, mold, dust from cat litter, cigarette smoke, perfume and certain foods
• Pre-existing heart conditions or illnesses
• Parasites
• Extreme stress
• Obesity

Paws wasn’t surprised to find stress on this list, because we have often surmised Little Yellow follows his human’s emotions. We also found Little Yellow is very allergic to dryer sheets and they went packing out the door. Right now, we are experimenting with different cat litters that could be triggers. We also wonder if the congenital diaphragmatic hernia could be putting pressure on his heart and lungs. With the hernia, the stomach, liver and intestines can move into an abnormal opening in the animal’s diaphragm, the sheet of muscle separating the abdomen from the rib cage area. Other symptoms that initially appear to be caused by a diaphragmatic hernia include a gathering of excess fluid in the space around the lungs or abnormally fast breathing due to other causes. This could be putting pressure on his lungs, mimicking asthma or causing the symptoms to get worse.

Stress can make feline asthma worse

As many as 800,000 cats, one percent of the nation’s domestic feline population, have acute or chronic asthma. Although the most commonly diagnosed respiratory disorder in cats is incurable, Ongoing research is giving veterinarians a better understanding of its causes, and there has been a lot of work at developing effective treatments.

According to research at Cornell University’s College of Veterinary Medicine, asthma attacks can be categorized as:

1. Mild – symptoms occur intermittently — but not daily — and they do not interfere with the cat’s lifestyle;
2. Moderate – the symptoms do not occur daily, but when they do, they are more severe and debilitating, and they interfere with the cat’s activities;
3. Severe – significantly debilitating symptoms occur daily; and
4. Life-threatening – bronchial constriction results in potentially lethal dyspnea and consequent oxygen deprivation, which causes normally pink tissues, such as the lips and nose, to turn blue.

It’s hard to say where Little Yellow falls on this scale. When he’s coughing, it is interfering with his lifestyle; however, he still wrestles and plays, though he gets winded quite easily.

Treatments are evolving

Corticosteroids and bronchodilators have emerged as the most effective agents in the treatment of feline asthma; however, research is finding there can be backhanded adverse effect with administering these drugs long-term in tablet form or by injection. Frequent and extended corticosteroid therapy in cats is associated with an elevated risk of pancreatitis, diabetes and other conditions. And both corticosteroids and bronchodilators pills and injections are inefficient, since they circulate systemically rather than targeting the specific respiratory system tissues involved in asthma.

Little Yellow went off the corticosteroids last fall, and began taking Flovent. Now that the 100 mg Theophylline has been discontinued, he will soon be using albuterol as an inhalant.

In recent years, veterinarians are recommending the administration of corticosteroid drugs such as fluticasone proprionate (Flovent©) and bronchodilators such as albuterol (Proventil©, Ventolin©) as inhalants, either daily or as needed. The drugs are contained in little chambers called “spacers,” e which fit into a mask that is placed over an asthmatic cat’s face for 10 to 15 seconds long enough,” he says, “for the cat to take a few breaths and inhale a puff or two of the drug. The advantage of the inhaler is that a higher level of the drug gets to the lungs. That’s exactly what my veterinarian told me last September when we moved Little Yellow off the corticosteroids.

Giving inhalers through Aerokat

The inhalants are given through a special mask and spacer system called Aerokat, a special ‘spacer’ designed for the delivery of inhalational drugs to cats. One end of the Aerokat spacer is specially made to allow a human metered-dose inhaler (MDI) to fit and deliver a dose of medication into the chamber (spacer).

There’s a face mask is attached at the other end with a valve that allows the cat to breath in the medication from the chamber. One to two puffs (according to your vet’s instructions) of the MDI are administered into the chamber. The face mask is held gently over the cat’s face so kitty can breath in the medication for typically 10-15 seconds. This is usually performed twice daily. Most cats tolerate the procedure very well and with a little practice it is said to be much easier than administering tablets. Paws isn’t so sure that’s the case.

Cats may need to adapt slowly to the inhaler. To familiarize your cat with the apparatus, position the mask portion over the nose for two seconds, without giving any medication, and then give the cat a treat. Repeat this until your cat is comfortable with the mask. At that point, you can try spraying the medication into the inhaler while the mask is placed on the cat.

What we’ve learned about feline asthma

• Terbutaline (Brethine®) is one of this bronchodialator class of medications that veterinarians often utilize for cats in respiratory crisis. It can be given to your cat orally or by injection. Another is albuterol (aka Salbutamol, = Proventil®, Ventolin®). Albuterol can be given as a inhalant, as it is in humans for which it was designed. Its effect is more rapid than terbutaline.
• Theophylline, which Little Yellow has been taking, is not a β2-Receptor Agonist. It belongs in a group of medications called methylxanthines. These compounds also enlarge air passages within the cat’s lungs. Vets have gotten away from using theophylline because it is not as effective as terbutaline or albuterol and many feel that it has the potential to cause more adverse side effects than the first two medications. Aminophylline, which is less potent and shorter-acting than theophylline, has the same drawbacks. Both are oral preparations – although they are effective in suppository form as well.

Tune yourself into any changes

The bottom line is to study your cat. Tune yourself into any changes in his breathing patterns. Make you give medications as prescribed, even though you may gulp hard at the cost. And be sure to have regular veterinarian check-ups and emergency care if necessary. Learn about the disease so you can know what to do and when to do it.

If you think your cat has asthma or any other health issues, schedule a visit with your veterinarian immediately. The contents of this blog post are for informational purposes only, and should not be used in place of professional advise from your veterinarian.

Have you ever had a cat with persistent coughing? Have you every had a cat that has been diagnosed with asthma? Do you think your veterinarian may have glossed over feline asthma, thinking it could be something else? Please weigh in on this discussion and share your thoughts.