A Breath of Fresh Air: Modern Treatment Options for Feline Asthma

Photo Credit: by neuro, flickr.com

When it comes to asthma, cats take after their human guardians with regards to this allergic, airway disease. But unlike people, the traditional treatment for feline asthma is injectable steroids or tablets. Systemic steroids work for a cat with asthma, but there’s a downside, which is the risk of side effects. However, vets are learning from their human colleagues and can now treat feline asthma with inhaled steroids (such as the Flovent inhaler.)

This article aims to give concerned cat guardians an over view of the pros and cons of injectable steroids versus inhalers.

Understanding Feline Asthma

To choose the treatment that works best for an individual patient, it helps to understand what happens to the lungs of a cat with asthma.

In a healthy lung air passes along narrow branching tubes (bronchi and bronchioles) where oxygen eventually passes across the airway lining and into the bloodstream. In a cat with asthma the tubes spasm and narrow, the lining becomes inflamed, and the lumen fills with mucus. This makes it difficult for the lungs to fill and hard for oxygen to get into the bloodstream. The result is the cat struggles to breathe.

The signs (struggling to breathe) of asthma are general, and any cat with breathing difficulties should see a vet urgently.

Signs of a Cat with Asthma

Be on the lookout for any of the signs below and contact a vet urgently.

• Breathing through an open mouth

• An extended head and neck

• Exaggerated breathing movements of the chest and belly

• Neck extended, head low to the ground, elbows held away from the body

• Blue lips or gums

• Audible breathing noises, such as wheezing

• Rapid breathing, even at rest

• Coughing

Steroids are a potent anti-inflammatory prescription medication. For a cat with asthma, opening up the airways can be life-saving. However, the short term benefits (which can be the difference between life and death) have the potential for long term complications.

Steroid Injections or Tablets: The Pros & Cons

Let’s be straight. This article is NOT advising against the use of steroid injections or tablets. For many cats these represent their best chance of leading a long and happy, wheeze-free life. However, which therapy to choose should be an informed decision, which means understanding both the benefits and the drawbacks of each treatment choice, to decide on the best fit for that individual.

The Pros

Three big ticks for steroids because they are:

• Effective

• Cheap

• Easy to administer (vet can give by injection)

Indeed, a depot form of steroid can last roughly a month, meaning the cat guardian can chill between doses and not worry about medicating their pet. And let’s face it, not all cats are great at taking tablets, so a jab in the butt by the vet is easy street.

Many owners learn to manage their cat with asthma, by getting the injection when their cat shows mild symptoms. This stretches out the gap between treatments and gives the cat’s body a ‘steroid holiday’. (Note, this is not possible for severe cases.)

The Cons

The downside of steroids are the side effects. Happily, cats are more resistant to complications than other species, but the risk is still there. These include:

• Weight gain due to a stimulated appetite

• Increased thirst

• Increased risk of developing diabetes mellitus (sugar diabetes)

• A theoretical risk of developing Cushing’s Disease (a rare condition in cats)

• Cats can be difficult to pill

Steroids stimulate the appetite and weight gain is common, and should be taken seriously. Carrying extra weight places a strain on joints, increases the risk of urinary tract disease, and also obesity is a recognized risk factor for diabetes.

Steroids also change how the body reacts to insulin, the hormone which controls blood sugar levels. Prolonged use of high doses of steroid can give a cat that’s erring toward being diabetic, a helping paw over the finish line. Signs to watch out for include:

• Weight loss despite a good appetite

• Excessive thirst (be aware a cat taking steroids may drink more anyway.)

Making steroid safer

Tips that make steroid use safer include:

Medicate with tablets rather than long acting injections

Once the injection is in the system, it can’t be taken out. For a depot steroid injection that works for several weeks, if a problem such as diabetes occurs the injection can’t be reversed. However, a cat taking steroid tablets can be weaned off (under the direction of their vet) the medication so this complicating factor is removed.

Aim for alternate day dosing

Giving the oral medication every-other-day gives the body a break from the negative effect steroid has on naturally produced hormones in the body. This alternate-day-dosing can often be achieved in stable cats, under the direction of their veterinarian.

Use short-acting injections

For cats that are impossible to pill and suffer from asthma only intermittently, the vet may suggest short acting steroid injections as required. These alleviate the immediate crisis, whilst avoiding steroid hanging around in the system for weeks.

Use steroid inhalers

Human asthmatics use inhalers to treat asthma. The idea is the anti-inflammatory drug is delivered directly into the lungs for maximum effect. This also means the surface of the lungs receives the treatment, rather than the blunderbuss effect of treating the whole body.

To understand inhalers better, let’s look at them in more detail.

Inhalers for Cats: The Pros and Cons

Just as people use inhalers, with a little know-how and encouragement so can cats.

The pros and cons of inhalers for cats

The advantages of training a cat with asthma to use an inhaler include:

• The medication is delivered where it’s needed (the lungs), and avoids medicating the whole body

• The risk of side effects is much lower

• Different inhalers have different properties, which offers a way to fine tune the cat’s asthma management to prevent flare ups

Examples of inhalers include:

• Salbutamol

• Fluticasone

• Beclomethasone

The disadvantages include:

• It requires the purchase of a special ‘chamber’ such as the Aerokat, to deliver the inhaled medication. These chambers can be pricey

• The actual nebuliser inhalers can be expense (which is where Canadian Pharmacy World can help make treatment affordable.)

• Not all cats tolerate using an inhaler

• Dosages may be twice a day, which means the owner needs to be home to give them

Why a spacer-chamber?

A spacer chamber designed for cats has a cat-friendly face mask on one end, and the nebulizer attaches at the other. The medication is ‘puffed’ into the chamber for the cat to breathe in and deliver to their lungs. This method overcomes the need for the cat to breathe in deeply at the exact moment the puff is dispensed.

This clever system is great but it depends on the cat accepting a face mask being placed over their mouth and nose. This can often be overcome with patience and encouragement. But for some more highly strung cats, this is an indignity too far and they never get used to the idea…so back to the drawing board with injectable steroids or tablets.

Injectable Steroids vs Inhaler

There’s no absolute right or wrong when it comes to treating a cat with asthma. Most important is the cat receives an effective treatment for this potentially life-threatening condition. Depending on the cat’s temperament, owner finances, and their guardian’s schedule, the answer may be steroids by injection, inhalation, or as tablets.

Whilst inhalers are great, they are more expensive and require a co-operative cat. Alternatively, steroid tablets, especially if given every other day offer a cheap and effective low risk option. For the naughty cat that can spot a pill from the next room, then injections may have to be the way ahead. The important thing is to weigh up what’s best for that individual and ensure they get the help they need to breathe easy.

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Dr Pippa is a veterinarian with over three decades of experience working in companion animal practice. She loves working with owners to give their animals the best possible health and quality of life. In addition to work in clinical practice and as a shelter veterinarian for the Cats Protection, Dr Pippa is a developmental editor for veterinary textbooks and a freelance veterinary copywriter with her work widely published in print and online. Dr Pippa is an advocate of Fear Free Practice. Twitter: @PetvetP