Simone and Feline Asthma
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Just as in people, feline asthma (also known as feline allergic bronchitis) is becoming more common. This case report follows the step-by-step diagnosis and treatment of an asthmatic cat named Simone.
Feline asthma, also known as allergic bronchitis, is an allergy-triggered inflammatory disease of the airways. Think of it as an allergic reaction of the lungs to normal environmental factors. |
What causes feline asthma?
Just as in people, feline asthma requires a combination of a sensitive individual being exposed to an irritating substance that their body has decided is sufficient to cause an allergic reaction. When an asthmatic cat is exposed to an allergen trigger, the airways become thickened and inflamed resulting in a narrowing of the airways, thereby making it hard to breathe. The most common triggers of feline asthma include smoke (cigarette especially), perfumes, and dust (such as from litter).
What are the symptoms?
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The most common symptom of feline asthma is coughing. Cats cough because they are trying to clear the mucous and other inflammatory gunk that has filled their airways. In addition to coughing, some owners can hear a wheezing noise when their cat breaths in and out. The wheezing is because air is no longer going smoothly through the small bronchioles (small parts of the lungs) during the respiratory cycle.
In cases of acute asthma attacks, a cat may be in severe respiratory distress because they cannot get enough oxygen. This constitutes a life threatening medical emergency. In Simone's case, her primary symptom was coughing (as shown in the video clip). Coughing cats look very similar to cats trying to vomit. In fact, one of the most common history complaints I hear is owners describing their cats “trying to bring up a hairball but nothing ever comes up”. |
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What workup was done to confirm a diagnosis of asthma?
History and physical exam, particularly listening to the lungs with a stethoscope (lung auscultation) can be very suggestive of feline asthma. Tests to definitively diagnose this disease include:
- Chest x-rays: Standard in any coughing cat as this helps to evaluate lung structures, gauge severity of disease, and look at heart structures.
- Lung cytology: This test is done in an anesthetized cat where a small amount of sterile fluid is placed in the lungs and then flushed back. The collected fluid is then analyzed for the types of cells present and to help rule out fungal, bacterial and viral infection. As asthma is an allergic disease, the cell type we are looking for is called an eosinophil. Eosinophils are one type of white cell (immune cell) responsible for allergic disease.
- To rule out any other diseases that may interfere with treatment and/or gather supportive evidence of allergic disease
- To ensure that a patient is safe for long-term medicatio
What other diseases can mimic feline asthma?
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The reasons for chest x-rays, blood work, and lung cytology is because other diseases can mimic the symptoms of asthma in cats. These include:
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How can we treat Simone?
When Simone was first diagnosed with asthma, the goal was to get the inflammation under control quickly. As her blood work did not show any other diseases being present, she was a good candidate for systemic steroids. Steroids (such as prednisolone) suppress the immune system, which is required to control this immune-driven inflammatory disease. After several weeks of systemic steroids, Simone was transitioned onto an inhaler where she receives daily puffs of locally acting steroid (Flovent). Because we use human inhalers, Simone has a special chamber and mask that fits over her head so the drug can be administered. In some cases, the puffers are not strong enough to control the asthma symptoms so they stay on long-term oral medication.
Special thanks to Simone’s “parents” for allowing us to present her as a "case of the month" and providing us with her lovely photo and video clip of her coughing.
Special thanks to Simone’s “parents” for allowing us to present her as a "case of the month" and providing us with her lovely photo and video clip of her coughing.
