Chronic high RR

Hi vets. Looking for advice. Alanza is a 4 year old, spayed kitty. Short story: she has high RR since Feb. Treated with antibiotics, steroids and asthma meds. No improvements. Did lung wash with cultures and fungal culture. All negative. Lung x-rays look a little worse each time we retake x-rays. She never responded to any meds. Now when we medicated her with Transdermal pred and inhaler, she turns purple so I've stopped meds. She eats and drinks fine, playful. WAY more affectinate than normal. Is there any new suggestions we can try? Any tests? She's just so young and I don't want this to cause her to pass. I have 5 other pets and none have respiratory issues. Most recent pic of her lungs hing.

Hello!   What an interesting question.  I have been an Internet vet for a while now and this questions comes up a lot:  'My pet has (X condition - in this case, breathing quickly).  How shall I treat it?' And of course, the answer is nearly always the same:   'it depends.'  Most people think that we, as vets, see a change in the body and get a diagnosis from that change, but it never works this way.  Any change, from fast breathing to coughing to drinking a lot to limping, has not one, but multiple - sometimes many multiple - possible explanations, all of which will have different treatments to ease the change.  Fast breathing, for example, can be caused by an acid/base imbalance in the blood, by pain, by heart disease, by lung disease, by parasites, by... literally hundreds of different internal scenarios.   Taking a radiograph can narrow it down to some extent - if the chest contains the intestines and the liver, for example, a hernia can be ruled in immediately.  If the lungs are speckled, there could be a variety of explanations from parasites to fluid to cancers to infections and so on.  By this time the vet would ideally have a picture from two directions (side to side and top to bottom - although sometimes, if done conscious for example, the cat might not lie still for both views) and could no doubt conclude the short-list of things that may be wrong.

Even then, however, one certain lung pattern might well have more than one explanation, and the vet would look at the history of the case, the current state of the patient, the signalment (things like age and breed) and lifestyle, as well as the sounds of the lungs and the pictures taken, to decide which conditions would be most likely and how to continue to narrow down the possibilities.  Sometimes, the clinical picture at that stage is enough to give a likely diagnosis;  sometimes not.

I am a vet, but will never give a better explanation of a case based on one picture, than the vet who has examined the animal, heard the breathing, recorded the response of the breathing to any early treatment, seen both of the two x-ray views and so on.  It would be insulting - and indeed, poor professional ethics and potentially detrimental to the outcome of the case - to offer one.   Your vet should be in a better place to talk to you at this point, so we would strongly advise approaching them.  Good questions might include:  What was on the differentials list before the radiograph was taken?  What did the radiograph rule out?  Does it rule anything in?  What do you recommend that we do next a) to chase down a narrower diagnosis, unless you are satisfied?  and b) to support the patient at this stage?    By speaking with your vets, you will usually get a good, appropriate  answer.  Alternatively, if for some reason your vet isn't sure, 'Do you think it's worth getting a second opinion at this point?' is usually an excellent question.  However, second opinions should come from someone with a greater knowledge of the subject than the first vet, in order to be helpful.  This service may be performed in person and on-line, and should always involve the vet, who can thereby give a full clinical history.  This is sadly beyond the scope of this site and hopefully, you can see that it would be unethical.   I hope that this has explained more about the diagnostic process, although not the answer that you sought.  Good luck with getting to the bottom of your cats' breathing issues and please do let us know how things progress from here.

Ps  Alanza.  I'm sorry - I forgot how  to spell her name towards the end of that post and had to press 'send' and then look back and check.  It's a beautiful name and we wish yourself Alanza all the best from here.