Lung Issues (Fibrosis, Cancer, Asthma???)

My cat Pepper is 14 years old and was slowly losing her appetite and losing weight over the course of a year or so (8 lbs down to 6.8 lbs).  I had also noticed her coughing (~1x per day or so for 1-2 minutes) and I always assumed she was trying to cough up a hairball that never produced itself.  More recently I saw a few videos of asthmatic cats and determined that she looked like she was having asthma symptoms when she was coughing and so I decided to take her to the vet alongside the increasing loss of appetite.  Also her resting respiration rate was 45-60 breaths per minute. I took her to the vet, they did bloodwork which was normal and xrays which showed disease throughout her lungs which the vet said looked like infection.  This was the first xrays on February 15th here She was put on an antifungal -  Itrafungol (itraconazole) and an antibiotic - Veraflox (pradofloxacin) for 2 weeks as well as an appetite stimulant.  Appetite improved but coughing and fast respiration did not. Xrays were repeated 2 weeks later on March 1st here: They look similar to the first ones and at this point the vet no longer believes it is infection and had considered a tracheal wash but wanted to reduce some inflammation beforehand and so we started her on albuterol and prednisolone (5mg, 2x per day) for 2 weeks with the prednisolone tapering during week 2 so she could have the potential tracheal wash at some point in the near future. Xrays were repeated 2 weeks later on March 15th Here: Upon reviewing these xrays the vet informs me that it is likely fibrosis or cancer and that I should continue albuterol and prednisolone until she declines and I have to put her down.  She does not feel the tracheal wash is worth it at this point.  The albuterol and prednisolone helped reduce her coughing dramatically and her resting respiration rate is still high but lower than it was (36-42 breaths per minute). Does anyone see anything on these xrays that could indicate anything I should be doing differently or alternative diagnoses that haven’t been addressed?  Could this just be asthma?

Hello!  It sounds as if your vet is not getting enough information from the radiographs to reach a diagnosis and would like to treat symptomatically (according to the symptoms), where as you would really like a diagnosis based on definite facts.  I would not be confident answering your question from these radiographs and nor am I placed to; however, you (by which I really mean your vet on your behalf) could send the pictures of the patient's lungs to a medical specialist and ask for a second opinion as to how they would take this case forward, or could carry on treating the symptoms.   As a vet, I have always loved it when owners have opted for referral with difficult cases (eg for lavage if appropriate); this way, if there is anything else that could be done I would learn from it.  Meanwhile the main concern is the welfare of your cat.   In your position, I would advise talking your desire for more diagnostics and possible referral through with your vets.  Please will you let us know what happens next?

Thanks for the feedback.  Yes, my vet basically has come to the conclusion that maybe it is fibrosis, cancer, asthma, etc, and the treatments are essentially the same for how widespread it is in the lungs.  While I do not want a definitive diagnosis just to put a label on it (if the treatments are all in fact the same whether it's cancer, fibrosis, or asthma then it really makes no difference to me which one it is).  But if there is something being missed I certainly would like to keep going with diagnostics and address it. I completely agree with your feedback and I think my next step will be a consult with a specialist to review the current info and what the next steps could be.  I will follow up.

If this is aligns with your cats welfare needs, it sounds like a reasonable plan.   Please do let us know how things so.

If this is aligns with your cats welfare needs, it sounds like a reasonable plan.   Please do let us know how things so.

If this is aligns with your cats welfare needs, it sounds like a reasonable plan.   Please do let us know how things so.