Asthma is a common disease of the lungs, affecting many species of animal including humans and cats. In cats it causes bouts of coughing, wheezing. And in more severe cases, episodes of difficulty breathing, commonly termed an “asthma attack”. It is a disease that is more common in certain breeds of cats such as Siamese and Burmese, and usually starts when they are relatively young. Unfortunately, treatment is usually required life-long.

How do I know if my cat has asthma?

Your vet may suspect your cat is asthmatic if they have been showing a combination of clinical signs. On examination, they may notice that your cat is finding it harder to breathe and hear wheezing when listening to their chest. Tests are usually needed to confirm the diagnosis; often an x-ray and sometimes blood tests, examination of the lungs (using a long camera bronchoscope) or taking samples of fluid from the lungs.  

How is it managed?

Asthma causes inflammation of the airways and spasms of the muscles in the airway walls. This can be triggered by many things including infections, allergies and cold air. Having asthma makes it harder for your pet to move air in and out of their lungs, and causes the signs described. Once the diagnosis of asthma is confirmed your vet will usually prescribe medications. This may include steroids to reduce the inflammation, antibiotics to clear any associated infections, and bronchodilators to open up the airways. The basic principles of treating asthma are similar to human medicine. It seems logical therefore to consider using the same sorts of inhalers that we would use.

Initially, asthma medications in our pets will usually be given either by injection or by tablet. 

There are pros and cons to this approach. While tablets are in theory an effective way of delivering medication, getting them into your reluctant pet may prove more of a challenge. Steroid medication is often needed long term and in tablet or injectable form. This means the whole body gets a dose of steroid, increasing the likelihood of side effects such as weight gain, increased risk of infections and diabetes. Inhalers were introduced into human medicine in the 1950s as a way to try and target treatment more effectively. The lungs could receive the steroids they needed while the rest of the body was spared the adverse effects.

Inhalers can also work very well for our feline asthma patients

However, most cats will require a period of gradual introduction and training. It is important that your pet is taught positive associations with the treatment in order to help them accept it. Usually steroid inhalers are the first type of inhaler that is introduced. The use of inhalers in animals requires a specially designed “spacer” device. This is basically a chamber with a mask at one end and a fitting for the inhaler at the other. Human asthmatics have to time their breath with the activation of the inhaler, which would be pretty tricky to teach our pets.  The spacer means that the inhaler can be dosed into a holding chamber. Then your pet can gradually inhale the medication over a few normal breaths.

The first challenge is getting your cat used to the mask and chamber. 

There are lots of great online videos (see below) demonstrating how to do this. It is important that the spacer is designed to be cat specific; in order that it fits well over their face and creates a tight seal. The first step in training is providing positive associations with the chamber and mask by allowing them to examine, sniff and explore the devices in their own time. They should be frequently rewarded with treats and fuss as they investigate. This method can also be used to get them accustomed to the “hiss” of the inhaler being activated. 

Next the cat needs to tolerate putting their head into the mask. This can be achieved by placing treats or tasty paste inside initially wide, shallow containers, working to smaller ones and eventually the mask itself. It is important that each stage is taken slowly at the cat’s pace. And that they are rewarded frequently and never forced. This process may take several weeks. It is important that you liaise with your vet about continuing oral treatment until your pet can be reliably medicated with the inhaler. 

Moving from tablets to inhaler treatment

Once they are happily accepting the steroid inhaler your vet will usually recommend a slow reduction in their oral steroid dose, with the aim of weaning them off completely. Your vet may also recommend the use of a bronchodilator or “reliever “inhaler. This is an inhaler that can be used if your pet has a flare up of their signs, in order to open up their airways. It is very important that they are familiar with and tolerate the spacer and inhalers before this is introduced. Trying to place a mask over a cat’s face while they are struggling to breathe can make matters worse if they are not used to it.

With time, patience and lots of bribery most cats can be taught to use inhalers to treat their asthma.  If you currently have an asthmatic cat, then chat to your vet about whether this may be a good option for them and how to get started.

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