What's the Best Treatment for Feline Asthma?
photo 2007 Maggie | more info (via: Wylio)
Dr. Barchas, I just read the sad letter from the person whose 3 year old cat was found dead in the litter box. So sad. You said likely it was heart disease, but also mentioned asthma.
My cat is a 10 year old very (very!) mixed breed. She developed asthma when she was about 5 years old. I give her theophyline treats daily. She will have an attack every 5 to 8 weeks without a depo steroid shot.
When she does go into an attack, she gets a shot and it stops them. Is there any better treatment now?
Garden City, SC
Feline asthma unfortunately is a big deal. It is a syndrome in which the air passages in the lungs become irritated and narrowed. Although many cats with the syndrome suffer only intermittent coughing or mild breathing crises, I have seen many others develop severe, life-threatening respiratory distress. For some cats a fatal crisis is the first symptom of asthma. Other cats with long standing, seemingly well controlled asthma may suffer from an acute exacerbation of symptoms.
Bronchodilators such as theophylline are common first line medications in the fight against asthma. Oral or injectable steroids also are used with great frequency.
Steroids are double edged swords. In most cases they significantly reduce the symptoms of asthma. But they often cause side effects, and sometimes the side effects are severe. In particular, cats who repeatedly receive injections of Depo Medrol (which I'm sure is the one your cat has been getting) are prone to diabetes.
Fortunately, there is a newer class of medications that work really well for most cats without causing many side effects. I am referring to inhalable steroids.
Humans with asthma often rely on inhalers as their first line of treatment. Inhalable steroids provide most of the benefits of oral or injectable steroids, but they have much lower rates of side effects.
In particular, a human medication called Flovent seems to work well in most cats. The standard human Flovent inhaler can be fitted to a device (called a spacer -- ask your vet to order one) that adapts it for feline use. Most cats can be habituated to the inhaler with relative ease. And many asthmatic cats will be symptom free with a few puffs of Flovent each week.
I can't guarantee that Flovent will work for your cat, but it's definitely worth trying. If it works, it will be much safer than repeated steroid injections.