I have a 6-month-old male kitten. His mother was killed, and we have had him since he was 4 weeks old. He was found in a shed. He has had a cough since we got him, although now it has gotten worse.

My vet has done a blood panel and a tracheal wash. We then did a culture on the wash, which said he had bacterial lung infection. My vet said it was Actinobacter, a drug-resistant bacteria.

The kitten has been on Clavamox, Zeniquin, Convenia, and now doxycycline. He is still coughing, a little more now. Could it be asthma-related? It seems like an asthma cough, and he did have doughnut marks on his X-rays. It is getting frustrating, because he is suffering with this cough.

Thanks, Jan
Washington State

I am impressed that your vet did a tracheal wash. This procedure involves infusing sterile saline solution into the windpipe (usually through a sterile breathing tube) and then withdrawing it. The solution harvests bacteria and cells from the respiratory tract. It is not done often, but it is a good way to diagnose infections in the lungs. It also is a good way to diagnose asthma, if the proper tests are run.

Did your vet also request cytology from the lab? Culturing involves placing a sample of the fluid onto a growth medium to see whether bacterial colonies develop. Cytology involves centrifuging the sample and then looking at cells that were harvested from the lungs. If cytology was not requested, asthma could have been missed.

I strongly suspect that asthma is playing a role in your cat’s symptoms for several reasons. First, drug-resistant bacteria are human creations. They develop in hospitals and in individuals where antibiotics have been used excessively. Although your cat counts as an individual in whom antibiotics have been used excessively, he was not swhen the problems started. Simply put, kittens that are found in sheds tend to be infected with opportunistic pathogens — the type of bacteria that are susceptible, not resistant, to most antibiotics.

And goodness knows your kitten has been on antibiotics. In fact, your list includes just about all of the most advanced ones known to veterinary medicine, which would kill all but the most dangerous of bacteria (known as superbugs). If your kitten were suffering from pneumonia involving the most dangerous of bacteria, he should be much sicker by now.

But instead of getting better (which should have happened if the kitten were infected with a common opportunistic pathogen) or worse (which should happen with a superbug), your kitten is still plugging along with the same symptoms. This implies that neither is involved. In fact, it implies that no bacteria is involved in the symptoms.

It sounds to me like your kitten has asthma. You should consider another set of X-rays, and either another tracheal wash (with cytology as well as culture) or presumptive treatment for asthma with bronchodilators (avoid steroids, which can exacerbate infections, until this is all finally sorted out). I do not recommend any more antibiotics at this time — that would be a recipe for superbug creation.