Treatment In-depth Many cats with asthma are too sick to undergo such testing and need to be treated medically first, based on examination or examination and chest X-rays. Treatments for feline asthma vary. If your cat has only mild clinical signs, no treatment may be recommended. In this case, a regular follow-up is important to follow progression of disease. In the case of acute respiratory distress, hospitalization is needed initially. Drugs may be administered orally, by injection or by
metered dose inhaler (MDI) depending on the needs of the patient.
Recommendations for an acute asthma attack may include:
Minimal handling if distressed. The patient should be stabilized first before instituting diagnostics such as the chest radiograph or laboratory work. Treatment is essentially aimed toward treating the symptoms until the patient can be stabilized.
Oxygen cage or cool well-ventilated, quiet area.
Bronchodilators may be used to relax the airway smooth muscle contraction. Aminophylline, theophylline (Theo-Dur), albuterol, or terbutaline may be most effective drugs since they work faster than steroids. Bronchodilator therapy is often used orally for chronic therapy and by inhaler (MDI) for "rescue" therapy.
Steroids such as dexamethasone sodium phosphate (Azium SP®) or prednisone sodium succinate to reduce inflammation in the acute phase.
Steroid therapy is the most effective long-term treatment for asthma. Oral prednisone or prednisolone is recommended when there is no evidence of pneumonia. In some cats, long acting injectable corticosteroids work better; however, there is also greater risk of side effects.
Epinephrine (Adrenaline) may be given if airway obstruction is life threatening or if there is a poor response to above treatments.
Antibiotics may be indicated if there is evidence of an infectious component. Antibiotics are not routinely indicated in asthma, however, and do not relieve asthma symptoms.
Panacur deworming is recommended in cats that might be exposed to lungworms. Routine deworming is recommended on a regular basis.
Cyproheptadine (Periactin®) is an antihistamine that shown positive effects in some asthmatic cats. Indications include cats that are unresponsive to maximal doses of steroids and bronchodilators. Cyproheptadine comes in pill and liquid forms.
Cyclosporine is used in some cats that are unresponsive to traditional treatments. If used, drug blood monitoring is recommended.
Anti-Interleukin-5 is an experimental treatment for asthma that is not yet available.
Heavy sedation, intubation and ventilation are required in cats suffering from impending respiratory arrest.
Cyproheptadine is used in some cats to help alleviate airway hypersensitivity. It can work in a small percentage of cats.
Prognosis
The prognosis for cats with feline asthma is dependent on the severity of the disease. Mildly affected cats have a very good prognosis and live a normal life with minimal intervention. Cats with severe disease may have frequent attacks that require periodic hospitalization and injectable or inhalation therapy at home. In severe cases, airway inflammation can damage the lungs causing a poor prognosis.
