Chronic Coughing in Cats
Overview of Chronic Coughing in Cats
Coughing is a common protective reflex that clears secretions or foreign matter from the throat (pharynx), voice box (larynx), windpipe (trachea) or airways, and protects a cat’s lungs against aspiration. It affects the respiratory system by hindering the ability to breathe properly.
Below is an overview of Chronic Coughing in Cats followed by in-depth information about the causes and diagnostic tests to determine the underlying cause of this condition.
What to Watch For
Watch for a chronic cough, or one that lasts for more than two or three weeks. It can begin suddenly or develop gradually. An occasional, infrequent cough is normal in cats. See your veterinarian if your cat has a chronic cough.
Diagnosis of Chronic Coughing in Cats
Veterinary care should include diagnostic tests to determine the underlying cause of the cough. These may include:
- A complete medical history and physical examination
- Chest radiographs (X-rays)
- A complete blood count (CBC)
- Blood tests to help determine the cause and identify any related problems
- Heartworm test
Additional diagnostic tests may include:
- Specialized tests such as ultrasound examinations or bronchoscopy to examine the inside of the lungs using a small scope
- Lung fluid samples to determine presence of infection or inflammation
Treatment of Chronic Coughing in Cats
Successful treatment depends on accurate diagnosis.
Home care recommendations depend upon the underlying cause of the problem. There are several things you can do to help your pet:
- Minimize exercise and stress until the cause of problem is determined.
- Allow your pet to rest in a well-ventilated environment.
- Provide plenty of fresh water.
- Provide soft (canned) food, which is easier for pets with a coughing problem to tolerate.
- DO NOT administer human, over-the-counter medicines such as Robitussin, aspirin, Tylenol or ibuprofen, which can be extremely toxic (even in small doses) to cats. Talk to your veterinarian first before trying any of these remedies.
- Give medications prescribed by your veterinarian as directed.
In-depth information on Chronic Coughing in Cats
Coughing is a symptom of many different diseases or conditions. These diseases can be differentiated by various diagnostic tests. Diseases that cause coughing include:
- Sinusitis, which is sinus inflammation usually occurring after infection, or rhinitis, inflammation of the mucus membrane of the nose, with postnasal drainage
- Pharyngeal (throat) or tonsil inflammation
- Upper airway obstruction with mucous, food or fluid
- Redundant (elongated) soft palate
- Pharyngeal polyp, which is a mass or growth protruding from the back of the throat
- Laryngeal disease, disease of the larynx or voice box which is the entrance into the windpipe
- Respiratory or breathing problems
- Tracheal collapse or obstruction – the trachea is the air passage from the larynx to the main bronchi or the windpipe
- Mediastinal mass, which is a mass in the space between the right and left halves of the lung, with compression of the trachea
- Esophageal diseases leading to inhalation of food from the esophagus (the tube extending from the mouth to the stomach) or dilatation (stretching) of the esophagus causing compression of the trachea
- Hilar lymphadenopathy, which is a disease of the lymph nodes, usually tumor or fungal, that may result in enlargement of the node and compression of adjacent bronchi within the lungs
- Parasitic infection such as Osleri, which is a type of nematode or parasite
- Tracheitis or infection or inflammation of the trachea
- Tumor of the trachea or bronchus
- Left atrial enlargement, which is enlargement of the left atrium, or entrance chamber, of the heart, leading to bronchial compression
- Collapse of a major bronchus
- Bronchial obstruction, irritation or inflammation due to bronchitis (inflammation of one or more of the bronchi)
- Lungworms (Filaroides) or migrating nematodes, usually occurring in young animals
- Environmental irritants
- Bronchiectasis, which is stretching and infection of the bronchi as a result of chronic bronchitis
- Bronchial foreign body
- Pulmonary edema (fluid accumulation in the lungs) secondary to heart failure or other causes
- Heartworm disease (Dirofilariasis)
- Infectious or aspiration pneumonia caused by inhalation of matter into the lungs
- Pulmonary granuloma, a tumor-like mass or nodule in the lung
- Immunologic disease of the lung, including “allergic” pneumonitis, or inflammation of lung tissue, caused by allergie, and pulmonary infiltrates of eosinophils, a type of cell in the blood
- Pulmonary neoplasm, a tumor of the lung
- Pulmonary emboli, blood clots in the lungs
- A complete history and physical examination
- Chest radiographs (X-rays) with several views: with your cat on his back (dorsoventral) and on his side (lateral). These help to evaluate the heart, blood vessels, lungs, pleural space, or space between the lung and the body wall, diaphragm and mediastinum, which is the area between the left and right lungs.
Radiographs are taken during both inhalation and exhalation to evaluate the airways and lungs. Fluid around the lungs (pleural effusion), lung tumors (neoplasia), or heart failure may be identified.
- Complete blood count (CBC), heartworm test and serum biochemistry tests
- Fluoroscopy (moving X-ray) or tracheoscopy, which uses a scope inserted into the trachea or windpipe to produce an image, to document airway collapse
- Removal of a fluid sample from the chest cavity in cats with pleural fluid. This is called a diagnostic thoracentesis. The fluid is evaluated for cells, bacteria, protein and other constituents and is often sent to a clinical pathologist for analysis.
Additional diagnostic tests may be recommended depending on earlier test results and/or lack of response to initial treatments. Recommendations may include:
- Ultrasonography. This is an imaging technique in which deep structures of the body are visualized by recording echoes or reflections of ultrasonic waves. It is performed on the thorax (chest) when heart disease, pericardial effusion (fluid within the sac around the heart), heart-base or mediastinal tumor, hernia or large pleural effusion is suspected.
- Serology. This is a blood test of antigen-antibody reactions for toxoplasmosis (a parasitic disease), systemic mycoses (fungus infections) and other infectious agents.
- Cytology and culture of respiratory fluid is often done to determine cell type and bacteria present. The exact method depends on clinical condition, breed, clinician experience, availability of equipment and the nature of abnormalities on the chest X-ray. You should discuss the relative risks and benefits of each procedure with your veterinarian.
- Tracheal aspiration may be done to obtain a sample of tracheobronchial secretions. The procedure may be done under a local anesthetic or a general anesthetic (asleep). When a local anesthetic is used a needle is inserted through the skin and into the trachea. During general anesthesia a sterile catheter is placed through a sterile, endotracheal tube. Fluid is then obtained.
- Bronchoscopy. A scope is used to enter the bronchi to obtain a biopsy and to obtain samples for cell culture and cytology (complete cell study). It provides clear visualization of the trachea and smaller airways.
- A fine-needle aspirate (FNA) of the lung is an alternative for assessing the patient with multiple, diffuse (not localized) or very dense lung disease.
- Endoscopy. This provides direct visualization of the upper airways, trachea and bronchi using a scope, and is indicated in cases of unexplained airway obstruction or inflammation. Rigid or fiberoptic (coated with flexible glass) endoscopes with brushes and biopsy instruments are used. Following visual inspection, fluid may be flushed into the airway and retrieved for analysis.
- Biopsy. Removal of cell or tissue sample of the lung for examination, usually microscopically
- Surgery to remove portions of the lung that contain tumors, infection, or foreign material
- Direct fecal smears or special sedimentation methods (Baermann) along with fecal flotation to screen for lungworms if X-rays suggest lungworm infection (Paragonimiasis).
- Fluoroscopy or tracheoscopy to demonstrate dynamic collapse of a major airway when it cannot be shown by routine X-rays
- When the eye, skin or lymph nodes (glands) are abnormal in a cat with chronic cough, specialized tests may be helpful. These can include blood tests, laboratory tests for infectious diseases, biopsy samples or needle aspiration of abnormal tissue.
- Esophagoscopy. A scope is inserted into the esophagus and specialized blood tests for myasthenia gravis (skeletal muscle weakness) to diagnose problems of the esophagus that may lead to aspiration pneumonia
- The electrocardiogram (EKG), a recording of the heart’s electrical action, and echocardiogram, a test recording the movement and position of the heart, are both useful for assessing patients with suspected heart failure or pericardial disease. The pericardium is the sac enclosing the heart.
- Consultation with appropriate specialists is recommended when the problem is confusing or difficult to diagnose.
Definitive therapy of any chronic condition is always depends on first determining the correct diagnosis. There are numerous potential causes of coughing. It is necessary to identify a specific cause to provide optimal therapy.