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Dr. Kara
Dr. Kara, Veterinarian
Category: Cat Veterinary
Satisfied Customers: 16726
Experience:  Over 20 years of experience as a veterinarian.
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My cat has dry heaves multiple times a day. I thought it was

Customer Question

My cat has dry heaves multiple times a day. I thought it was a food allergy, and changed her food many times. (raw food, cooked food etc.) Nothing helped for long. Do you know what is causing this?
Submitted: 2 years ago.
Category: Cat Veterinary
Expert:  Dr. Kara replied 2 years ago.
Hello, my name is***** and I have over 20 years of experience as a veterinarian. I am sorry to hear that your girl is having dry heaves. I do have some further questions for you.
1) How old is she?
2) Is she eating and drinking normally?
3) Does she go outside unsupervised?
4) Is she a hunter?
5) Is she having normal stools?
6) Does she ever actually vomit or is it always dry heaves?
7) Is she on heartworm prevention?
8) How long has this been going on?
9) Is she losing weight or seem unwell in any other way (lethargic or less active at all, unable to play as long as she used to)?
10) Any coughing?
11) Is she wormed routinely?
12) Has she seen her veterinarian for this problem and if so was any diagnostic testing done?
13) Any other pets in the house and if so how are they?
Thanks for your patience with all of my questions, they will help me narrow things down a bit as different ages and lifestyles tend to lead to different problems.
Customer: replied 2 years ago.
She is 2 years old. She eats normally. Yes she goes outside unsupervised. Yes she is a hunter. Don't know about her stools, she goes outside. She never vomits. This has been going on a year. No she is not losing weight. Her coat maybe less shiny than before but no other signs of being sick. The dry heaves are so similar to cough, I don't know if it is cough or not. She has been wormed twice. She has seen the vet. At the time she was eating raw chicken. He said cook the chicken. No help at all. No tests were done. There is a lab in the house. She is very healthy and never coughs or retches. My daughter's cat is from the same litter, the vet gave him a shot. She thinks it was benedril. He was the same. She took him back and they gave him a bigger shot and it stopped. He never said what was wrong with him. Would really like to know what is wrong with her. This is an on and off thing by the way. She will go for months not doing it. Then it will start again.
Expert:  Dr. Kara replied 2 years ago.
Thanks very much, your additional information is extremely helpful, I am very glad I asked additional questions.
I understand that it might be difficult but if possible I would like you to see if you can find where she defecates and check her stools. I suspect that they will be very normal, so this is more being complete than an absolute necessity.
What wormer was given, do you remember? Since she goes out and hunts more unusual parasites like lungworm do need to be considered. I would worm any cat that goes out and hunts every 2-3 months with a broad spectrum wormer like Drontal (pyrantel + praziquantel). In cases where lungworms are possible we need to add fenbendazole (Panacur) too.
Since she seems to dry heave but never actually brings anything up, and this is very episodic, I too think you may be seeing more of a cough, or even more likely bronchospasms.
If she has an intermittent cough without any nasal or eye discharge a bacterial or viral infection seems very unlikely.
A dry cough can be a sign of heartworm disease. The most common symptoms for heartworm disease in a cat are coughing or gagging/vomiting. A simple blood test will help diagnose heartworm.
Another possibility, as I mentioned before especially since she is allowed outdoors to hunt, is a lungworm infection. These can be more difficult to diagnose but checking several stool samples for eggs or trying a course of fenbenadazole (Panacur) worming medication may be diagnostic if she gets better.
Of course the other possibility is feline asthma. We can usually diagnose them with radiographs of the chest when they are showing symptoms. But if we don't catch them during an episode radiographs can look clear. In her brother's case I suspect that the injection was a cortisone injection, which is exactly what is needed for asthma to quiet the spasming bronchioles. Asthma can run in families so she too may have it.
Heart disease is another possibility but I would her to be sicker with heart disease, and her cough to be more consistent. If she seems relatively normal otherwise, eating and drinking well, and active than heart disease is less likely.
It would be very reasonable to check a heartworm test as well as a stool sample and worm her with fenbendazole. If those aren't diagnostic and she isn't improving the next step would be to take chest radiographs and look for changes consistent with asthma and compare them to the previous ones taken to see if there have been any changes, if she has ever had radiographs taken before.
If her radiographs look suspicious for asthma or even if they look clear when she isn't coughing then try a course of bronchodilators (oral like theophylline or inhaled) and inhaled cortisone (like fluticasone). In most cases inhaled formulation of both drugs work best. In some cases your veterinarian may start with an injection of steroids to get her some immediate relief. Inhaled formulations can work directly on the lungs though, and thus tend to work better in the long run, and because they aren't systemic they have less side effects.
Rarely a nasopharyngeal polyp or a fungal infection can be the cause of a cough, so looking further with sedation and a nasal scope, as well as a look behind the soft palate may be needed, if she isn't coming along. With those things though I would expect a more consistent cough.
There aren't any good over the counter medications to give a cat with a cough, other than a wormer like fenbendazole, but hopefully I have given you the information you need to approach her cough and the diagnostic testing that will help pin the cause down and get her appropriate treatment.
Best of luck with your girl, please let me know if you have any further questions.