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Has Charlie had chest X-rays yet?
Did they offer to send the X-ray off to a radiologist to make sure there is no fluid?
OK good just making sure that they checked because that can complicate things exponentially.
I would see abut getting Charlie on an albuterol inhaler and getting the Aerokat attachment for cats
Then he can receive 1 does in the morning and one dose in the evening.
I would also recommend getting your air filters changed twice as often as recommended to help cut down on inhaled allergens that can make treating feline asthma worse.
If you do not use a low dust litter for respiratory issue in cats to help reduce dust inhalation. A good one is here https://www.amazon.com/Precious-Respiratory-Premium-Natural-Essences/dp/B005D4NXI4
As there currently is no curative treatment for feline asthma, three key components of management consist of environmental modulation, glucocorticoids and bronchodilators. These treatment options focus on decreasing environmental triggers of allergic symptoms, blunting airway inflammation and reducing bronchoconstriction. All are unfortunately achieved once the allergic cascade has already been well established. Environmental modulation consists of avoiding or minimising inhalation of irritants in asthmatic cats, and allergens to which a cat has been sensitized. Irritants might include smoke (cigarette smoke, smoke from wood stoves or fireplaces, aerosols, powders, dusty cat litter, etc.). HEPA filters are useful when cats are indoors. Glucocorticoids are critical for asthma, as they are anti-inflammatory and inflammation drives other pathologic sequelae. Bronchodilators are most important for asthmatic cats with wheeze or episodic respiratory distress; they may not be necessary for asthmatic cats that have cough as the sole clinical manifestation.
There have been a variety of other treatments which have been assessed for use in feline asthma. Dietary omega-3 polyunsaturated fatty acids and luteolin (an antioxidant flavonoid) administered to experimentally asthmatic cats for 4 weeks showed no effect on airway inflammation, but did show a decrease in airway reactivity.4 Importantly, although this prophylactic treatment holds promise to diminish airway hyperresponsiveness, because it does not blunt eosinophilic airway inflammation (which ultimately contributes to worsening airway hyperresponsiveness and airway remodelling), it should not be given as monotherapy to treat feline asthma.
I would make sure that he has had a heartworm test.
We can also try a medication called cyclosporin it is not first line but since Charlie is failing to respond to traditional therapies we can add it in if the inhaler does not show benefits.
Cyclosporine decreases IL-2 production, leading to inhibition of T cell proliferation. It has been used in severely asthmatic people as a GC sparing anti-inflammatory drug. In experimental feline asthma, cyclosporine did not inhibit the early phase response to allergen challenge (mediated in large part by mast cells), but it was effective at blunting airway hyperresponsiveness to acetylcholine and airway remodeling. Its routine use is not advocated because of a lack of proven efficacy, the need to monitor this expensive treatment often, and the potential for adverse effects. Nevertheless, this is a reasonable option for cats that fail to respond to standard treatments.
Good luck with Charlie. I hope this helps guide you on some other therapies to try
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Dr. Meghan Denney
You are very welcome hopefully it works
I am so very sorry to hear this. My thoughts are with you.
I could not agree more and you did everything you could for Charlie