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Ask Dr. Meghan Denney Your Own Question
Dr. Meghan Denney
Dr. Meghan Denney, Cat Veterinarian
Category: Cat Veterinary
Satisfied Customers: 1391
Experience:  Veterinarian at Kingsland Blvd Animal Clinic
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Two weeks ago he became acutely breathless and we rushed him

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Two weeks ago he became acutely breathless and we rushed him to the vet where he quickly stabilised on diuretics and O2 . They thought he had fluid on his lungs . His heard looked normal. He stayed overnight and came home the next day but continues to have spell of extreme breathlessness. He has since been back and had more bloods which were all normal apart from slightly raised eisonophils . Now he is on twice daily frusmide and steroid s but he is still breathless quite often. He also had a heart doppler and ECG which showed nothing particular - he has a provisional diagnosis of feline asthma - but his treatment isn't helping much
JA: I'm sorry to hear that. What is the cat's name?
Customer: Charlie
JA: Is there anything else important you think the Veterinarian should know about Charlie?
Customer: He,
Customer: replied 3 months ago.
He is only four years old

Hi I am Dr. Denney. I am currently reviewing your post now. Please give me a few minutes to type my response. Thank you for trusting us with your question.

Has Charlie had chest X-rays yet?

Customer: replied 3 months ago.
just one set - when he first went to the vet - they thought it was pulmonary oedema a second vet reviewed the same x- ray and thought it looked more like asthma . They said the lungs looked white but should look black
Customer: replied 3 months ago.
His heart looked normal but they thought perhaps his stomach was - slightly enlarged - they weren't overly concerned by this though as they thought it might be from swallowing air

Did they offer to send the X-ray off to a radiologist to make sure there is no fluid?

Customer: replied 3 months ago.
No but they have done an ultrasound of his heart and lungs but found no fluid - although he is on frusmide

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

https://www.trudellmed.com/animal-health/aerokat

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

If this was helpful and guided you on what to do I would be most appreciative if you could take the time to rate my assistance so the site will credit me with helping you.

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I am also here for additional questions you may have just reach out to me here and I will be more than happy to assist you.

Kind regards,

Dr. Meghan Denney

Customer: replied 3 months ago.
Thank you for your help - I wil look into the treatment you have suggested

You are very welcome hopefully it works

Hi Hilary,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Meghan Denney
Customer: replied 3 months ago.
Hey thanks for your help - Charlie has picked up a bit now he's eating well again and not so breathless. He seemed to do better off his steroids - I wonder if they were making fluid build up worse?? He has a follow up with the vet tomorrow
Depends on how severe heart disease is with the steroids causing fluid back up. At lower doses it shouldn't cause an issue
Customer: replied 3 months ago.
He took a turn for the worse this evening /-and we had him put to sleep - it was his heart - thank you for your help

I am so very sorry to hear this. My thoughts are with you.

Customer: replied 3 months ago.
Thank you - pets are a blessing we did what we could

I could not agree more and you did everything you could for Charlie

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