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VetTechErin, Licensed Vet Tech
Category: Cat
Satisfied Customers: 681
Experience:  Published author in veterinary medical journals and on the Veterinary Information Network with a focus in toxicology
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I was reading your answer to a question about a cat with aspiration

Customer Question

I was reading your answer to a question about a cat with aspiration pneumonia. My cat Moshe was having aweful wet coughing fits. I videoed them for the vet and I had an x ray done. The vet said it loked pretty much ok but sent it to a radiologist whi said it looked like the beginngs of pneumonia so we gave him a conveneia inj. Well 2 days ago I reallized the cough comes after he has been drining water! He likes to drink out of the dripping faucet (frm below) but it must be going straight into his trachea !! problem is I have also seen him choking when drining from his regular bowl. He has not always done this, just the past few months. How do I fix this? What will help him drink more effectively? ALSO I have a very cool AeroNeb-go nebulizer that is silent (it's electrostatic or something) and I have albuterol solution and some that has ipatropium bromide mixed in. Would using this infront of Moshe be helpful in getting the water out? Will either of these medicines hurt him? How much or long should I let hom breathe it?
Submitted: 2 years ago.
Category: Cat
Expert:  VetTechErin replied 2 years ago.
Hi there! My name is ***** ***** I would be happy to answer your question for you! I have a couple of questions for you if you don't mind answering them for me. How long have the coughing fits been going on?Have you seen any improvement at all after the injection?
Customer: replied 2 years ago.
Slrry couldn't get back to you, busy day today. I have seen him couging off and on for about 6 weeks. Convenia didnt help. I am almost positive he is inhaling water. When I payed closer attention these coughing fits are always after he drinks. There was another vet here that suggested using Proventil to help a cat with aspiration pneumonia so I was wondering of I should use the nebulizer with him.
Expert:  VetTechErin replied 2 years ago.
Thanks for answering those for me. The inhalers themselves are bronchodilators, so that means they open up the airways when a cat is having difficulty breathing. It's not going to help dry up any water that might be inhaled. The doses for cats is also sometimes different than for humans depending on what we're treating, and with these inhalers, we can see some really nasty and life-threatening side-effects with overdoses. In this case, it's best not to use the nebulizer until you've had a vet check the doses and make sure the proper amount is being administered and if it is strictly necessary - this is not an FDA approved treatment for cats, meaning when vets use this it's off-label. So even at therapeutic doses, we can see vast changes in heart rate, overstimulation, and even muscle tremors. This is also not something we typically do as a long-term therapy, but in situations like asthma attacks or if they're having a breathing crisis, much like you would for humans. The effectiveness of a nebulizer may also not be the best for what you're seeing. If a cat is coughing from asthma or constricted airways, the albuterol really helps to open them up, but coughing due to inhaled water is a different story - opening up the airways is not going to stop or prevent that issue in any way. It is really unusual for a cat to be coughing and aspirating every time it eats or drinks, as this is not a normal problem that we see without some other disease going on. Aspiration tends to occur most frequently when an animal vomits and then inhales while vomiting, or while swallowing a substance that is a high-risk for aspiration like peroxide, soap, fuel, etc. I am concerned that there is an underlying issue going on with Moshe that's making him inhale every time he's going at the water. If you think that he's inhaling when he's drinking from the faucet, the first step is to ensure that he has no access to the faucet whatsoever to prevent him from inhaling while he drinks. You can try elevating his bowls of food and water so he doesn't have to bend his head down to eat or drink to see if that helps a little bit. There is a condition called megaesophagus where their esophagus is enlarged and causes them to have difficulty swallowing things. This can lead to more regular risk of aspiration when eating or drinking. Something like this is what the vet should be looking for when trying to determine if Moshe is actually aspirating. Aspiration pneumonia is also something we tend to see some really bad signs with, so when they inhale, they have difficulties breathing, they get very sick and lethargic , continual vomiting, difficulties breathing. IE, it's something we tend to rush them to the emergency vet for because they're really sick - not something that tends to be continual over the course of several weeks. This leads me to believe that potentially you may not be dealing with an aspiration pneumonia, but something else along the lines of walking pneumonia (which is a mild infection in the lungs that can perpetuate over a long time), or something like asthma, fungal infections like pneumocystis, etc. I think since you are not seeing any improvement from the antibiotics and you are looking to potentially try a nebulization solution, you should get her back into the vet for a recheck (this is a good idea anyway so they can take a comparative radiograph to see if anything has changed/worsened/improved), and they can give you a cat-friendly dose of albuterol if they think an at-home treatment is warranted. In most cases, though, with a cat that has asthma, steroids is the drug of choice, and breathing treatments like the nebulizer are reserved for only emergency situations. I hope this has given you a little bit more information about your situation, and if you have any further questions, please hit "reply" to get back with me, and I'd be happy to answer any follow-ups you may have.
Expert:  VetTechErin replied 2 years ago.

I'm just following up on our conversation about Moshe. How is everything going?