Feline Asthma (Lower Airway Disease)

There are several different diseases that can affect the lower airways in the cat. All these diseases can be combined under the diagnosis of Feline Bronchopulmonary Disease (FBPD), formerly known as Feline Asthma. Regardless of the cause, this condition leads to a narrowing of the cat’s lower airways and you will observe your cat to show coughing and difficulty breathing.

What causes airway disease in cats?

Veterinarians used to believe all cats with airway disease were victims of allergens or irritants in the air. Such allergens include smoke (either cigarette or fireplace), scented aerosol sprays (such as air fresheners, hair spray, cleaning products), perfumes, and dust from cat litters (especially clay based). While it is still believed some cats do develop airway disease from air-borne irritants, there are many other potential causes. These include allergic airway disease (from inhaled pollens, grasses, and dust mites), food allergies, parasitic reactions (to parasites either primarily living in the lungs or others migrating through the lungs as they complete their life cycle), heartworm infection, and bacterial or mycobacterial infections.

How are the airways affected?

One of the reasons most veterinarians lump all the types of airway disease under one description, FBPD, is that feline airways respond the same and lead to the same clinical signs regardless of cause. Once the airways are “irritated” or “inflamed” from any cause, the cat will experience a dramatic narrowing of the lower airways or bronchioles. When this happens, the narrowed airways cannot handle the necessary flow of oxygen and the cat will show signs such as coughing or breathing changes.

What signs should I look for in my cat?

In the more mild and chronic cases, cats will assume a crouched position, with their heads and necks extended, followed by a hacking and non-productive cough. This may occur for several minutes until the cat returns to normal. The cat’s breathing rate or effort may not change during these episodes and owners may mistakenly interpret this as the cat trying to cough up a hairball. In more serious episodes, the cat may have sudden and severe narrowing of the airways that leads to true respiratory distress with labored breathing, open-mouthed breathing, rapid breathing rate, and cyanotic or “bluish” color developing in the gums. This requires immediate transport to the veterinarian for emergency treatment of the airway disease crisis.

What should I expect when I arrive at the Vet’s office?

If your cat is experiencing a respiratory crisis, treatment will be started immediately and will include oxygen, a steroid (to decrease the inflammation), and a bronchodilator (to open the airways).

Oxygen is ideally administered through an oxygen cage which contains a much larger concentration of oxygen than the outside air. Cats do well in this setting as they do not have to be restrained or experience additional stress while receiving other medications. If this is not available, veterinarians can supply oxygen via a face mask, a small tube of “flow by” oxygen, or a small tent.

Steroids are an important part of the treatment plan to quiet the inflammation causing the airways to narrow. There are several ways to administer steroids. In an emergency situation, either injections are given or an inhaler (just as in people) can be used for aerosol administration.

The third arm of treatment is a bronchodilator medication to open the airways and decrease the work of breathing. Ideally these are initial given by injection or via an inhaler.

What tests will need to be run by my Vet?

Once your cat has received the initial medications and is considered to be stable, chest X-rays will be taken to look for causes of respiratory disease. In FBPD, there are classic changes in the airways and lungs that will clue the veterinarian in on this diagnosis.

Blood tests, urinalysis, fecal exam, and a heartworm test are also recommended to look for other causes of your cat’s condition. Generally blood tests and urinalyses are normal in cats with airway disease. Fecal tests will show evidence of parasites and a heartworm test will identify if feline heartworm disease is the cause for your cat’s respiratory signs.

What medications will I need long term for my cat?

Once a cat is discharged from the hospital, assuming there are no parasites or heartworms present, he will be prescribed long term steroids and bronchodilators. Many times these are oral (tablet) medications. More recently veterinarians and cat owners are becoming aware of the long term side effects of steroids (primarily in the development of diabetes in cats). In many cases, your veterinarian will recommend considering inhalant medications (using a specifically designed feline inhaler) used by humans to decrease the likelihood of these side effects.

Is this condition curable?

Most cases of airway disease in cats can be controlled by medications but are rarely cured. This is due to the changes in the lungs over time that can eventually lead to chronic scarring and eventual emphysema. Most cats do well and have a good quality of life on medications as needed at home but will have occasional episodes or recurrences depending on the underlying cause of their airway disease.

What can I do to prevent my cat from developing airway disease?

There are some steps you can take to help limit the likelihood of your cat developing airway disease. These include avoiding obesity in your cat, limiting the use of aerosol products (such as air fresheners, household cleaners, perfumes), avoiding dusty clay-based litters, and eliminating smoke (cigarette and fireplace) in your cat’s environment. Siamese cats are predisposed to developing airway disease so owners of this breed should take extra care to limit potential airway irritants listed above.