Treatment Instructions for Asthma and Bronchitis in Cats

By Malcolm Weir, DVM, MSc, MPH; Krista Williams, BSc, DVM; Robin Downing, DVM, DAAPM, DACVSMR, CVPP; Ernie Ward, DVM

Why does my cat need an inhaler?

Feline asthma and bronchitis cause narrowing and swelling of the airways in the lungs. Most cats with asthma will experience coughing, difficulty breathing, open-mouth panting, and other signs of respiratory distress. If left untreated, death may occur in severe cases.

For cats with frequent and persistent symptoms, treatment involves administering corticosteroids, which reduce inflammation, and a bronchodilator that helps relax the muscles in the lungs allowing the airways to open. Some bronchodilators also help to reduce inflammation and help clear mucus. For cats with only occasional symptoms, the inhaler (also known as a puffer) may only be needed when an asthma event occurs. Depending on the severity of the disease, an inhaler can be a lifesaver for cats suffering from asthma.

Why is inhaled medication better for my cat than oral medications?

Long-term oral corticosteroid use in cats often produces harmful side effects, including diabetes mellitus. An inhaled steroid appears to be more effective than an oral one for the symptoms of feline asthma and bronchitis, and inhaled steroids are associated with fewer side effects than oral steroids.

Is there a specific type of inhaler for cats, and how do I use it?

The inhaled medications used to manage feline asthma and bronchitis - corticosteroids and bronchodilators - are human medications and are delivered using a special aerosol chamber designed for cats. The inhaler canister attaches at one end of the chamber, and a soft face mask covers the cat's mouth and nose at the other end of the chamber.

Fluticasone propionate (Flovent®) is the most commonly used inhaled corticosteroid, and albuterol/salbutamol (Ventolin®) is the most commonly used inhaled bronchodilator. Some veterinarians recommend combining fluticasone and salmeterol, another bronchodilator (brand name Advair®). Your veterinarian will discuss these treatments with you and prescribe the best medications for your cat's condition. Most cats readily accept using the aerosol chamber with the inhalers with little anxiety or nervousness, and administration of the medication takes only a few seconds.

To help your cat stay calm while receiving their inhaled medications, introduce the mask slowly over about a week. Tricks like putting a few kibbles or treats in the mask for your cat to eat, then having your cat breathe room air through the mask without the inhaler can make it much easier to medicate your cat in the future. Most cats will need one to two weeks of oral medication to control their initial case of asthma, so that time can be used to help your cat accept the inhaler.

Your veterinarian will demonstrate the safe and correct use of the inhaled medications and the aerosol chamber.

Instructions for administration of medication:

Your cat has been diagnosed with feline asthma and will require long-term medication for this condition, possibly for life. It is essential that you follow the appropriate instructions for this treatment. The instructions that are specific to your cat have been checked below.

_____ Your cat was given an injection of corticosteroids. Relief should be apparent within 12-24 hours. If water consumption or urination increases, please inform us for future reference. These side effects are common with steroid administration and will go away in a few days without treatment. Long-term use of corticosteroids in cats may lead to serious side effects.

_____ Return for further evaluation when the first signs of respiratory distress or noisy breathing return. A good tip is to start counting how many breaths the cats takes while sleeping. If this number increases consistently, their asthma could be worsening.

_____ Your cat has been prescribed an inhaled medication. This medication is a:

_____ corticosteroid

_____ bronchodilator

Administer _____ puffs of ____________________

every _____ hours / days, and _____ puffs of ____________________ every _____ hours / days.

_____ Your cat has been prescribed oral corticosteroids. The specific drug being dispensed for your cat is labeled on the bottle. Give the tablets as directed:

Give _____ tablet(s) of __________________________________ every _____ hours. Report any increase in water consumption to us at once.

_____ The oral corticosteroids prescribed for your cat will require a dose adjustment to reach the minimum effective dose. Once symptoms are under control, call your veterinarian for specific instructions on how to do this. Write these instructions down in the space provided below:

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

_____ Your cat has been prescribed oral bronchodilators. The specific drug being dispensed for your cat is labeled on the bottle.

Give _____ tablet(s) of __________________________________ every _______ hours.

_____ Return for a follow-up appointment and recheck examination in _______ days / weeks. If your cat has a respiratory emergency, seek the assistance of a veterinarian immediately.

Asthma inhaler instructions

1. Inhaled asthma medications come in multiple sizes and concentrations. Verify that the inhaler you are using matches your veterinarian's current prescription.

2. Remove the safety cap from the asthma medication inhaler.

3. Shake the inhaler well for 5 to 10 seconds, then insert it into the right end of the aerosol chamber.

4. Place your cat on your lap, a towel, or a soft surface.

5. Place the aerosol chamber mask around your cat's nose and mouth. Ensure that you have a good seal around your cat's face.

6. Deliver the prescribed number of puffs of medication into the chamber. If your cat reacts to the noise, try delivering the puffs while holding the chamber away from your cat, then placing the mask over their nose and mouth.

7. Hold the inhaler mask in place for five to six breaths.

9. Follow your veterinarian's recommendations regarding the frequency of administration as prescribed above.

10. Reward your cat with praise and a treat after dosing.

11. Be sure you know when to replace your cat's inhaler. Most inhaled medications are now metered to show how many doses are left. Monitor the number of remaining doses, so you do not run out. With experience, it is easy to tell by weight when an inhaler is empty, but you can always give it a shake and test it before administering it.

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