Barney was none too happy to be at the office. His plans for the day had clearly revolved around eating some cat food, curling up in the sun by the window, and then going back for some more cat food later. Unfortunately for him he had been periodically hacking for the past four days, and his owner was getting tired of racing across the house to hold a newspaper under his chin in an attempt to catch the hairball that he was apparently trying to bring up. So far no hairball had actually been produced, but the cat was still hacking.
“Trying to hack up a hairball” is the most common description I hear for cats who are actually suffering from asthma. When you awaken in the morning to your cat going hack, hack, hack, GAAAAAK it is natural to think that the problem is gastrointestinal, but if at the end of the performance your cat has not left you a slimy puddle to step in on your way to the bathroom it may be that lung disease is actually his problem.
Asthma is one of the few things in this area that will actually make a cat cough. Cats are not very prone to bacterial or viral pneumonia, and most of the fungal lung diseases and parasitic lung problems like heartworm disease and lung flukes, although not impossible, are not seen often in this region. Heart disease and cancer will occasionally be a sneaky cause of coughing, but they are much less common reasons for coughing than asthma. Some x-rays and blood work, and maybe other diagnostics depending on the case, can make the distinction between these possible causes of coughing so that appropriate treatment can begin.
In cats asthma tends to have a waxing and waning course at first. They may cough for a few days, and then seem to get over it without any intervention at all. Eventually the episodes start coming closer and closer together until the coughing and wheezing becomes continual. The problem with leaving asthmatic episodes untreated is that even though they initially seem to resolve on their own, there is permanent damage being done to the lungs each time. As that damage accumulates with each attack the cat is left with less and less functional lung tissue. It is not unusual to have a cat present at thirteen years of age in extreme respiratory distress and find that the lungs are so scarred from years of untreated asthma that there is nothing left to work with. At that point the prognosis is poor. If we can catch them earlier, however, we can often prevent this outcome.
The goal of asthma treatment is to stop the inflammation in the lungs before it causes damage and scar tissue formation. One of the best ways to do this is to stop exposure to things that cause the inflammation. Cigarette smoke and dust from cat litter are two notorious triggers for asthma. If you can’t get the cat to stop smoking, maybe you will have more luck convincing the human smokers in the house to take their smoke breaks outside. Often the cause of the asthma can’t be identified or eliminated. At that point we direct our energies to controlling the symptoms.
Cats with mild asthma can sometimes be treated with a single anti-inflammatory shot that is given when a flare-up occurs. The best candidates for this type of treatment have coughing episodes once every six months or so. Cats with more frequent asthmatic episodes are at risk for suffering negative side effects from getting the anti-inflammatory shot too often, and alternative treatments should be explored. There are several oral medications that can help. A company called Aerokat makes cat specific modified pediatric inhalers which can be used to deliver treatments of inhaled drugs like FloVent and Albuterol. This form of treatment is very effective and surprisingly well tolerated by the patients.
So the next time your cat makes you sprint across the house to try to catch an impending hairball but doesn’t produce a prize at the end, think about asthma. You may be able to prevent a future respiratory meltdown if you act early.