WHEN MISHA THE CAT WAS A YEAR old, he gave his owner, Donna, quite a scare. It had been just about one month since Donna had adopted both Misha and Misha’s brother, two playful, healthy cats. But one night, Misha started wheezing so loudly that Donna could hear him in the next room. Misha also coughed frequently and couldn’t seem to find a comfortable position to lie in.
Concerned because Misha seemed so distressed and wasn’t eating or drinking anything, Donna took him to a local veterinarian as soon as she could.
Chest x-rays and blood tests for feline leukemia, feline immunodeficiency virus, feline infectious peritonitis and toxoplasmosis were all normal. But based on Misha’s symptoms, his vet suspected asthma.
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A typical asthmatic cat has a history of a sudden onset of difficulty breathing and wheezing similar to human asthma. Coughing also often occurs with the cat in a characteristic crouched posture. X-rays are often normal, especially in early cases. Feline asthma is caused by an allergic reaction to specific–although usually unknown–substances in the environment and results in constriction and spasms of the smaller airways in the lungs. At the same time, mucus secretion increases.
The whole process obstructs the airways, making breathing very difficult and resulting in coughing as the cat attempts to expel the irritating substance from the lungs. The most commonly implicated allergens are pollen, kitty-litter dust, aerosols, cigarette smoke, perfume, carpet-cleaning solutions and household dust.
BUT WAS IT REALLY ASTHMA?
Donna’s veterinarian started treatment that day. She gave an injection of corticosteroids and a pill to dilate Misha’s airways. Since corticosteroids block allergic responses, most cats with asthma respond quickly and dramatically to treatment. Misha seemed better, but the next day, his respiratory distress and coughing returned.
This time, the veterinarian suggested that Donna take Misha immediately to a specialist. At Angell Memorial Animal Hospital in Boston, emergency doctor Deborah Cogan, D.V.M., saw Misha’s severe breathing difficulty and rushed him into the intensive care unit and into an oxygen cage. (Animals don’t do well with oxygen masks.)
As Misha began to breathe more easily, Dr. Cogan reviewed his history, noticed some dehydration and started intravenous fluids. She also gave Misha a bronchodilator by injection but held off on corticosteroids. Until she was sure of the diagnosis, she didn’t want the corticosteroids to suppress Misha’s immune response or interfere with further diagnostic tests.
CONFIRMING THE PROBLEM
As soon as Dr. Cogan felt that Misha could handle it, she ordered more x-rays. This time, the x-rays indicated that Misha probably did have asthma. His small airways were thickened, and his lungs were more inflated than normal because Misha was having trouble exhaling whatever air he was able to take in.
But some other diseases still had to be ruled out, including migrating parasites. So Dr. Cogan gave Misha anesthesia and took some fluid from Misha’s lungs. When she examined it under a microscope, Dr. Cogan noticed a prominence of eosinophils. This indicated that Misha did indeed have asthma. Some fluid was also sent to a lab to check for bacteria.
TREATMENT FOR LITTLE LUNGS
Dr. Cogan immediately started Misha on corticosteroids at a higher dose than before and continued the bronchodilator. She also gave Misha oral antibiotics for bacterial infection, just in case. (The bacterial culture was later found to be negative.) Within hours Misha was breathing normally. He also got his appetite back and was able to start drinking on his own.
The next day, Dr. Cogan sent Misha home on corticosteroids, a bronchodilator and antibiotics. She advised that Donna try to avoid the common things that are implicated as causes of asthmatic attacks. She recommended keeping Misha quiet and cool, preferably in an air-conditioned room. She also suggested using low-dust cat fitter.
Misha did very well. Dr. Cogan kept Misha on the corticosteroids for a month and then gradually decreased his dose. It is now five years since Misha’s bout with asthma. He has never had a recurrence.
Misha was lucky; many cats with asthma have recurrences once or twice every year. Asthma is often a seasonal condition as in people, so pet owners can prepare themselves by having a ready supply of cortisone on hand.
Dr. Marder is a clinical assistant professor at the Tufts University School of Veterinary Medicine and animal-behavior consultant Massachusetts SPCA and Angell Memorial Animal Hospital, Boston.
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