New Kitty has asthma! (eating, vomiting, feline, carpet)

[harrison21]

As I posted before, I just got a new cat from a shelter this past Thursday. The first two days were great- yesterday, there was obviously something wrong with him. He started gagging like he had a hairball but couldn't throw it up. He did this all day and all night and I ended up taking him to emergency care this morning because I thought the might have something in his throat or something. They did an x ray and said they think he has mild asthma and prescribed predisone. Of course, he didn't do the "gagging" thing one single time while at the vet.

I gave him the medicine a couple of hours ago and he seems to be worse! Before he was at least acting normally (playing, sitting on my lap, eating, drinking, etc.) and now he is just hiding under my bed and won't let me touch him . He's been under there for several hours now and he's still "gagging". Is this normal? How soon can I expect the medicine to work? Any advice? I am afraid to leave him alone, but I start a new full time job tomorrow.

[ParallelJJCat]

Long term, your new kitty is probably going to need to be on inhaled steroids and a broncho dilator. Oral steroids aren't as effective for asthma. My boy JJ has feline asthma. He gets two inhalers twice a day (morning and night.) He hasn't had an attack in almost a year now.

If possible, you'll probably want to seek out a specialist, as your local vet may not be well read on feline asthma and its treatments. If you have a University or specialist center near you, you can ask for an appointment. A feline only clinic may also be a good choice.

How was the asthma diagnosed? Did they say anything about 'doughnuts' in his lungs on the x-ray? Doughnut shapes are characteristic for feline asthma, but he could still be positive even if the x-ray didn't show them. It's important to know why they diagnosed him with asthma...if it was just based on his symptoms, there are other things it could be like lungworms. Asthma depends to either be under or over diagnosed depending on the clinic...some places will call every cat with enlarged airways on x-ray as asthma case, some never diagnose it even when there's doughnut holes everywhere. The gold standard test is a lung wash, which has to be done under sedation. They wash fluid into the lungs, then take it back out and look at it under a scope to see what kind of cells are present.

Short term, it may be the stress of a new home that is setting off his attacks. I would call the vet and ask about an oral bronchodilator. The steriods take time to build up in his system and he needs relief now. The bronchodilator won't control the condition long term, but it will open his airways and help him breath. Hopefully if you can break the cycle he'll start to calm down. Cats are predators and instinctively want to hid when they don't feel well...I wouldn't say he's hiding because of the pred because again, that takes time to really start to work. It's possible he's having a bad reaction to it, but more likely he's starting to get more and more stressed because he's having attacks.

There's a terrific asthma cat group on yahoo groups...it's a mailing list and they really helped me when JJ was diagnosed. I highly suggest joining.

Speaking long-term again, you want to try and control his environment and get rid of irritants. Invest in a good quality air purfier for at least his sleeping area, but avoid any that say 'ionic', as they aren't good for asthmatics. Vaccum frequently and keep him indoors, especially during pollen season. The big step, which not everyone can take for obvious reasons, is to get rid of your carpets...carpets collect most of the irritants in the home. Get used to dusting a lot.

All of this sounds scary, but feline asthma can almost always be well-controlled and he'll have a long, normal life. The inhalers are pricey (320 dollars for a two month supply local) but you can get them much, much cheaper if you look into Canadian pharmacies. The most important thing right now is finding a knowledgeable vet and breaking the cycle of attacks. Make sure you stay calm and don't try to touch him while he's having an attack, it'll just upset you both.

Again, I know this is scary for you both...but of all JJ's medical problems, his asthma is the one I worry about the least.

[harrison21]

Thank you for your response. He was diagnosed based on my description of his symptoms and the x-ray. Of course, he literally did not cough/gag or whatever you want to call it the entire time we were in the clinic, even though he has been doing it almost non-stop for 2 days now. They said that may be due to the adrenaline of being afraid to be in the office, although he really seemed pretty calm when he was there. The vet said the marks on the x-ray where extremely small and that he wouldn't have even picked them out had I not described the gagging. He said that he had a very mild case, that most cases he saw were much more serious, and that he probably wouldn't need anything other than a few doses of the medicine when I saw an attack coming on. He even said his lungs "sounded clear." It at least assured me that there was nothing stuck in his throat or anything like that, since to me it literally looked like he was choking when he was supposedly "coughing." The vet said his x-rays and exam showed he was in excellent health otherwise.

We came home, he let me hold him for awhile and played with one of his feather toys. After that he was just wondering around the house as normal. He ate a few kibbles and I gave him a treat which he ate eagerly. I didn't see him drink any water. He "coughed" a few times, but nothing major. The vet had recommended that I wait a few hours before giving him the medicine so he didn't throw it up after the stress of the vet trip. I gave him the prednisone about 2 hours after we got home and he immediately started "coughing" when I squirted it in his mouth. Then he ran under my bed and has stayed there since. It's been about 8 hours now. If I go to the side of the bed, he moves to the other side so that I can't reach him. I got him to eat two treats earlier (with tons of coaxing and leaving them in front of him- he usually follows me around begging for them if he sees the bag), but it scared me to death b/c he ate them and started having "coughing" fits immediately, way more severe than before. I set his water dish under the bed next to him hoping he would drink something, but so far no luck. He seems to be constantly swallowing/moving his tongue around. I can hear liquids moving around in his body when he does this- as if he is swallowing something back down.

He is usually wanting to be right next to you and in the middle of everything. The first two days he was here, I literally couldn't do anything without him- even if he was sitting on my friend's lap (I have a friend in town right now) and I left the room, he would jump up and follow me around. So it's really, really unusual that's he's just sitting under the bed for 8 straight hours. I hate seeing him like this. I am wondering if I should call the clinic again or not. They said he needed to come in immediately if I saw him panting/breathing open mouthed and otherwise they would call in 2 days to see how the medicine was working. I am very concerned with his reaction and the fact that he has not drank any water since last night. I am also wondering why he seems so sick when this was supposedly a very mild case. The "stress of the new home" is the only "trigger" that I really have here for him- and really, I am also finding it hard to believe that coming to/being in the shelter wasn't more stressful. They have any health things they noticed right on the adoption papers, so I know if it would have been listed had he done this before. I am so afraid to leave him by himself for 8+ hours tomorrow. Since I've only had him for a few days and this is my first pet, I don't have a regular vet for him to go to yet. I'm going to try to call one tomorrow and see if I can get him in there too.

[ParallelJJCat]

Asthma is a chronic condition that needs to be treated on a chronic basis, not just when attacks come on. Asthma causes long-term damage to the lungs, so what is mild asthma now could become worse later on. Treating it as a chronic condition could help avoid that.

JJ also would appear to be a 'mild' case, especially in comparison to your boy. JJ's attacks were unusual in that they always occurred while he was asleep and took the form of a sudden sneezing fit. He would sneeze violently for about twenty seconds, followed by five minutes or so of wheezing and swallowing. The attacks occurred very rarely...maybe one every six months.

So here's a cat that appears to have very mild asthma based on x-rays and his symptoms...but when they did the lung wash they found he had bleeding in his lungs and much worse inflammation than the x-rays showed. X-rays are simply not a good diagnostic test for asthma...many asthmatic cats have completely normal x-rays. It does sound like he has asthma, but you can't tell if it's mild or not by an x-ray.

This is what I mean about finding a specialist...because feline asthma is rare and a cat only disease, many vets only know the bare bones about it. You CAN'T treat a sudden asthma attack with oral pred...it's not physically possible. Pred takes days to a week to start to build in the system enough to become effective, so if you're treating it only when he has an attack, you're not accomplishing anything. It's like treating allergies only when you sneeze...a lot of allergy meds you want to start taking a few weeks before pollen season hits, and you're meant to take them daily throughout the season, not just randomly. Asthma in cats is an inflammatory disease, and once the airways are inflamed a single pill or even a few days of treatment won't stop the process.

If he's an allergy cat, you MAY be able to treat with inhalers only during allergy season, but even that isn't recommended. I was very leery about treating JJ long term with oral steroids, so I did a lot of research on if I could treat him only when he had symptoms and found that's just not the right way to treat the disease.

Now that you've described a little more about what's going on, I'm wondering if the med did set him off. Or rather not the med itself, but is sounds like they gave you a liquid? Either the taste was so bad it stressed him into a full blown attack or he accidentally inhaled some. JJ does the gulping/swallowing thing during an attack too...I actually have video of it somewhere. It also be a regurg or heart burn response.


The fact that he's been going this long is worrisome. Is it possible for you to call the vet and ask about a bronchodilator? They do come in a pill form that while not as effective as the inhaler may help. They'll probably have to call it in to a local pharm. You could also ask if it would be okay to give him a pepcid in case he's having a response to the form of the med and it's bothering his stomach. It could be nausea on top of the asthma.

[leanansidhex]

JJ ... could you tell us the Proper way to administer liquid medicine to cats?

I know if it is done incorrectly they can aspirate. What are the signs or symptoms of problems created by giving liquids incorrectly?

I've been wondering about this, because I'm giving Meeko amitriptyline that is dissolved in water, because I can't get the 1/4 pill to stay in his mouth.

He is squirming more each time and I don't want to "miss" and drown him by putting fluids down his throat the wrong way.

Thanks.

[ParallelJJCat]

Originally Posted by leanansidhex

JJ ... could you tell us the Proper way to administer liquid medicine to cats?

I know if it is done incorrectly they can aspirate. What are the signs or symptoms of problems created by giving liquids incorrectly?

I've been wondering about this, because I'm giving Meeko amitriptyline that is dissolved in water, because I can't get the 1/4 pill to stay in his mouth.

He is squirming more each time and I don't want to "miss" and drown him by putting fluids down his throat the wrong way.

Thanks.

It can be very difficult when you have a squirming cat, but the trick is you never want to squirt the meds toward the back of the throat. When most people give meds from a syringe or dropper, they tend to open the mouth at the front and squirt straight back in the hopes the cat will swallow quickly. The problem is that if they happen to inhale at the same time you're going to get it in their lungs...that could lead to aspiration pneumonia, which is not good.

So instead you want to angle the syringe so you're squirting at an angle. It's easiest if you go in from the side of the mouth, just behind the big canine fang. Stick the tip of the syringe in enough to open the mouth slightly- you don't need to crank it all the way open. You squirt in so that it goes either across the mouth toward the far side (not directly across, at an angle) or alongside the teeth. Then you clamp the mouth shut and stroke their throat to get them to swallow.

The problem of course is that they're more likely to taste the meds this way then if you aim straight back. This is why if at all possible you give the meds mixed in with food. You can also give a syringe of water right after the med, but again make sure you aren't aiming straight back. Compounding pharms can mix the meds in with different flavorings if you have a very difficult patient.

If I have a squirmy patient, I usually kind of sit on them. I straddle the cat between my legs and cross my feet behind me so they can't squirm backward. I use one hand to either scruff and pull the head back or grasp the lower jaw...I usually find it easier to grasp the lower jaw. The other hand controls the syringe. If they won't open their mouths I switch my hand to the upper jaw and squeeze lightly just behind the canines, which will make them open up.

Signs of aspiration pneumonia are about what you'd expect...coughing, wheezing, sneezing, crackly sounding breathing. It can also be more subtle with just rapid breathing or a fever. But all that will start within a few days after the aspiration event. It can be difficult to tell the difference between a cat that just aspirated and a cat that is reacting to a nasty tasting medication. With nasty tastes they tend to drool, gap their mouths, and may swallow or gulp. If they just aspirated, they're more likely to cough (which in cats can sound remarkably like they're vomiting or bringing up a hairball...this is why many people don't realize a cat with 'chronic hair balls' is actually a cat with asthma.) But a cat that just aspirated may also be a cat that is drooling and foaming at the mouth because the med they inhaled tastes terrible, so again it can sometimes be very hard to tell. All you can really do is keep a close eye on them. Make sure you keep an eye on the breathing rate, because again it isn't always overt...the breathing rate for a cat at rest is between about 20-40 breaths a minute. If they're breathing rapidly at rest or belly breathing where you can see the abdomen sucking in and out, get thee to a vet.

I will say that I think aspiration pneumonia is pretty rare. In all my years as a tech I can remember three dogs and one cat that were treated for aspiration pneumonia and all of them were due to inhaling their own vomit. We also had a few young puppies that aspirated while being syringe fed by the owner. I can't remember any cases that aspirated on meds specifically...it happens, I'm sure, but not often.

Hope that helps a little!

[harrison21]

Thanks for your help, Parallel. I ended up taking him back to the clinic to stay on a 24 hour watch. It wasn't too pricey and it is worth my peace of mind to know someone is watching him through the night and while I'm at work. I am starting a brand new job tomorrow and I got NO sleep last night getting up and checking on him/waking up when he was coughing. They did a quick exam when we got there to make sure he didn't need an IV or anything like that, and they said his lungs were clear...I'm pretty sure they think I'm totally nuts, but at least I know he is safe. Also, hopefully with him being there for a whole day they will see what I'm talking about. I live in a pretty big city, so I should be able to find a specialist for him. I'll start looking.

[ParallelJJCat]

If you're anywhere near DE or NJ, the Delaware Specialty Center is where I take JJ and they're terrific. There's also the University of Pennsylvania. The asthma cat mailing list can also help you locate a good vet.

I know it's confusing when your vet is telling you one thing and some stranger online is telling you something different. My best advice is to start doing some research. I SO didn't want to have to treat JJ daily, but I had to admit defeat after learning more about the disease. Luckily he doesn't mind his inhalers at all...he knows he gets cheese after. Even the other cat comes running to get her share!

[leanansidhex]

Thank You for the detailed reply.

It is better [over all] and much more useful than anything I found searching on-line.

[harrison21]

Well, I am happy to report that my kitty is home and seems to be feeling much better. He hasn't been coughing and is acting normally. I have an appointment for him with a cat vet on sat. just to get a second opinion and talk about treatment options for the future. I don't want that to ever happen to him again! When I picked him up the clinic mentioned that I should watch for an accelerated heartbeat since that could signal an attack within a couple of days. My friend that was here and I both noticed he seemed to have a really fast heartbeat when we picked him up, so I guess that makes sense. I hope the new vet has some answers. He was really highly rated according to the online reviews, so we'll see. I'm also going to ask about getting a humidifier and what kind to get- I have really dry skin which obviously isn't helped by the dry climate here, so I was thinking of getting one for myself anyway.

Unfortunately, I'm in Denver- nowhere near the NJ area, lol.