It can be pretty alarming watching (or hearing) a cat cough. Their body contorts like a feline yoga master all while making ‘Jurassic Park’ sound effects. Most of the time, the finale to this short-lived, dramatic show is the appearance of a slimy, sausage-like fur ball and a relieved, nonchalant cat.
But there may be times when your cat’s cough seems more persistent than usual and no fur ball appears. Or you’re just more aware of your cat’s breathing but are not sure why. It’s always best to seek specific veterinary advice, especially where breathing is concerned. There are many conditions that could cause your cat’s cough — one possible explanation is feline asthma.
What is feline asthma?
Every time your cat inhales, air travels through their nose and throat into the trachea (windpipe). Inside the chest, the trachea splits into two smaller, air-filled tubes (bronchi) each connecting to a lung. The bronchi further divide many times, forming a root-like network of tiny airways within each lung.
The air we all breathe contains many tiny, unseen particles (allergens) that usually don’t cause any issues. For cats with asthma, these microscopic particles can spell big trouble. Inhaled allergens irritate the lining of the cat’s airways, triggering an allergic response (inflammation). The airways narrow making breathing more difficult. In an attempt to protect the lungs, cells produce mucous that builds up within airways causing blockages and infections.
Potentially harmful allergens are everywhere. From cat litter to candles and perfume to pollen, it’s almost impossible to avoid breathing them in. It’s not even a cleanliness thing. In fact, ‘Hinch-ing’ your house could make your cat’s asthma worse; strongly-scented cleaning products can really irritate the airways. Don’t abandon the mop completely though as living in a dusty environment isn’t great either, nor is breathing in smoke from cigarettes or fires. For some cats, exercise can trigger a bout of asthma (although these cats probably have underlying allergies too).
Vets often use different terms for feline asthma: ‘chronic bronchitis’, ‘allergic airway disease’ or ‘allergic bronchitis’ all describe the same condition.
The vet may run a variety of tests.
Vets need to rule out and test for a variety of conditions before diagnosing your cat with asthma. Fur balls commonly imitate asthma symptoms and they’re straight forward to treat with a special laxative to move them through the digestive tract.
Other cough-causing conditions include: foreign bodies (such as tickly grass irritating the throat), pneumonia, heart disease, lung cancers, and airway parasites. Up until recently, lungworm in cats was relatively rare in the UK and predominantly considered a doggy problem. It’s becoming more common now though and while the parasite is different to that found in dogs, the effects can be just as devastating.
Before carrying out any tests, your vet will examine your cat and listen carefully to their chest. You get extra brownie points for taking a video of your cat coughing as they rarely ‘perform’ for us during the consultation. Once we understand more about your cat’s symptoms, we can plan which tests will be the most useful:
● BLOOD TESTS
Along with checking your cat’s biochemistry (liver and kidney function), blood tests show any changes in the blood cells themselves. Some cats with asthma have high levels of disease-fighting white blood cells called eosinophils. There are other conditions that cause eosinophil levels to increase but asthma is certainly one of the possible reasons.
It can be difficult to diagnose asthma from chest X-rays as often the lungs look normal. Sometimes areas of lung appear over-inflated (due to mucous blocking small airways) or brighter than normal (caused by the accumulation of inflammatory cells).
A tiny camera inserted down your cat’s throat into the airways and lungs allows your vet to check for — and biopsy if appropriate — any suspicious tissue. Your cat will need a general anaesthetic for this.
● BAL (bronchoalveolar lavage)
This sounds like an odd procedure but it’s straightforward and gives vets tons of information. We flush sterile liquid into your cat’s lungs then withdraw samples for analysis. Laboratories check the recovered cells for inflammation, infection, and cancer cells.
Allergens can be anywhere, but certain household items are known to aggravate the condition.
Although incurable, there’s plenty that you and your vet can do to help ease your cat’s symptoms and prevent severe bouts of asthma. If you suspect there’s a specific allergen that triggers your cat’s symptoms, try to limit their exposure. Preventing your cat from entering certain rooms at home is doable whereas avoiding allergens outdoors is trickier as it’s impossible to remove all pollen and plant particles from the air.
If your cat’s test results show an infection, your vet will prescribe antibiotics to clear it up. For most cats with asthma, the mainstays of treatment are anti-inflammatories (to reduce lung inflammation) and bronchodilators. Steroids are potent anti-inflammatories and come in tablet, liquid, or injectable forms, as well as an inhaler (see below for more details).
Bronchodilator medication opens the airways, helping to maximise airflow and oxygen intake. They work well alongside steroids, especially in inhaler form.
Use a dust free cat litter to avoid irritating your cat’s asthma.
Using an inhaler
Inhalers are widely used in human medicine to effectively treat asthma. Even less compliant children get used to them with a bit of bribery! It’s understandable to feel sceptical (and slightly terrified) if your vet suggests treating your cat with an inhaler. And why even consider it if medication is available in other forms? Inhalers are preferable because:
● They have fewer systemic side effects. Long-term steroid use can cause weight gain, liver problems, and diabetes mellitus. Inhalers deliver medication directly into the airways so less is absorbed into your cat’s bloodstream.
● They are easier than tablets (honestly!). With a bit of practice and a lot of patience, your cat will learn to tolerate their twice daily inhaler.
Your cat’s device will consist of a mask, spacer (tube-like chamber), and a port to attach the inhaler. The International Society of Feline Medicine have a series of online videos showing how to train your cat to accept their inhaler, visit icatcare.org/inhaler-training
Your cat’s long-term outlook
With the correct medication and care, your cat can continue to live a happy, comfortable life. Your vet will need to examine your cat regularly to monitor their lungs and adjust their medication as necessary.
Learning to use an inhaler
Here one of Penny’s cat-loving clients tells us about how she managed when her cat Poppy was diagnosed with asthma.
“I first realised something was wrong with Poppy in December 2020 when she was eight years old. She started to have strange coughing episodes about once a week. It looked like she was trying to bring up a fur ball as she’d crouch low on the floor, extend her neck, and make a wheezy cough sound. By the end of the month, Poppy was having three or four coughing episodes a day and becoming increasingly more panicked each time.
“I booked an appointment at Avonvale Veterinary Centre to see our vet, Andrea Davies. She checked Poppy over and looked at a video of her coughing. After X-raying her chest and carrying out bronchoscopy, Poppy had a course of antibiotics to rule out infection — we had a comedy week of giving her tablets!
Poppy with her owner and vet Andrea.
Poppy using her inhaler.
“When Andrea suggested we try getting Poppy to use an inhaler, I was quite reticent (and scared!). Andrea and her team taught me how to use the Aerokat inhaler and put me in touch with a receptionist at the practice who uses one with her cat.
“Initially, we left pieces of the inhaler near Poppy’s toys so she got used to smelling and seeing them. Using lots of rewards and praise, Poppy eventually accepted the mask part over her face. It took a further five days for Poppy to get used to the chamber attachment. I could tell Poppy was breathing normally as the valve moved in and out with each breath. I was dreading adding the inhaler as I was worried the ‘psst’ sound would frighten Poppy but she wasn’t bothered at all! The results were immediate as Poppy’s wheezy episodes reduced in number and severity.
“Over the next few months, Poppy used her inhaler twice a day. I’d say ‘inhaler time’ and she’d jump onto the sofa ready for her treatment. As her symptoms improved, we weaned down the inhaler and now use it when she needs it.
“We never worked out what the trigger was for Poppy’s asthma but feel confident that we can keep her symptoms under control and she can enjoy a normal, happy life.”