Like many cat owners, I no longer need to use an alarm clock. My cats keep time perfectly and wake me up every morning at 5:30 sharp for breakfast. As the time comes, one of the cats (Appomattox) will lie on the pillow, purring in my ear. Another cat (Kitty) likes to sit on the bedside table, systematically knocking everything off. The third cat (Clara Barton) runs back and forth across the bed. One morning, however, I was awakened much earlier by a horrible, almost indescribable noise. It was a combination of a cough, a hack and a wheeze, and it was coming out of Appomattox.
This noise is frequently called “coughing up a hairball” and that it is a sign of feline lower airway disease, also called feline asthma. Asthma in cats is a condition caused by inflammation and constriction of the airways in the lungs. Mucus forms in the respiratory tract and the airway walls spasm. The result is coughing, wheezing, and difficulty breathing. Many cats will have a mild form of asthma that is manifested only by an occasional cough. Other cats will have life-threatening asthma attacks that require hospitalization.
There are several diseases that can mimic asthma, including heartworm, heart failure and lungworms. Diagnosing asthma in cats starts with a chest X-ray to evaluate the heart and lungs. The inflamed airways cause a classic pattern in the lungs although some asthmatic cats can have normal X-rays. Other tests that help confirm a diagnosis of asthma include taking a fluid sample from the lungs to look for elevated numbers of eosinophils, a white blood cell that fights allergens. Testing to rule out the look-alike diseases is important before starting a treatment protocol.
It is currently believed that allergens are at least part of the cause of feline asthma. It is important to consider possible allergens in your home if you have an asthmatic cat. Exposure to cigarette smoke is a common cause. Dust and dust mites are common household allergens as are air fresheners. If your cat has seasonal signs, pollen may be the cause.
Treatment for asthma can require lifetime therapy. It usually involves a combination of a medication that dilates the airways and a steroid medication to suppress the inflammation. These medications are traditionally given orally; however, inhalers can also be used to decrease the amount of oral medications. Since cats won’t take a deep breath on command, use of inhalers requires patience, persistence and training. Removing any possible allergens in your home, trying low-dust kitty litter, and purchasing an air purifier may also minimize medication requirements. It is also possible to do allergy testing and use allergy shots for asthmatic cats.
As a side note, a cat can’t actually cough up a hairball. When your cat produces a hairball for you, it is a result of vomiting. However, if you have heard your cat cough or your cat has had a previous asthma attack, it is important to realize that there is a lot going on beneath the surface inside the lungs. In my case, Appomattox was lucky. We moved from a carpeted apartment to an apartment with hardwood floors, and her cough vanished. Having your cat evaluated for asthma, making lifestyle changes and adding treatments can go a long way to making your cat feel a lot better!
Dr. Natalee Holt is originally from the Washington, D.C., area. She received her doctorate of veterinary medicine from the Kansas State College of Veterinary Medicine. She became board-certified in Internal Medicine in 2011, completed a one-year internship at the Colorado State University College of Veterinary Medicine and a three-year residency at Tufts University Cummings School of Veterinary Medicine. Holt loves all aspects of internal medicine, but has a special interest in gastrointestinal diseases and immune mediated diseases. She and her husband Jonathan share their home with Becca the dog, Jasmine the rabbit, and their three cats, Kitty, Clara, and Appomattox. Holt is a board-certified internal medicine specialist who practices with the Animal Medical Center of New England, 168 Main Dunstable Road, Nashua. She may be reached for consultation at 821-7222.