How to treat asthma in cats

Feline asthma is a disease that affects up to five percent of cats. Here’s how to identify when your kitty has asthma so you can pinpoint the right treatment STAT.

Though we generally think of cats as fairly independent, low-maintenance pets, they're just as capable of coming down with a chronic disease as any mammal. In fact, there are certain conditions that they share with humans, such as asthma. And although there's still a lot that researchers have to learn about feline asthma, they believe it's likely set off by allergens in the same way that the disease is triggered in humans, says Stacy Choczynski Johnson, DVM, a veterinarian in Seattle, Wash. and veterinary expert for Pumpkin Pet Insurance.

The good news is that with the right treatment, cat asthma doesn't have to cause your feline friend undue stress.

Can Cats Have Asthma?

Yes, in fact, research finds up to five percent of cats are affected by feline asthma. Because they are mammals, cats and humans share many of the same disease processes, points out Johnson. "Humans get allergy-induced asthma," she explains. "And we think that for cats, it's also an allergy-induced process wherein there are inhaled allergens that incite an immune response." 

Allergens that affect cats and lead to asthma are based on where you live but could include any of the following:

• Dust and dust mites
• Pollen
• Mold
• Insects
• Dander of other animals
• Cigarette smoke
• Room fresheners 
• Smoke from fireplaces and candles
• Dust from clay litter
• Household cleaners

The response leads to the production of mucus in the airways, swelling, and inflammation. In turn, muscles in that area will start to spasm, which constricts the airways. "What happens is a cat will breathe in," explains Johnson. "Then, the air gets trapped in those lower airways, and they can't breathe out. They try, but then wheeze."

Cat Asthma Symptoms

Johnson notes that if a cat is suffering from asthma, you might notice any of the following signs:

• Wheezing
• Difficulty breathing
• Rapid breathing
• A chronic cough
• Labored breathing in which they push their bellies out 
• Open mouth breathing with panting
• Vomiting 

Over time, the anatomy of a cat's airways might actually change, for the worse. This is called airway remodeling, which can lead to a chronic cough, explains Johnson. And just like with any chronic illness, pets might lose weight or have changes to their coat.

If your cat is exhibiting any of these symptoms acutely or on an ongoing basis, it's best to see your vet or call your local animal hospital to let them know you're coming for an emergency visit, advises Johnson.

In order to diagnose asthma, vets will give cats blood tests or intradermal skin tests to see what they're allergic to in order to address the whole picture in a targeted way.  

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Cat Asthma Treatment and Home Remedies to Make Your Kitty Feel Better

If you head into the animal hospital due to an emergency situation during which your cat can't breathe, the vet will initially sedate them and get them oxygen. "It can be a kennel with oxygen supplementation or flow by oxygen," explains Johnson.

If health care providers confirm (usually by X-ray) that asthma is the culprit, they will provide the cat with a bronchodilator medicine—albuterol sulfate, also known as salbutamol (brand names: Proventil and Ventolin)—to address bronchoconstriction, or constriction of the smooth muscles of the bronchus, caused by an asthma attack. But that's not the mainstay of asthma, says Johnson. It's just the first step.

"From there, we need to get rid of the inflammation, so we use steroids like prednisone," she notes. Your options will generally include the steroid in either a pill form or an inhaler, like the AeroKat, for which there's a spacer made just for cats that fits over their mouths.

How frequently you'll treat your cat with steroidal therapy depends on your cat's asthma and vet's recommendations.

At the same time, your vet might also recommend allergy shots or sublingual therapy, in which allergens are compounded into a formula that goes underneath the tongue. "It's given at micro doses and slowly increased over time," explains Johnson.

In addition to the standard treatment with steroids, Johnson recommends the following lifestyle measures:

• Bolster your cat's well-being by eliminating any allergens that appear to be setting off the condition. 
• Change your household air filter. You might put it near where your cat sleeps. 
• To minimize dust mites, regularly wash and dry their bedding on a hot cycle.
• Don't smoke or vape in the house.
• Because omega-3 fatty acids have been shown to target the inflammation associated with cat asthma, consider giving them a salmon oil supplement.

What to Do If Your Cat Has an Asthma Attack

If your cat is having an asthma attack, they'll crouch down toward the ground and jut their head and neck out as they wheeze or cough. "If you are seeing open mouth breathing, the abdominal press, or any increase in respiratory rate, that would be a sign that you should go to the vet," says Johnson.

Do your best to keep your cat calm, then get them in a carrier and into the car. "Turn the air conditioning on if it's hot, get on the phone with your emergency room, and tell them you're coming," says Johnson. "And hopefully they'll get an oxygen cage ready for you. And you'll be able to elicit treatment right away."

Ultimately, if you're contending with cat asthma, Johnson emphasizes the importance of consulting with your primary care veterinarian or specialist handling the case to get specific instructions regarding your pet. After all, as every pet parent knows, every kitty is unique and will require individualized care.

Feline asthma affects a fair number of cats and is often associated with bronchitis. Asthma is technically an acute or chronic inflammation of the airways associated with several physiologic effects including increased responsiveness to various noxious stimuli, narrowing/constriction of the airways, reversibility of airway constriction, and the presence of inflammatory cells within the airways.

The term feline bronchitis describes the coughing and/or wheezing that comes from inflammation in the lower airway. Asthma and bronchitis are typically considered two parts of the same syndrome. This syndrome may also be referred to as chronic obstructive pulmonary disease (COPD).

If your cat's airways are sensitive to certain stimuli, exposure to those agents can cause an inflammatory response and your cat will experience bronchial (airway) spasms, increased mucus production, and possible accumulation of mucus in the airways. The inability to clear the bronchi of mucus can lead to airway obstruction and can result in secondary respiratory infections. Chronic airway obstruction may trap air in the tiny air sacs of the lungs called alveoli, leading to over-inflation and lung damage.

Are some cats more likely to get asthma?

Asthma and bronchitis are seen most commonly in cats two to eight years of age, and Siamese cats seem to be at higher risk. Overweight and obese cats are also at greater risk for developing chronic respiratory disease. Dental disease increases the risk that bacteria will travel from the mouth into the lungs and cause a serious secondary infection.

What causes feline asthma and bronchitis?

The cause of the inflammation associated with feline asthma and bronchitis is unknown. It is better to consider triggers that enhance the inflammation and cause asthma and bronchitis signs. These triggers may include dust from cat litter, cigarette smoke, perfume, hairspray, carpet cleaners, air fresheners, scented laundry detergent and/or fabric softeners, mold/mildew, and essential oil diffusers.

What are the signs of asthma and bronchitis?

Coughing and respiratory distress including difficulty breathing, shortness of breath, and open-mouth breathing are the most common signs of feline asthma and bronchitis. Coughing is a significant finding since there are relatively few causes of coughing in cats. Your cat may assume a squatting position with the neck extended when coughing. Your cat may also wheeze, sometimes loud enough to hear if you are close by.

As the disease progresses, your cat may appear to have less energy and may have difficulty breathing. Breathing may become noisy, and your cat may wheeze when exhaling. In later stages, the gums may develop a bluish tinge due to a lack of oxygen. Cats with asthma or chronic bronchitis rarely have a fever and their appetite usually remains normal.

How is asthma diagnosed?

Diagnosing asthma and bronchitis in cats requires ruling out other diseases that cause respiratory signs. These diseases include infectious pneumonia (fungal, bacterial, or parasitic), feline heartworm disease, primary lung parasites, and cancer (either a lung tumor or one that has metastasized to the lungs from elsewhere in the body). Diagnostic tests will include a complete blood count (CBC), blood chemistries, fecal exam, and urinalysis. These tests will assess the general health of your cat and may provide clues as to the underlying cause. One type of white blood cell, the eosinophil, is commonly associated with allergic events or parasitic disease and its presence supports a tentative diagnosis of asthma. Elevated blood proteins also occur in some affected cats. In some cases, special tests will be performed on stool samples, looking for evidence of lungworms.

"Diagnosing asthma and bronchitis in cats requires ruling out other diseases..."

Additional diagnostic tests may include:

Heartworm test. This blood test should be performed on any coughing cat and is often performed in conjunction with feline leukemia (FeLV) and feline immunodeficiency virus (FIV) tests.

Thoracic radiograph (chest X-ray). There are several characteristic changes seen on lung radiographs in cats with asthma and bronchitis. Radiographs can help eliminate other lung and heart diseases. For instance, feline heartworm and lungworm create specific suggestive lesions that can be seen on radiographs.

Bronchoscopy with cytology and/or culture. Bronchoscopy is a procedure typically performed by a specialist and allows the veterinarian to visualize the airways of an anesthetized cat with a small fiber-optic scope. Samples of the mucus and cells lining the bronchi may be obtained for examination under the microscope and for culture.

In most cases, a single underlying cause cannot be identified, despite a thorough diagnostic work-up.

How is asthma treated?

Most cats with asthma and bronchitis are treated as outpatients. If your cat is experiencing severe respiratory distress, hospitalization for oxygen therapy and/or intravenous medication to stabilize the condition may be required.

"Most cats with asthma and bronchitis are treated as outpatients."

Successful management of feline asthma and bronchitis typically involves some combination of the following:

Avoiding triggers. Any triggers that aggravate breathing problems in cats with this diagnosis should be avoided. This means trying low-dust cat litter, eliminating cigarette smoke from the home, minimizing any dust buildup, using air filters/purifiers, etc. It is important to pay close attention to environmental factors that may aggravate or worsen your cat’s condition.

Improving body condition. Being overweight or obese causes systemic inflammation that can contribute to feline asthma and bronchitis, as well as increasing the workload on the heart and lungs. Improving body condition is critical to success.

Corticosteroids. Corticosteroids have potent anti-inflammatory effects and can provide relief to cats experiencing the respiratory distress of asthma and bronchitis. A cat may receive an injection of a long-acting corticosteroid (such as Depo-Medrol®) that has the ability to relieve symptoms for several weeks to several months. More commonly, a cat may be prescribed a short course of oral corticosteroids combined with an inhaled corticosteroid, such as fluticasone (Flovent®), to limit the effects of the steroid on the lungs and minimize negative side effects. There is also a combination bronchodilator-corticosteroid combining fluticasone and the bronchodilator salmeterol (Advair®) in the same inhaler.

Hypoallergenic nutrient profile. Your cat may benefit from a diet that is either less allergenic or truly hypoallergenic. Nutrition takes time to have its effect on cats with asthma and bronchitis but may lower the reliance on medication.

Medical acupuncture. Neuromodulation via medical acupuncture is a technique that can provide relief to some cats with asthma and bronchitis. In those cats who respond to medical acupuncture, the reliance on medication may be reduced.

See the handout "Treatment Instructions for Asthma and Bronchitis in Cats" for more information on treatment.

Will my cat be cured of asthma and bronchitis?

Treatment of this disease syndrome is considered management, as a cure rarely occurs. Cats with feline asthma and bronchitis are rarely cured. The goal of treatment is to lessen the severity and frequency of the attacks and improve the overall quality of life. Most cats with feline asthma and bronchitis can live very full and active lives.