The standard treatment for feline acute asthma is the oral steroid called prednisolone. Although this often successfully treats acute asthma, even in cats, oral steroids like prednisolone carry the risk of significant side effects if used for prolonged periods of time. Some of the problems it can cause are diabetes, liver damage, kidney damage, lethargy (meaning less exercise), and increased appetite for both food and water (often leading to weight gain). These are just a few of the problems this medication can cause if used long term, and the development of any of these conditions often complicates the asthma problem and can greatly shorten a cat’s life. Since Grendel’s asthma is acute and debilitating when not treated, there’s been little choice but to use the corticosteroid treatment — until now.
Grendel was diagnosed with acute feline asthma back in 1997. Suffering from severe and debilitating attacks, it was first thought to be a form of congestive heart failure called feline hypertrophic cardiomyopathy (HCM). This is a common misdiagnosis in cats with acute feline asthma. After an echocardiogram (ultrasound of the heart) was performed and showed no heart problems, it was decided that a bronchoalveolar lavage (BAL), or bronchial wash, would be performed to check for lower respiratory disorders (such as asthma, infectious pneumonia or pulmonary infiltrates due to cancer).
Bingo! Grendel’s lungs were full of debris (mucus), and the tests indicated an acute case of asthma.
At the time of the diagnosis, the most widely prescribed and successful treatment for feline asthma was the use of systemic corticosteroids (specifically prednisone or prednisolone). Grendel was immediately put on prednisolone (5 mg twice per day) to get his asthma attacks under control. Because his asthma is seasonal, he was backed down to one 5 mg prednisolone every other day until he became symptomatic again. His medication would then be increased until his attacks abated, then he would be kept at that dosage for a few months before being moved to lower doses again.
Although this process seems to have successfully treated his asthma for several years, I have always been quite concerned about the long term health effects of oral steroid use (as I described above).
About a year ago, my vet informed me of a new treatment based on the inhaled treatments many humans use today. The only obstacle appeared to be delivery since it was unlikely a cat (even one as laid back as Grendel) would sit still and let you spray medicine down their gullet.
The solution? The AeroKat Feline Aerosol Chamber.
AeroKat is nothing more than a spacer used to contain a normal metered dose of asthma medication with a feline-fitted mask to allow a cat to breathe the medication without being subjected to the metered dose dispersal itself. This allows the asthma to be treated directly — in the lungs — without the systemic effects of corticosteroid use.
When the AeroKat finally arrived (having been on order for some time), Grendel took a road trip to the vet’s office for his first dose using the new contraption.
As usual, he took most of it in stride, although he was somewhat apprehensive when the mask was placed over his face. Given his infinite ability to adapt to new situations easily, I suspect it will not be long before he grows accustomed to this new twice-daily ritual. I’m also sure he’ll be happy to get off of the pills that he currently takes.
For regular usage (currently to be twice per day), he’s on Flovent, an inhaled corticosteroid that acts on the lungs directly without having to pass through the rest of his body. This cuts out the middleman, one could say, and removes the possibility of steroid exposure throughout his body causing serious health problems down the road. Once he’s grown accustomed to the new inhaled steroid, he’ll gradually be weaned from the prednisolone (a necessary step since sudden cessation of use can cause major problems).
Even more interesting is that Grendel now has an “emergency” inhaler to be used when he has an acute attack. This is Albuterol. This is intended to provide relief during an acute asthma attack and is for as-needed use only. Since Grendel has always responded well to the steroid treatment insofar as having attacks is concerned, I doubt the Albuterol will be used much at all.
I’m very excited about starting this new treatment with Grendel. I’m always concerned about his health and the long term effects of the current treatment, so I’m thrilled that this new option has finally become available.
Once he’s off of the prednisolone, I’m expecting his energy to increase and his weight to decrease. Although my roommate likes to call him “fatty” and “roly-poly” and other such terms (all with great affection, mind you), Grendel is only a pound or two overweight. That can have some health impact if he can’t lose the weight, but, given that he’s been on the prednisolone for so long, the vet had no expectations that he could shed the extra poundage. Perhaps now, though, he’ll be able to get his buff figure back.
It’ll be a few months before he’s off of the prednisolone — and that’s assuming that he responds well to the new treatment. I’ll be sure to post updates on his progress as we go along since I know you’ll be just as interested as I am in how he’s doing.