Cats that Cough, Hack, and Wheeze!

Many pet owners have witnessed a cat coughing up a hairball. Weird and kind of gross, right? This absolutely classic feline “moment” has even made it into the media via cinema (remember Antonio Banderas as Puss In Boots – Shrek 2?) Although this type of bodily function seems normal enough for cats, did you know that it can mimic a much more serious respiratory disease process?

Feline asthma (also known as feline bronchial disease, allergic bronchitis, allergic airway disease and allergic asthma) is similar to human asthma. An allergic reaction causes spasms in the bronchi, prompting airway inflammation, mucus, and swelling. This restricts airflow, causing respiratory distress, which can become life threatening in a matter of minutes for some cats. In others, it manifests as a chronic cough.

More than 80 million cats currently live in American homes, and veterinary epidemiologists estimate that 800,000 or more of these animals (1%) suffer from acute or chronic asthma (the most commonly diagnosed respiratory disorder in cats). Young and old cats seem to be similarly predisposed to asthma. Likewise, males and females appear equally at risk. The genetic predisposition to asthma is under investigation.

An asthmatic cat will squat with its shoulders hunched up and neck extended, while coughing, gagging up foamy, mucus-like material, and then swallowing hard.

This often appears as if the cat is trying to “cough up a hairball”, but nothing comes up. Other symptoms can include: inappetance, labored breathing, wheezing, and rapid breathing episodes.

Knowing normal resting feline breathing rates can be helpful. Rates greater than 30/minute support probable asthma or a problem worth investigating. Scheduling an examination by your vet would be wise. Whereas, breathing rates of more than 40/minute need immediate veterinary treatment, and are considered emergent.

Any laboring to breath with prolonged deep chest movements is also an emergency.

Unfortunately, the discomfort and dangers associated with feline asthma are not limited to those during an acute attack. Feline asthma can also cause permanent damage to your cat’s lungs if left alone indefinitely.

Untreated inflammation left unchecked, can lead to scar tissue and damage to the small airway branches so therefore, the longer the problem is left, the more long term problems the patient is likely to have. The good news is that many cats are very well controlled with various drugs and do go on to lead happy and healthy lives.

Definitive diagnosis of asthma is difficult to make, it is often easier to rule out other causes than to diagnosis asthma directly.

Several tests that may be done include: chest X-rays, simple blood testing, and bronchoalveolar lavage (BAL). Finally, your veterinarian may order a fecal parasite test to rule out the presence of lungworms, a parasite that can live in the feline bronchi and cause asthmatic-like symptoms. (Early stages of this Pacific NW parasite can be found in an affected animal’s feces.)

After looking at the chest x-ray your vet should be able to differentiate between asthma and fluid associated with infection or a heart problem. Not all asthmatic cat lungs appear abnormal in an x-ray, however, particularly if your cat is in the early stages of asthma. Heart problems can be further confirmed or ruled out with cardiac ultrasound (i.e. echocardiogram).

Bronchoalveolar Lavage (BAL) involves taking a mucus sample from the bronchioles and studying it under a microscope to determine whether there are an increased number of eosinophils (a type of white blood cell) typically seen in allergic asthma. These same eosinophilic allergy cells are measured in the blood. Other cell types present may support septic inflammation or infection of some type, which would warrant treatment.

Although feline asthma is incurable it is generally manageable. Treatment depends on the severity of the condition. Most commonly, it involves the use of a corticosteroid drug to reduce bronchial inflammation in combination with a bronchodilator to open up the airways.

In most cases, these drugs can be used at home, they are effective both therapeutically and preventively, and they may be administered in a variety of ways: orally in tablet form, through injection, or, ideally, via an inhaler/mask (Aerokat brand).

Potential triggers or allergens responsible for feline asthma may be one or a combination of many things, including: pollens, mold/mildew spores, smoke, incense/fragrances, cat litter, dust and dust mites, etc. It is very challenging to determine which triggers affect the asthmatic cat, but an effort to remove as many possible such allergens from the cat’s environment is recommended.

If your cat is coughing very often, or breathy “funny”, let your vet know and make time for a physical exam/consultation, as it may not be a laughing matter for long.

Mark Donovan, DVM
Northwest Veterinary Hospital

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