Small Animal Emergency and Critical Care Medicine Q&A 06
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This question was provided by Manson Publishing as part of the OVAL Project. See more Small Animal Emergency and Critical Care Medicine Q&A. |
A six-year-old, female, spayed domestic shorthair cat was presented with a history of occasional coughing. In the last 12 hours the cat has coughed with increased frequency and is now in significant respiratory distress. Physical examination finds the cat open mouth breathing, ‘air hungry’ and aggressive. The cat has a prolonged expiratory phase of breathing. Auscultation finds high pitched wheezes and normal HR, rhythm and sounds. The pulses are strong. This is all you can examine.
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| What is your tentative diagnosis from the breathing pattern, auscultation and history? | Feline asthma. |
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| Describe your initial therapeutic plan and options should the cat worsen. | Oxygen by flow-by or small cage; i/v catheter if possible; sedation – butorphanol may be sufficient; fast-acting glucocorticoids; nebulized bronchodilators such as terbutaline (cats will actually seek out this ‘mist’ and sit with their noses against the outflow spout!). Should the cat worsen, epinephrine (1:10,000) (0.25–0.75 ml i/m) can be used, or an albuterol asthma inhaler discharged during an open mouthed inspiration. |
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| What radiographic changes do you expect to see? | Hyperinflation of the lungs; flattening of the diaphragm; bronchiolar markings. |
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| What are concerns for long-term control? | Examination of the environment for inhaled allergens – cigarette smoke is a common initiator. Cats can often be weaned off glucocorticoids and it is then given only as needed by the owner. Should the cat have severe attacks, the owner can keep an albuterol inhaler. |
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