My cat is on Clindomycin for an allergy she was determined to have by a Dermatologist. She had been scratching and area on the back of her neck so much that the skin started to come of. I wrote to you about this problem a couple of months ago and you suggested I go to the dermatologist which is what I did.
But I am writing now for a different problem. Now about a month or so ago she started having these coughing fits which I thought were furballs at first. When they got more and more severe and frequent I took her in and the doctor told me it was probably an upper respiratory tract infection which I remember she'd had about 4 years ago and the doctor did an x-ray at that time which revealed that she has a congenitally narrower than normal tracea so would be prone to infection. Anyways the doctor perscribed lysine as she said it was a viral infection and the lysine would boost her immunity to fight it off.
After a week there was no change so I called the doctor and she perscribed Albuterol (Sabutamol) HFA Inhaler and Flovent HFA, Fluticasone Propionate inhaler. I started giving her the albuterol 2X a day and it seemed to get better after a few days so I stopped giving it. For about 3 days she was fine but then started coughing again. So I started giving it 3x a day.
I called the doctor to ask if I should keep giving it and the lysine and was told that the doctor thinks she has asthma now because the puffer helped her so I should keep giving her the pump as needed, ie. when she coughed.
It's been about a week now at 3x a day but she still has these attacks albeit they're less violent than before. And sometimes she has one right after I give her the Albuterol pump. After she coughs now she swallows a lot of what seems to be a lot of liquid that comes up. She just keeps swallowing. And the attacks are every second day or every day!
I haven't given her the Flovent puffer which was perscribed at all yet because she has the skin infection I mentioned at the beginning (and is on clindamycin) and the warning on the Floven medication says that FLovent could mask signs of infection or put the animal at greater risk of developing them.
So I don't know what to do about this. Do you think it's asthma? And if so should I risk giving her the Flovent puffer too. Should I keep giving her the Albterol too? Do you think it might not be asthma but may be something else? Do you think it could be related to her infection or the clindamysin she's on?
Thank you for your help.
Corinne Baumgarten
Dr. Marie replied:
It certainly does sound like Bubelah has asthma. (But keep in mind that I can't officially diagnose anyone over the internet).
You may want to talk to your vet about whether or not oral steroids would be an option for her. I can't remember whether or not she was on steroids for her skin.
While some cats with asthma do well with puffers I find that steroids often work better. But then, there are pros and cons to using steroids so you'll need to discuss those with your vets.
I do find though that I have a number of cats with asthma that are eventually controlled really well with a very small dose of prednisone every other day.
I have other cats that I give a steroid injection to once every 2 months or so and these cats do great.
There are other conditions that this could be, but asthma sounds the most likely to me.
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Customer reply:
Thank you for your reply.
My concern about giving her the oral steroid is the following. I was perscribed two medicines for the puffer. One was the bronchial (Albuterol) which I have been giving her but hasn't put a stop to the coughing attacks. The other one was a steroid medicine called Flovent which I haven't tried on her yet because I'm afraid how it will affect the skin infection that I'm giving her clindamycin for. The Flovent warning says that it could mask the signs of infections and also cause a greater risk for developing infection.
I imagine that the oral steroid would have an even higher risk of masking infection or causing more infection to develop, no? Yes, she was on prednisone for the skin infection last October for 5 days and then to taper it down.
According to her dermatologist, she should be on the clindamycin for another 3 weeks. I'm thinking maybe I should wait until that's finished and then try the steroid puffer. Then if that doesn't work, I could try the oral steroid. How does that sound?
One final question. I was wondering if you could tell me why you think her condition is most likely asthma and not other conditions?
Thanks so much for your help.
Sincerely,
Corinne Baumgarten
Dr. Marie replied:
Hi Corrine, sorry for the delay. I am currently at a veterinary conference in Toronto, so my internet time is shortened.
Regarding the steroid...the decision on whether to start one orally or not really can only be made with your doctor as there are many factors. What I can tell you is that we commonly will use steroids along with infection. If we use steroids at a really high dosage then yes, this can immunosuppress an animal and make fighting the infection difficult. But, I will commonly have animals with say, skin infection that is secondary to allergies, on a small dose of oral steroids to help with the itch at the same time as them taking antibiotics.
If you haven't used the steroid puffer, then really you should. Your vet wouldn't have prescribed it if they didn't think it was safe. This is probably why she is still coughing. Steroids are the hallmark of treating asthma in cats.
Now, why do I think this is asthma? Again, I have to say that I can only warrant a guess from where I am. I can never give a diagnosis online. However, when a cat is coughing, >95% of the time it is due to asthma.
Here's an interesting fact though...yesterday I was in a lecture about parasites here at the conference. The lecturer was saying that if we have a cat that we think has asthma but it is not getting better with steroids then we should consider heartworm. Heartworm is really, really uncommon in cats however, unless you live in the southern US.
I would highly advise using the steroid inhaler as your vet recommended. It will not affect the skin. However, if you are really uncertain you could call your dermatologists office and explain that your cat was prescribed flovent for asthma and ask if the dermatologist thinks that will affect the skin condition. I would be very surprised if they say that it would.
Customer reply:
Okay. I thought that the Albuterol was for treating the asthma so I thought I would avoid the steroid inhaler. But now that you've explained the steroid is the important one of the two for treating the asthma! So I will try this right away because it's awful to see her have these coughing fits which are now every day. I think it's worth any risk regarding her skin infection but I'm comforted to hear that you commonly have an animal on both the steroid and the anibiotic.
Thank for your time in explaining all of this to me. It really helps.
Have a good weekend and enjoy your conference. It sounds like you're learning a lot.
Corinne
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Veterinarian, Dr. Marie created this site to be able to provide quick, accurate veterinary advice online. She would love to help with your pet's problem!
Dr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.
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