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asthma
medications
by Nancy & Bob Johnson , featuring Little Guy, our 15 year old cat with severe chronic asthma symptoms
Metered Dose Inhaler
(MDI) medicines come in a pressurized canister and need to be vigorously
shaken for about 15 seconds immediately before dispensing "puffs" into the
Valved Holding Chamber (OptiChamber or AeroChamber). "Test spray"
once into the air before first use, or if unused for 1-3 weeks.
Each MDI holds a specific number of doses, and it is important to keep track of the doses used, so that you know when it is time to replace it. The MDI will not be completely empty, but it will not deliver an accurate metered dose of the drug, after you have used the number of doses indicated. Our 120 dose Flovent 220 mcg MDI (orange, cost $107) will need replacement after 30 days at 2 puffs each morning and night, so I put a reminder to get it refilled on my calendar. Our 200 dose Albuterol 17g MDI (gray, cost $16) will last 50 days if we stay with the same 2 puffs, twice a day schedule. Some cats are able to decrease to once a day or only use Albuterol when having an attack.
The mask has a triangular shaped opening and on a person you would apply it with the tip of the triangle over the nose and the base of the triangle below the mouth. We had problems getting it to fit our cat's face without overlapping his eyes until Jena suggested turning the mask upside down, which seemed to help. We still couldn't see the valve flaps moving as he inhaled and weren't sure he was getting the complete dose. Little Guy didn't like the pressure of the mask on his face and we weren't getting a good seal so we decided to borrow an idea from the anesthesia mask and cut a piece of soft flexible latex from a disposable glove and taped it over the opening so that it sealed (use clear tape, sticky enough to hold ~3/4" wide). Then we cut a small opening (with tiny sharp scissors) that allows his nose to poke through and the mask only needs gentle pressure and doesn't leak.
The OptiChamber
one-way valve has thin flexible flaps (actual color is gray) that move slightly
when he inhales, if the mask is sealing well. The valve should be
replaced after 6-12 months use. The manufacturer recommends
rinsing the OptiChamber and valve with warm water (and mild liquid soap) a few
times a week, allowing it to dry before the next use. The MDI should be
kept capped when not inserted in the OptiChamber, the plastic case should be
rinsed with warm water and dried after use.
Make sure you have a mask that fits properly- the large feline face mask used for anesthesia and sold by the Henry Schein catalog works best for most cats.
Consult your vet about how long to hold the mask in place for your cat to receive an effective dose. In the VCNA article from Nov. 2000, Dr Padrid recommended 7 to 10 breaths (7 to 10 seconds in the protocols). If your cat is breathing rapidly with shallow breaths, applying the mask for a specific time might be a better gauge for delivery of an effective dose.
MDI = Metered Dose Inhaler
8/2002
AeroKat® - Feline Aerosol
Chamber (FAC) 
Fritz the Brave's website - a wealth of information on feline asthma and treatments
The importance of shaking, actuation, applying, waiting and then repeating
(if that is one's Rx) is explained on:
http://www.fritzthebrave.com/inhaled.html
Scroll down to How to Use a Metered Dose Inhaler (MDI) with a Feline Aerosol
Chamber (FAC)
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AeroChamber http://www.trudellmed.com/copd_aerochamberplus_vhc_child.shtml
AeroChamber Plus model, valve and mask changed
http://www.trudellmed.com/copd_aerochamberplus_vhc_child.shtml
* ComfortSeal mask shape now triangular instead of
round, 3 sizes (in .pdf, Adobe Acrobat format)
http://www.trudellmed.com/pdfs/copd_aerochamberplus/masksizer.pdf
OptiChamber http://www.respironics.com/
OptiChamber Advantage Masks the Advantage is a newer model than is shown in Little Guy's photos
A prescription from your vet is required to purchase a Valved Holding Chamber. We provided the vendor information to the vet (vendor name and fax number, item name, order number, price) and he faxed a prescription to the vendor, then we placed the order on-line, noting the name of the Vet, clinic phone number, and the cat. Prices vary, you can search the internet and compare. Prices from Allergy Supply Company (5/01) are provided here as an example:
| OptiChamber | $ 10.95 | #800 |
| Small Face Mask for OptiChamber | $ 8.95 | #811 |
| OptiChamber Valve | $ 6.95 | #800V |
| AeroChamber w/Small Mask | $ 28.95 | #ACSM |
Allergy Supply Company
11994 Star Court
Herndon VA 20171
Tel. 703-391-2011
Tel. 800-323-6744
Fax 703-391-2014
Fax 800-681-5454
e-mail: allergy@allergysupply.com
http://www.allergysupply.com/
Allergy & Asthma Equipment Worldwide
Cat Mask Large Ea
Product Code: 3100151
A M Bickford Inc
Manufacturer Code: 09507
Anesthesia Mask Feline 3-1/2 Ea
Product Code:
5684030 (see picture at http://www.jorvet.com/Chap18.pdf top
of page 6)
Jorgensen Laboratories Manufacturer Code: J298-F
http://groups.yahoo.com/group/felineasthma/
Click to subscribe or
login to felineasthma
Offers a broad
range of support to new and veteran caretakers alike concerning all issues
relating to asthma and other respiratory diseases, including inhaled meds.
Public - anyone can view/post messages without registering, but Yahoo
Group Registration allows access to valuable information including the archived
messages, bookmarks, databases, and member files including the ability to add
your own information.
Inhaled Meds
Grouphttp://groups.yahoo.com/group/felineasthma_inhaledmeds/
Click to subscribe or login to felineasthma_inhaledmeds
(January 2002) The Feline Asthma Inhaled Medication Users Group has been formed to provide a focused forum that encourages discussion among current and prospective inhaled med users, veterinarians and medication and modality developers. By registering for the Yahoo group felineasthma_inhaledmeds, you will be able to view or post messages, bookmarks, databases, and member files. Alexis Thonen, creator of the more general Feline Asthma and Respiratory Diseases group has requested that you cross-post your messages to the inhaler group in her public group at http://groups.yahoo.com/group/felineasthma/
For a discussion of the use of inhalers with cats, please refer to Feline Asthma Diagnosis and Treatment by Philip Padrid, RN, DVM, in Veterinary Clinics of North America: Small Animal Practice, Vol 30, Number 6, November 2000. Dr Padrid
is at the University of Chicago, Section of Pulmonary/Critical Care Medicine, Animal Resources Center in Chicago, IL.Dr. Phillip Padrid's Protocols for Flovent and Albuterol, as well as an illustration of how to add an anesthesia mask to an OptiChamber are available here as Microsoft Word Documents (with permission)
| Flovent Protocol |
| Albuterol Protocol |
| Spacer how to add Anesthesia Mask to OptiChamber |
Philip Padrid, DVM
Midwest Regional Medical Director,
Veterinary Centers of America Hospitals.
1-800-966-1822 ext. 5266 (voice mail)
1-773-947-8945 (fax) Office 773-947-8944
University of Chicago Associate, Department of Medicine,
Comittee on Molecular Medicine
Mailing address: Dr. Philip Padrid, VCA Berwyn Animal Hospital 2845 S. Harlem
Ave., Chicago, IL 60402
*NOTE: send self-addressed stamped envelope if requesting response
Options for treating feline asthma by Patricia M. Dowling, DVM, MS, DACVIM, CACVCP in the May 2001 issue of Veterinary Medicine
has a picture of the small AeroChamber and mask being held on a cat. Dr. Dowling is at the University of Saskatchewan Western College of Veterinary Medicine in Canada.A compilation of asthma medicines discussed by members of the Yahoo
Feline Asthma Group in 2001 with links to more information about them can be
found at:
http://plaza.ufl.edu/johnsonn/catasthmameds2.htm
and
http://groups.yahoo.com/group/felineasthma/files/LittleGuy/catasthmameds2.htm
Sadly, Little Guy died August 18, 2001 at age 15 years. His asthma became much worse following a dental cleaning with anesthesia. After 5 days, he had a respiratory crisis and died on the way to the vet.
Created 6/10/01 and last updated 8/24/02 by Nancy Johnson
Send comments
and updates to Nancy Johnson at johnsonnd@hotmail.com
Permission to
use photos with attribution and to print copies is freely given.