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asthma medications

How we give Inhaler Medicines to a Cat

by Nancy & Bob Johnson , featuring Little Guy, our 15 year old cat with severe chronic asthma symptoms

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.  

OptiChamber Valved Holding Chamber with the Small (infant) Face Mask.  

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.

OptiChamber with MDI and Small face mask attached. OptiChamber with MDI and Small Face Mask attached (from mask end, not rotated for cat) Small Face mask, upside down for cat, with latex gasket Little Guy with modified small OptiChamber mask applied


OptiChamber valveOptichamber valveThe 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.

Chambers for (MDI) Inhaler meds

MDI = Metered Dose Inhaler 

8/2002 AeroKat - Feline Aerosol Chamber (FAC)

Trudell Medical International
725 Third Street
London, Ontario
CANADA N5V 5G4
Monday - Friday, 08:30 - 17:00 EST
Telephone:1-800-465-3296   +1 (519) 455-7060
Fax: +1 (519) 455-6478
Email: aerokat@trudellmed.com
Website: http://www.aerokat.com  on-line store, no prescription necessary for 

Fritz the Brave's website - a wealth of information on feline asthma and treatments

Pictures of the AeroKat being used on Fritz the cat  

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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Human Chambers used for Cats in the Past:

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

How to Order a Human Chamber and Mask (AeroKat is now preferred for felines)

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

A Feline Anesthesia Mask (has a rubber diaphragm seal) can be ordered from:

Henry Schein Catalog, Veterinary Supplies (Vet must order)
http://www.henryschein.com/

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


Feline Asthma website 
http://home.triad.rr.com/alexisandjason/asthma.htm

Feline Asthma and Respiratory Diseases Group website/messageboard (Yahoo Group registration optional)

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 Group
website/message board (Yahoo Group registration required)

http://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/ 


References

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 

Dr. Philip Padrid - Contact Information

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. 


Asthma Medicines used with Cats

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.

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