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Medications used for Asthma in Cats

Compiled from treatments discussed in the Feline Asthma Group messages and databases, 2001 at http://groups.yahoo.com/group/felineasthma/.  Please send corrections and updates to Nancy Johnson at johnsonnd@hotmail.com   Note that drug action in cats may not be the same as in humans, but specific research has not been done on the use of many asthma drugs in cats.  Most links here are to sites discussing human use of the drugs, ask your vet how these medicines affect your cat.  Anecdotal reports and case studies suggest possible treatments, but can't provide information on the actual efficacy and  long-term risks of using a particular drug with a cat. 

Veterinary uses of drugs are discussed at: 

MarVista Pharmacy http://www.marvistavet.com/html/pharmacy_center.html
Drs Foster & Smith PetEducation.com http://www.peteducation.com/category_summary.cfm?cls=0&Cat=1303

Human uses of drugs are discussed at most sites (effects may be different for cats)

RxList    http://www.rxlist.com/
MedicineNet.com Asthma medications  http://www.focusonallergies-asthma.com/
Informed Drug Guide (1994/1995)   http://www.infomed.org/100drugs/index.html

Search for a Drug at AltaVista.com http://www.altavista.com/sites/dir/search?pg=dir&tp=Personal/Health/Drugs_.26_Medicines/Drugs_A.2dZ/

Discussion of Glucocorticosteroids (glucocorticoids, corticosteroids, steroids) at PetEducation.com, Drs. Foster & Smith.  These steroids frequently are prescribed to treat asthma in cats.


Table of Drugs used to Treat Asthma in Cats

Steroids
long-term anti-inflammatory effect
Forms available Asthma Emergency Maintenance drug for Chronic Symptom Relief/Attack prevention Comment
Prednisone (MarVista Vet site)
Systemic effects increase the risk of developing diabetes.

pill not really a rescue drug, but dose often temporarily increased then tapered lower (or off) as tolerated (without symptoms re-occurring or worsening) often given as a daily drug (1x =sid, or 2x=bid), or "every other day (qod)  
Prednisolone (MarVista Vet site)
Prednisolone (
Informed Drug Guide 1995)
Prednisolone (MedicineNet.com) 
may be administered in tablet form or produced by the body from prednisone. These medications are considered to be interchangeable.
pill dose often temporarily increased then tapered lower (or off) as tolerated  given as a daily drug (1x =sid, or 2x=bid), or "every other day (qod)  
Depo Medrol
(Methylprednisolone Acetate)

Systemic effects increase the risk of developing diabetes.  2-3 shots/year generally considered safe.
IM (shot usu. at vet) Frequently used as a rescue drug for relief in minutes. 1 shot provides long-term relief for weeks-months (varies with severity and nature of symptoms).  Duration of relief lessens as disease progresses.    
Flovent (Flucticasone propionate) flovent.pdf inhaler chamber w/mask No daily dose, usually 2x=bid,  often in conjunction with Albuterol.  "Takes 10-14 days to reach peak effects" Several reported ~4 wks to see improvement in cats.
AeroBid (Flunisolide) http://www.frx.com/products/aerobid/ inhaler chamber w/mask No daily dose, usually 2x=bid not studied in cats/dogs
Bronchodialators Forms available Asthma Emergency Maintenance drug for Chronic Symptom Relief/Attack prevention Comment
Brethine (Terbutaline) usually a pill, can be IM or Sub-Q shot IM shot = rescue drug 1/4 or 1/2 pill often given as a daily drug (1x =sid, or 2x=bid)  
Aminophyllin usually? a pill, can be IM IM shot = rescue drug ?  
Theophylline (MedicineNet.com)
(Theo-Dur) (Informed.org)
pill, syrup, solution ? 1/4 or 1/2 pill  given as a daily drug (1x =sid, or 2x=bid)  
Albuterol (Ventolin, Proventil) http://www.rxlist.com/cgi/generic/albut1.htm inhaler chamber w/mask rescue drug, relief in 10-15 min. (<4h effect) may be given as a daily drug 2x=bid or 4x=qid in conjunction with steroids, if daily symptoms warrant it  
Serevent (Salmeterol) inhaler 
chamber w/mask
? relief takes >1 hr 12 hr control of  bronchoconstriction  
Other Forms available Asthma Emergency Maintenance drug  Comment
Cyproheptadine HCL (Periactin) pill,
transdermal gel
no? daily dose, believed the anti-serotonin effects rather than anti-histamine is what helps asthma also appetite stimulant, but may cause lethargy, "zombie" cat 
Accolate (Zafirlukast) pill (anti-
leukotriene)
? daily dose not studied in cats/dogs, risk of liver damage
Antihistamine Forms available Asthma Emergency Maintenance drug  Comment
Chlorpheniramine maleate (Clor-Trimeton) pill, syrup, or shot   sometimes used for nasal congestion  
Hydroxyzine (Atarax) pill   sometimes used for nasal congestion, 10 mg bid not all cats respond to antihistamines

Antihistamines for cats with allergies

Source- Drs Foster & Smith North American Veterinary Conf  2001

Dogs that suffer from allergies have long been a big problem in the United States. While much has been written about their treatment, allergic cats have often been neglected. While there are not as many allergic cats as dogs, veterinarians are well aware that there are still many cats that suffer from inhalant allergies. Oral antihistamines have been a mainstay along with fatty acids and biotin to help control allergies in both cats and dogs. Unfortunately there are very few veterinary antihistamines available for animals and in the past veterinarians have had to resort to using human antihistamines in animals. The human antihistamine most commonly used in dogs have been diphenhydramine (Benadryl) and hydroxyzine (Atarax). Cats have often not responded as well to these antihistamines and appear to respond better to the antihistamine chlorpheniramine (Chlor-Trimeton). With the introduction of new antihistamines in the human market, veterinary dermatologists have found an additional antihistamine that appears to be working well in cats. This new antihistamine is fexofenadine (Allegra) and is being used effectively in many allergic cats. If you have a cat suffering from inhalant allergies ask your veterinarian about the use of this drug.

Risks

Steroids

Oral and IM (shots) are absorbed by the body and have systemic effects.  In time, the adrenal glands will atrophy so that when the medication is discontinued, the patient will be unable to respond to any stressful situation. A circulatory crisis (shock) can result.  Inhaled steroids affect the respiratory system directly and have very little systemic impact. 

Switch from systemic steroids to inhaled steroids (ex. Flovent =Flucticasone propionate).   For up to a year, a risk of Adrenal insufficiency (fatigue, lassitude, weakness, nausea & vomiting, and hypotension) exists which can lead to a  circulatory crisis w/trauma, surgery, or infection (esp. gastroenteritis) as systemic corticosteroids are reduced/replaced.  Add systemic steroids to help cope.


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. 


Chambers for (MDI) Inhaler meds

MDI = Metered Dose Inhaler 

8/2002 AeroKat - Feline Aerosol Chamber 

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

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

Pictures of the OptiChamber being used on Little Guy the cat are at
http://plaza.ufl.edu/johnsonn/MDI.htm and 
http://groups.yahoo.com/group/felineasthma/files/LittleGuy/MDI.htm


Created 6/11/01 and last updated 8/24/02 by Nancy Johnson
Send comments and updates to Nancy Johnson at johnsonnd@hotmail.com

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