Asthmatic Siamese?

Re: Asthmatic Siamese?

Martin Atkinson — Wed, 16 Apr 2014 18:46:00 GMT

[quote user="Mike Martin"]One other observation. The heart size on the lateral is increased extending to 3 rib spaces. It might be worth an echo to check for heart disease therefore. [/quote] Or perform an NT-proBNP!

Re: Asthmatic Siamese?

Mike Martin — Wed, 16 Apr 2014 13:41:19 GMT

Clenbuterol can be use for life if needed.

We all do things differently - I - tend to medicate cats with bronchodilators and steroids orally on first presentation, then once stablised, wean over to inhalers after a few weeks. It takes time for both the owner and cat to get get used to inhalers, in my experience, and not all do, so I tend to keep on the oral meds until the owner reports they are confident the meds are getting in by inhaler, then wean off the orals. But keep the owner watching for signs of relapse. The inhalers do not work for the owner or cat, then keep on the oral meds.

The other thing I do sometimes is to give a good course of Panacur as well, just in case.

Good luck.

Re: Asthmatic Siamese?

Laura Marshall — Tue, 15 Apr 2014 22:49:10 GMT

Sorry, I don't know why when I post from an iPad it removes all my spaces... What I meant was:

Thank you for the really useful info from all three of you, I think I was getting bogged down and couldn't see the wood for the trees!

Andrew - looking through the history a little further I can find a prescription for a ventolin inhaler, so I wonder what's happened with that. I have spoken to them about potential irritants and they are clear.

Kate - I was thinking about doxy too, as I tend towards this for resp cases. For flixotide doses I found 250-500mcg/day.

Mike - thanks for the feedback on the X-rays, that's really helpful. The clenbuterol has helped a lot, how long can we use this for? Should I have them use this while they reintroduce salbutamol inhaler, or directly switch?

Laura

Re: Asthmatic Siamese?

Laura Marshall — Tue, 15 Apr 2014 14:53:22 GMT

Thank you for the really useful info from all three of you, I think I was getting bogged down and couldn't see the wood for the trees! Andrew - looking through the history a little further I can find a prescription for a ventolin inhaler, so I wonder what's happened with that. I have spoken to them about potential irritants and they are clear. Kate - I was thinking about doxy too, as I tend towards this for resp cases. For flixotide doses I found 250-500mcg/day. Mike - thanks for the feedback on the X-rays, that's really helpful. The clenbuterol has helped a lot, how long can we use this for? Should I have them use this while they reintroduce salbutamol inhaler, or directly switch? Laura

Re: Asthmatic Siamese?

Mike Martin — Tue, 15 Apr 2014 09:13:03 GMT

Hi Laura,

I think your correct - these lungs are markedly hyperinflated (indicative of air-trapping and bronchoconstriction) with a broncho-interstitial lung pattern. There's two old rib fractures seen on the lateral (10 & 11th ribs). So keep aggressive with the bronchodilators and using both clenbuterol orally + the flixotide by inhaler + preds works for me. It can take some time for some of these cases to ease off.

We often do provide a course of doxycycline as well.

One other observation. The heart size on the lateral is increased extending to 3 rib spaces. It might be worth an echo to check for heart disease therefore.

Best of luck

Re: Asthmatic Siamese?

Kate Richardson — Mon, 14 Apr 2014 21:33:21 GMT

I agree with Andrew's post, I would only add that you should give the inhaled bronchodilator 10-15 minutes before the corticosteroid so the airways are as open as possible to allow optimum distribution of the corticosteroid within the airways. I would certainly try to get a repeat bal done if you can and as well as cytology of the fluid i would suggest you a resp infection pcr panel which includes pcrs for mycoplasma and bordatella. If the owners really don't want to do this then a trial of 2-3 weeks doxycycline may be worth considering as this will treat mycoplasma/bordatella and is a great antibiotic for resp infections in cats. 10mg/kg Sid. If a good response, consider treating for 4-6 weeks total. If no better with inhaled bronchodilators or doxy then you may need to increase the oral pred but it would be preferable to do a bal first. I don't have fluticasone doses to hand- are you at maximum dose there? I will see if I can find any further info on additional therapy. Hope that helps Kate

Re: Asthmatic Siamese?

Andrew Kent — Mon, 14 Apr 2014 10:40:01 GMT

Hi Laura,

Have you ever used inhaled bronchodilators in this cat? If you have had a response to oral clenbuterol then using salbutamol inhalers would be worth a go. In people with asthma they are really the backbone of management as asthmatics have very reactive airways that easily spasm. So we would normally start with an inhaled bronchodilator with the steroid and many will need to continue with both.

The other thing is to talk to the owner about airborne irritants - do they smoke? or use incense or plug in room fresheners? Or lots of sprays or anything around the cat? All of these can be potentially troublesome in asthmatic cats.

Do let us know how you get on.

Andy