not so good news :(

No insights, but sending you some big hugs and prayers. You've been through so much with your guys recently.

That is upsetting news. Here you are, first time cat parents, and you've had so many issues with your two guys. It's not usual at all. And I'm sorry it is happening to all 4 of you.

We can only hope the cardiologist has answers, and good ones.

Robin

Sorry to hear. I have a kitten(9 1/2 months) with a grade 4/5 and shows nothing at all except if holding him you can tell. Good luck

Just that you'll all be in my thoughts - and that while it doesn't seem fair that your two young kittens have had so many issues, especially poor little Hobbes, I do think Hobbes was put in your home, and hearts, so someone would love and care for him.

I hope you get some good news soon.

If love alone could heal Hobbes, he'd live to be 30 years old...and you are doing so much for him, never forget that. Try not to panic, and try not to read the internet too much until you have more results from the vets...the net is great, but you can really panic yourself (hey, I did when I needed a breast biopsy - my doctor was right, I never have googled as much as I did!).

Hobbes and Calvin will be loved all the days of their lives from the moment they entered your heart - and what more can any of us ask?

We have a tendency to do that, and believe me, it can be worst than not...
Let's see the "ifs": First of all: There are different tests used to diagnose Heartworm, and some of them can come with a false positive if the kitty has intestinal parasites or allergies. Be sure to get a Heartworm antibody specific test.
Second: Treatment is considered almost as dangerous as the worms themselves, as the dead worms can dislocate and get stuck in the pulmonary artery; so in the majority of the cases you just monitor the cat for the life spam of the worm - 2 to 3 years, and offer the cat supportive care: Steroids, oxygen, for example as needed. It is a dangerous disease, but not a death sentence by any means.

If it is asthma: There are adapters for the inhalers such as the AeroKat that do a wonderful job, so no worries there
Quite a few cats here have asthma and live a long, plentiful life!

Also:
Lucky had an unknown cough once that was "cured" with a shot of antibiotics, an antihistamine and a shot of a short term steroid. It calmed down her airways, and it never came back again. It was a weird cough that just hung on for days and days, producing no hairballs.

Hang in there and wait for the doctor to say what it is... usually we tend to think the worst; I learned that with the many ordeals I went through with my Bugsy

I'm sorry to read that Hobbes is having such a hard time.

Poor baby!

I know it's so hard, but try to be positive during this waiting process. Like others have said, the internet can make nearly anything seem super scary. Heck, google the common cold and you'll think you're about to die!

Just keep doing what you're doing, giving your Hobbes (and Calvin!) all the love you have for them.

Sending positive vibes your way...

Oh dear, I will keep him in my prayers. I am so sorry you are going through this. Does not seem fair.

But like they said, you don't know until you know. So love on him as much as you can.

You are quality people for doing all this for your little one.

I don't know if this will make you feel better or not, but I have a cat with asthma who takes the inhaler REALLY well...and I didn't expect that to happen. From what I understand, the pills and the shots that can also be used to treat asthma are pretty harsh on any cat, not just one with heart problems (although obviously you don't want to deal with a heart problem and a harsh asthma treatment). I was worried that we would have a really hard time administering the inhaler to him. In general, he's not a very cooperative cat, but he is amazingly calm when we give him his inhaler twice a day. So just don't panic if it ends up being asthma. I never thought that giving a cat an inhaler would be easy, but for us, its turned out really well!

On the heart disease issue, please don't panic yet. I do what you do - I google for hours on end when I think something is wrong with one of my cats and I've scared myself numerous times. I know that everyone's situation is different so your experience could easily be different than mine but here's are my experiences with heart disease:

~One cat died very suddenly from what we believe to be HCM. He showed ZERO signs of heart disease until about 2 weeks before he died. He had no heart murmur, never coughed...had no symptoms at all. He had regular vet checkups and was always given a clean bill of health. 2 weeks before he died, we suspect that he developed a blood clot, which ultimately led to his death (we opted to not have a necropsy done based on the vet's opinion that it may not even show what was wrong with him - so we (us and the vet) are just assuming, based on symptoms and time progression that it was HCM.

~My cat with asthma showed an enlarged heart when his lungs were xrayed so off to the cardiologist we went. It turns out that there is absolutely nothing wrong with his heart. We were told that since an xray is just a single snapshot, it could have been numerous things that caused it to look enlarged.

~Another cat has a heart murmur and has coughed 3 or 4 times. She also saw a cardiologist who saw absolutely nothing wrong with her heart. Our vet classified the murmur as a 3/4, but the cardiologist said it was more of a 1/2. When I questioned him about the occasional coughing he said that while coughing IS a symptom of heart disease, its often NOT the symptom that presents itself the most. He said that in his 20+ years as a cardiologist, he has seem more coughing cats that have had asthma, or another respiratory problem, and not heart disease. If I remember correctly, he estimated that about 15% of the coughing cats he sees have heart disease, while the other 85% have asthma.

~And finally another one of my cats tested positive for heart worm about 5 years ago. I'm a little unclear of exactly how heartworm tests work, but I do know that the test she was given was one that isn't always accurate and can show exposure instead of actual heartworm. So to be perfectly honest, we never knew if she had heartworm or if she was just exposed to it. Because there is no treatment for cats, we decided along with the vet to continue to give her Revolution (which doesn't do any harm to cats with heartworm) and just keep an eye on her. About 4 years later, she was retested and tested negative. It was explained to me that while there is no cure for feline heartworm, cats tend to get fewer heartworms than dogs (often only 4 or 5 of them) and if they happen to all be the same sex, then they will eventually die. It CAN be dangerous if they die and move into the lungs, but they can also die off and get adsorbed into the cats body. Our vet thinks its very possible that my cat did have heartworm and they all died in that 4 year gap between the two tests that she had, and just didn't cause her any problems in the process.

So I'm sorry I'm rambling, but my point is - don't panic! I absolutely know how hard and heartbreaking it is to get bad news about your cat, especially when they are so young (I cried for days when that heartworm test came back positive), but in my experience, sometimes the things that I expected to be the worst case scenario turned out to be perfectly fine in the end. In fact, the only cat I lost to heart disease didn't have any symptoms at all. And while that in itself is a scary thing, its also taught me to not panic about symptoms that do present itself.

I'll keep you and your kitty in my thoughts and send good vibes your way. So stop googling! (although I know I don't stop when people tell me to) And try to think positively. Your kitties are obviously very loved by you and no matter what happens, just remember that you are giving them the best possible life they can have

Oh sweetie, I'm really sorry.

I'm just quoting that because its a good idea . And I figured I'd post my own advice too, since I wish someone had given me this advice to begin with. I don't have the Aerokat, but I have something similar to it (not sure of the brand offhand but it came from the vet). So I don't know if the Aerokat has an elastic piece to put over their head to hold the mask on (but I think it does), but mine does and my cat FREAKS if you try to put the mask on that way. When I was first starting to give him the inhaler I was concerned for a day or 2 because I didn't think it was going to work, but then I realized that if I hold the mask to his face with JUST my hand and leave the elastic piece far away from his head...then he does just fine. Its not even that tight, and it can be loosened if it was, but for some reason he just really doesn't like the idea of that mask being held to his head that way. So I just hold it tightly to his face with my hand and all is well. I just wish someone had given me that advice on the first 2 days I was trying to do this .

That mask sounds odd Brooklet.

I have three on flovent. One likes to play hard to get sometimes, one struggles a little(doesn't like being held), and the other one makes little grunting noises… but she does that for other things, too, then I have to push her out off my lap because she's a lap cat and thinks med time is snuggle time.
In short, it's very easy with the aerokat, don't let anyone tell you otherwise.

How does his chest x-ray look?
In the case of inflammatory bronchitis, that my cats have, coughing isn't really consistent. Some cough more easily, others have to get quite a bit of inflammation to trigger the cough. Their episodes do not look like the videos of asthmatic cats- it's a spontaneous dry cough. They cough in whatever position they're in then go on with their business like it never happened. I was lucky to catch my vet's son, a veterinary cardiologist, when he was visiting his dad. I caught it before their hearts were affected, though it took a while because at first it was looking like an infection.

Oh no not at all! I just said that because the OP mentioned that giving an inhaler to her cat would be difficult. And I absolutely didn't take offense to anything that you said at all. I'm not sure why it came across that way, but I promise - I don't have a problem with a single word that you said . I just quoted you and added onto my personal opinion/experience too. So sorry if I came off sounding rude or annoying - that wasn't my intention at all!

ETA: Oops - sorry, I just realized that you quoted strange wings and not me there. Wow I'm just being extra confusing today - sorry! I thought I said something similar about it being easy to use, which is why I thought you were quoting me. So anyway, I'm so sorry for being so confusing! No one has told me that its hard to use and I wasn't offended or annoyed by anything you said!

strange wings - I might not have described the elastic on the mask very well, but there's a picture of what it looks like here if you scroll down a short ways:

http://www.keriosity.com/?p=186

I just looked up Aerokat pictures too and saw that it definitely doesn't have the same thing like you said. I just pulled it off of my mask after realizing it wasn't going to work for my cat, since it wasn't doing any good by being there.

Per the OP's post…

My own vet thought much the same and didn't know better. I wish they wouldn't say things like that because it discourages those that don't know better.

Just know you have LOTS of supporters here at TCS! I have not too much to add here other than you are really doing everything you can for Hobbes. He is loved each and everyday and your care couldn't be better. So hang in there! Sending lots of prayers tonight to you, your DH and Hobbes and lots of hugs too

Just a bit of info per asthma vs. bronchitis. Asthma responds to broncodilaters better than bronchitis does (if it does at all). These cause tachyarrthymias due to not being very specific in what they target - hence the cardiologist's concern. But if it's not asthma, they won't help as much anyways.

As a precaution, have you eliminated all possible inhaled allergens and irritants? Remember, cat litters are both.

That sounds a bit like my Blasa! She's more shy with her coughing and doesn't tend to "let it rip" like the others do. I've always described their cough as sounding similar to scraping my fingernail across the edge of cardboard (I get bored and "test" sounds of things... ) - it makes a very dry raspy sound. Their oxygen levels seem well maintained during occasional coughing - no one turns blue or seems to be struggling.

A chest x-ray should have honestly been the first thing done when you brought him in for coughing! The longer this goes on the more likely the heart will be affected even if the heart is not the original source. My vet charged around $80 for the x-ray. A specialist is not needed to do this unless the regular vet doesn't do x-rays.
I kind of hate to suggest this in case it is his heart, but maybe get the x-ray ASAP and then use that to decide if more expensive tests are really needed? I sort of wonder if you weren't pushed into more expensive testing too soon.

Have all infectious causes been eliminated? If not, depending on how the lungs look, a tracheal wash can show if there's anything in the lungs or if it's just inflammatory.

How is Hobbes energy level? Does he seem to be playing a bit less or or breathing hard during play?
I have one who's more cough resistant, but I can see it in her stamina during play - she tires and has to take breaks just like a person would. The male doesn't really seem to do this unless he's really bad off... but then he's a young boy cat and I haven't had a young male cat yet that doesn't try to push boundaries a bit. This is why he's most likely to have a coughing fit. The third one, Blasa, doesn't really do much of anything ever and never has - so I have no stamina gauge on her.

Now here's the problem for you: All cat litters are bad. Clay, grain, wood, silica, dusty newspaper (though lesser for this). They all make dust or have allergens in them. I have a cat that has problems with clay, hence the reason I haven't used it in nearly 4 years. I wasn't using it when the kittens came along. I was using chicken feed and grains are common allergens in animals and people. Whether this triggered it or not, I will never know. Swheat is wheat, and could be problematic because of that.
I now use DIY versions of the smart cat box with safflower seeds. One person in another thread mentioned using popcorn kernels in much the same way. A store bought option is Tidy Cat Breeze. In all cases there is no odor control (just keep the boxes clean) and urine drains into a bottom box - some use pads to absorb it, my DIY boxes just collect it which I then flush. (less litter going to a landfill!) You have to wash the boxes often, though.
These can be harder for cats to adjust to because they're not soft litters, though I've not had problems. Due to the life span of the litter replacement material (I don't know what else you'd call it?) and the amount you use, cost is comparable or a little less than litter is.

To start with, I'd eliminate everything else you possibly can in the home as it's not difficult to stop using scented products, dust/vacuum more often, and change air filters more frequently. If it turns out Hobbes lungs aren't the source of this, there's no harm in cleaning.

ETA: Mine started coughing at ~10 months old.

He has a history of URI? What caused it? Was it ever identified?

I'm so sorry you guys are going through this. Please know I'm thinking about you - and I hope you get good news tomorrow. <<<Many hugs.>>>

God bless!

AC

Re possible litters to use - Dr. Elsey (Precious Cat) has come out with a new line - R&R Respiratory Relief Litter (both clay and silica gel) - it's supposed to help control sneezing, running eyes and coughing (quoting here from Cat Fancy). I honestly would at least check it out - I use Cat Attract since my boy had litter box issues, and I now swear by Dr. Elsey (he's a cat only vet in the Denver area - he developed Cat Attract since he saw so many cats given up due to box issues). It may seem expensive starting out - but, if it helps, it'll be worth it. At least that's what I found with the Cat Attract litter.

Flowerbelle had horrible herpes infection when we first rescued her, and I remember the cycle of URIs when she was young - going to the vet often triggered them, and she needed to see the vet fairly frequently initially.