Chronic asthma, steroids aren't helping, any other things to try?

Looking for some ideas on what else I could be doing around the house, and if there's anything I could be talking to the vet about. I'm getting desperate as she hasn't breathed normally in nearly 3 months now. She's miserable, I'm a wreck, and I just want her to feel better!

Puff turned 5 this year, and about 3 months ago I noticed she was constantly breathing faster than normal and she was breathing hard all the time. She never once panted, or seemed out of breath, or was in distress, but when she would sit on my lap my legs would get sore from her chest heaving. This did not (and still has not) stopped. Otherwise though she still had the same activity level as normal.

Got her in to the vets, and they ran an x-ray, and her lower bronchial tract was severely inflamed. Like severely. Her passageways were huge and bright white, and the rest of her lung was cloudy. They figured it was asthma but wanted to treat for lungworm and possible bronchitis first, so she was put on meds for two weeks and sent home. After two weeks there was no improvement, so she was started on 5mg of prednisilone a day.

(I also found out at this point that the "dry heaves" I thought were hairballs that she was not bringing up was actually coughing. She'd been doing that for at least a year, and I never knew it was a sign of asthma. )

A month in and still no improvement in her breathing, but she did gain a pound. A follow-up x-ray showed some very slight improvement in her lungs, but nothing like what should have happened after being on steroids for a month. Her lung sounds were also much more clear in regards to crackling, but she still had heaving sides and a way too fast respiration rate. She also started sleeping a lot more and not moving as much, and she also wasn't nearly as high-strung as she normally was. Vet upped her prednisilone dosage to 10mg (half in the morning, half at night). 

It's been another two weeks on the 10mg dose, she's gained even more weight, and she's still exactly the same. I just don't know what to do at this point. The vet said if she doesn't respond to the higher dosage then the damage is most likely permanent. I really hate the thought of her having to live like this. She's already had all her teeth removed (at age 2) due to severe stomatitis and ulcerating of her mouth and throat. (Which is why the weight gain this time has me stumped - she's been on pred for months before with no major gain.) She's sleeping nearly all day now and won't move for anything, where as before if I were to roll over in bed she'd be stomping off in a tizzy for having disturbed her. 

I have severe allergies to everything (seasonal, household, perfume, food, etc.) and I also have extremely bad asthma, so I make sure the house is asthma friendly to begin with. We even changed her litter to a different no-dust no-scent clay (I can't use any of the other types) to see if that would help. I don't know what else I can do!

Anyone have any advice on other things we could be trying? Anyt alternative therapies I could be talking to my vet about? He's saying that if the pred isn't working then nothing will, which is scaring me to death since that means she's going to be stuck like this for the rest of summer, if not always.

Not sure what part of the world you live, but is heartworm a possibility?

Diet can play a role in the overall health of the immune system - what does Puff eat? A consultation with a holistic vet might be useful at this point. They often have a better idea of how to find and address the source of the issue rather than just trying to suppress the symptoms.
 

Forgot to include some links in case you haven't seen these before:

http://www.felineasthma.org/reldisease/index.htm

http://www.marvistavet.com/html/body_feline_heartworm_infection.html

http://www.fritzthebrave.com/

Also, perhaps inhaled steroids would be more effective (and have fewer side effects) than the oral pred:

http://www.fritzthebrave.com/meds/inhaled.html
 

We're in Ohio, so heartworm is a possiblilty, though a faint one. It was the first word out of my mouth during the appointment, followed by lungworm. He says there's no sign of it being heartworm as her x-rays were completely clear in regards to her heart. Even if it was, treatment would be the pred. 

She's been on z/d for a month (again) just to make sure it's not food allergies. Since she and her sister both are missing teeth they do best with a small-pellet food and they are usually on science diet. We've tried others (including several of the better brands), but both of the girls did the best surprisingly on SD. (I know it's a "junk" food, but after what we've been through, we're just happy they're eating and are no longer 4 pounds!)

I've checked out Fritz's site, along with a couple of the other asthma kitty sites, but they focus on cats with acute asthma attacks rather than more chronic problems like what Puff has. (She has the feline form of COPD, essentially.) I haven't been able to find any first-hand accounts where it's non-life-threatening symptoms that have lasted for months on end with no respite. 

I've been trying to push for inhaled on top of the pred, but I keep getting told that if the pred isn't having an effect then the inhaled will do nothing. If it turns out that it's going to be a long-term issue then there won't be a choice and the inhaleds will be the only option, which means this will be as good as she'll get. 

My sweet Ophelia <RB> was first on oral meds for her asthma, and was eventually put on inhaled medication (love aerokat..makes it relatively easy to administer).  I'm currently using an inhaler with her son, Dee (post-pneumonia now with heart failure).  As I recall, we tried two oral meds with her - prednisolone, and brethine.

I wish you all the best. I know how it feels to be watching their respiratory rate and just wanting it to slow down, and for them to breath easy.  Dee was clocked at 80 breaths per minute when he crashed with his pneumonia..scary time.

Oh, I'm so sorry!!!! :rub:

I would absolutely try to find a holistic vet (a DVM trained in chinese medicine and acupuncture) you can get to: http://www.ahvma.org

Acupuncture can really help; typically has wonderful results. :nod: I also think you should try inhaled steroids. When Flowerbelle was diagnosed with early asthma, the first thing the vet suggested was inhaled steroids, not oral.

I have asthma. I don't take oral steroids for it, I take inhaled steroids (Advair). :dk:

Vibes for you and your girl!

I have a cat with asthma-like symptoms.  Vet is afraid to call it asthma because she has some other issues and it might just be a side effect of that.  I give my girl 1/8 -1/4 t of pure evening primrose oil a day and it helps keep the inflammation down.  I just add it to her wet food in the morning.
 

Oh boy I feel so badly for you guys I think getting to a holistic vet at this point might be your best option.  Sounds like you've tried just about everything else.   I don't know if her diet might have anything to do with the inflamation but it might be something to take up with the holisitic vet.  There has to be a root cause of all these problems.  Hope you find it soon.  My very best to you!

stephanietx said:

I have a cat with asthma-like symptoms.  Vet is afraid to call it asthma because she has some other issues and it might just be a side effect of that.  I give my girl 1/8 -1/4 t of pure evening primrose oil a day and it helps keep the inflammation down.  I just add it to her wet food in the morning.

Click to expand...

That's very interesting. Evening primrose is high in GLA, a type of omega 6. I know it's recommended for use in skin-related issues in cats (dogs and humans LOL). OK - found this:

http://www.umm.edu/altmed/articles/gamma-linolenic-000305.htm

Now - I know cats lack the digestive enzyme necessary to convert AA to LA... but can they convert GLA into DGLA? :dk:

I found this: http://www.peteducation.com/article.cfm?c=1+1400&aid=665

Seems GLA may be beneficial. :nod: I'm going to do more work on this because of Flowerbelle's asthma.

You have had her how long?

Where does she go you don't pops into my mind or where does she go more often then you.  if you slepe 8 hours in bedroom probably not that room.  if you work where is she?  do you have a basement did carpet ever get wet(or is it possible it did before you moved in)

She like to go under the beds("cheesecloth")

Have her blood sugar checked.  sleeping/not moving much is sign of diabtetes too.

There isn't a holistic vet within a hour and a half's drive from where we are, and she's so unstable that I don't want to risk driving that far yet. It's 25 minutes to the normal vet and she was panting so hard by the time we got there she was nearly turning blue. (Which has never happened before, so I know it's related to her breathing.) 

She's in the bedroom with me most of the day. The air is in here and I stay home since I have health problems as well. She follows me out into the house when I do things out there and in the evenings for dinner and TV watching with the husband. (Who she is mostly terrified of, unless he has a leg available to sleep on. He's just not allowed to touch her!) She and I are basically attached at the hip, which is partly what's making it so rough. She never ventures into the basement anymore since she prefers having her own (mostly) private potty and will ask to go in when she has to go. The intense heat has been making it hard to do (or want to do) anything but watch TV and play video games, and I know she's been enjoying the last few weeks of having near constant mommy attention. (Yes, she's extremely spoiled!) 

The lining under the box spring got tore up a long time ago and was removed thanks to our massive male cat who likes to eat upholstery. (He's since moved on to part of the couch. *rollseyes*) He thinks he's a black lab, and he's not too much smaller. I make sure to dust under there regularly since her sister uses it as a safe refuge from everything she's afraid of - which is everything. 

I believe that bloodwork would be done anyways to check her since she is on steroids. She's thankfully not showing any other signs than weight gain. (No excess drinking or urinating.) 

I've got an appointment for Monday, and the tech I talked to said the next step will be putting her on cyclosporine and see if that helps any. It's super powerful so I'm praying that it works and she'll only need a month or two max on it.

Also, her respiration rate when sleeping is 70 breaths per minute, and when she's happy and purring and getting petted it's 80. And it's been like that, constantly, for three months. She never coughs or chokes or "hairballs" at all, she just can't slow her breathing. 

Oh! And I've had her five years in May - she about three weeks old when I took her in, no mom was left with her. She was a really sick kitten (that whole group of fosters were). There were three but one sister died. 

YES, THERE IS SOMETHING:

HELLO FELLOW KITTY LOVER.I AM SO VERY SORRY AND KNOW EXACTLY WHAT YOU ARE TALKING ABOUT

I TOO HAVE BEEN IN YOUR SHOES WITH THE NO IMPORVEMENT PHASE AND WAS SO UPSET WAS NOT SURE WHICH ONE OF US WAS GOING TO DIE FIRST, RUDY FROM HIS CONDITION, OR ME FROM WORRY AND NO SLEEP.

RUDY HAS BEEN ON SEVERAL THINGS: PREDNESALONE 5 MG 2 TIMES A DAY AND DURING CRISIS EVEN HIGHER DOSES AND ADDITIONAL MEDS LIKE TERBUTALINE AND FLOWVENT.

I MEAN, WE ARE TALKING LIFE AND DEATH CRISIS WITH THIS POOR LITTLE THING. I STAYED AWAKE ALL NIGHT FOR ALMOST A YEAR TO MAKE SURE I WAS THERE WHEN HE WHEN INTO CRISIS AND RUSHED HIM TO THE EMERGENCY. WAS WORRIED I MIGHT GET FIRED , NOW I HAVE A SITTER WHO WATCHES RUDY FOR FREE. NOT SURE HE NEEDS IT ALL THE TIME BUT I AM STILL SCARED.

HOWEVER,

I REFUSE TO GIVE UP ON HIM. I TRIED TO CONTROL THE ASTHMA WITH JUST THE PILLS BECAUSE I WAS SCARED TO GIVE HIM THE INHAILER. ABOUT 6 MONTHS AGO I DESIDED THAT THE PILLS WERE NOT GOING TO DO THE TRICK AND HE VERY WELL COULD DIE ANY DAY. SO I PUT HIM ON THE FLOWVENT INHAILER PLUS THE MEDS. HE ACTUALLY DOES NOT MIND IT BECAUSE HE GETS TREATS. LOL

SINCE THEN HE HAS HAD MORE STABLE TIMES THAN NOT. HE DOES NOT HAVE THE LABORED BREATING LIKE HE DID BUT IT IS HEAVY WHEN IT IS HOT OR HE GOES UNDER A BED WHERE THERE IS DUST.

 HE IS BY NO MEANS A NORMAL CAT AND HAS BLOWN UP TO 32 LB FROM THE PILLS BUT HE EATS, PURRS,GOES POTTIES AND WANTS LOTS OF LOVE.

HOWEVER HE IS SO FAT FROM THE STEROIDS THAT IT IS HARD TO WALK AND HE CANT GOOM AT ALL  BELOW HIS SHOULDERS. SO I JUST WIPE HIM DOWN EVERY DAY AND IF HE HAS BREATHING PROBLEMS, I CARRY HIM SO HE DOES NOT EXSERT HIMSELF.

COMPARED TO WHERE HE WAS BEFORE, I WILL TAKE THIS ANYDAY. IF YOU HAVE ANY QUESTIONS THAT I CAN ANSWER, PLEASE LET ME KNOW.  I HAVE EVERYTHING DOCUMENTED FROM DAY ONE , EVERY MED AND EVERY PROBLEM EVEN THE DRY HEAVES.

I HAVE TRIED AND SEEN IT ALL.  MANY BLESSINGS TO YOUR BABY CAT., FONDLY , VICKI AND RUDY

Hey, Rudy, thanks for your post.  Could you please turn off your caps lock?  It makes it very hard to read your messages, and it makes it impossible for those members who are using a special reader due to visual impairment.  Those readers just can't deal with all caps.
 

mr banche, I am so very sorry about the cap locks.  I should have known better, since I work with VIP and Blind individuals. If you would like,  I would be happy to rewrite the information for you, minus the cap locks. Again my apologies! Rudy123

Quick question - has her blood pressure been checked? When Flowerbelle had bronchitis (she was on Doxycycline for a month for that treatment), but her x-rays looked like she might also have asthma, and her heart looked slightly enlarged, they tested her blood pressure as well. It was high. We're taking her for a cardiac ultrasound in a few weeks (the vets went back and forth on whether a cardiac ultrasound or echocardiogram was the best next step, and decided cardiac ultrasound was best).

FYI, in Flowerbelle the vet did ask about testing for heartworm in light of the way her veins/arteries (whatever) looked on the xray. But Flowerbelle did have a horrible lung worm infestation when she was first rescued, and once the treating vet knew that, she felt there was no need to test/treat for heartworm. Was your kitty given a shot of ivermectin for lung worm? Almost all the ferals we've trapped and had sterilized here have had it. But the first time we brought one in, they thought asthma based on how kitty sounded with a stethascope and even after looking on the x-ray. Took a stool sample to identify it was lung worm, and that shot of ivermectin cleared it right up.

The problem we have with Flowerbelle is that she DOES have high blood pressure, and is now being treated for it. But the traditional asthma treatments are contra-indicated for high blood pressure, so no steroids. I did a lot of research. I found that omega 3s can help. She's been on an omega 3 supplement for several months now, and she has had no wheezing or little coughing episodes at all. Being in the states, you can order MegaRed (500mg). You can puncture it with a needle and use pliers to squish it out onto food once a day. (I know - :lol3: ).

So are you going to pursue the acupuncture?