Opinions, please? Is Flowerbelle having a mild asthma attack or a weird purr?

ldg

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We took Flowerbelle to the holistic vet in November 2011 because of her cough, which we thought was related to her hairball issue (but wanted to make sure). The pattern in x-rays indicated both asthma and bronchitis. Flowerbelle was on doxy for 20 days, and her cough cleared up.

She infrequently seems to have breathing problems. It's a little difficult for us to tell, because she spends about 50% of her time purring. She's little and her whole body is involved when she's really purring. When she's really happy, she also squeals and squeaks while purring.

We also did all the diagnostics on her sometimes cough to rule out heart disease. She does have high blood pressure due to scarring of the arteries in her lungs from a severe lung worm infestation when rescued. And she lost most of hear hearing (you can hear me "click" in the video - that she can hear that, as you can see. That's what Flowerbelle thinks her name is. :lol3: ) and one of her eyes to herpes, which most likely affected her turbinates - which may also affect her breathing.

So in September, she's coughing. We go get x-rays again. There is NO pattern of bronchitis or asthma. All clear. But we put her on Doxy again - and the cough cleared up inside of three days. This time she was only on it for 10 days. It came back again in November! As always, it started slow enough to leave us wondering... is it a hairball? But it increased in frequency, and we put her on Doxy again. And again - gone in three days.

So we've heard of other kitties with asthma that never presented on x-ray. Is untreated asthma maybe why she seems to be developing chronic bronchitis? :dk:

Here's a video of Flowerbelle this evening as I was about to make the kitties dinner. That means she was purring. But this isn't her normal "I'm excited about dinner!" purring. In fact, she didn't eat as soon as it was ready. She's usually done by the time I'm done making it for all the cats. She ended up sitting at the far end of the counter going through these... leaning her head up to breathe better? episodes until everyone else was DONE with dinner.

Obviously I'll be sharing this with the vet. But I wanted other opinions. Does it seem Flowerbelle is having trouble breathing to you?
 

otto

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To me it does look like she is having trouble. Not all the time but...periodically throughout the 90 seconds. When she puts her chin up, and those last 30 seconds especially, you can really see some laboring. I don't know what is normal for her, but just watching that made me feel very anxious about her comfort. I had to start re-assuring myself right away that she is in the best hands possible. :hugs:
 
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mani

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Obviously I'll be sharing this with the vet. But I wanted other opinions. Does it seem Flowerbelle is having trouble breathing to you?
Yes, she does, even with all the information about her usual 'sounds'.  When she lifts her head there seems to be some movement around the the throat that doesn't look right either.

I once had a 13 year old who had fluid in her lungs.  This is something that has to be done very gently, but I used to press my thumbs very softly in a massaging motion over the chest area, and then sweep my thumbs up the side of the trachea, from the lungs, all the way to the jawline.  I would notice that Woozie (my cat) would start to swallow stuff that I had brought up... not ideal, I know, but better than being in her lungs.  She really liked me doing it and would seem to 'ask' me to do it. I'm not saying this is something you should do, as there may be a blockage or swelling in Flowerbelle's throat, but just thought I'd mention it....
 
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ldg

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Thanks. It's just so odd that she can clearly be having these issues from time-to-time, and the coughing - and yet the x-rays show absolutely nothing.

I just wanted to make sure I wasn't crazy. Thankfully, these don't happen often - and I FINALLY caught it on video! But she started coughing (a couple of coughs in a row, 1 - 2x a day) two days ago, and then this happened this morning and this evening, and it has happened before. Others have said that their cats have asthma, even though nothing ever showed up on x-ray.

I'll show the vet the video tomorrow. I'm guessing the suggestion will be to start her on inhaled steroids. It'll be a process, because of her already high blood pressure (for which she's on medication). But I know in people, there's usually one that won't raise BP.... oral steroids are out of the question for her though.

:sigh:
 
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ldg

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To me it does look like she is having trouble. Not all the time but...periodically throughout the 90 seconds. When she puts her chin up, and those last 30 seconds especially, you can really see some laboring. I don't know what is normal for her, but just watching that made me feel very anxious about her comfort. I had to start re-assuring myself right away that she is in the best hands possible. :hugs:
Thanks. But I felt the same way about her labored breathing. :( That's not normal (thankfully).
 
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ldg

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Yes, she does, even with all the information about her usual 'sounds'.  When she lifts her head there seems to be some movement around the the throat that doesn't look right either.

I once had a 13 year old who had fluid in her lungs.  This is something that has to be done very gently, but I used to press my thumbs very softly in a massaging motion over the chest area, and then sweep my thumbs up the side of the trachea, from the lungs, all the way to the jawline.  I would notice that Woozie (my cat) would start to swallow stuff that I had brought up... not ideal, I know, but better than being in her lungs.  She really liked me doing it and would seem to 'ask' me to do it. I'm not saying this is something you should do, as there may be a blockage or swelling in Flowerbelle's throat, but just thought I'd mention it....
Did you ever have any imaging done? Because Flowerbelle's x-rays, other than that one time, keep coming up completely clear. And she doesn't ever seem to cough anything up - no swallowing, etc.

I guess she can have constricted bronchial tubes (or whatever they're called) without fluid? :dk:
 

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So fluid will show up on an x ray? But you make a good point, would bronchial inflammation show up on an x ray?

:vibes::vibes::vibes: Flowerbelle :heart3:
 

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Thanks. It's just so odd that she can clearly be having these issues from time-to-time, and the coughing - and yet the x-rays show absolutely nothing.

I
Sorry.. missed the 'xrays showed nothing' bit, so clearly not a fluid thing.

It does seem like asthma could be the answer.. there certainly seems to be a constriction there and that is what happens with asthma.  I wish I knew of a natural therapy for asthma for cats.. I know yogic stuff for humans, but I don't think you can really take Flowerbelle aside for intense pranayama instruction....
  Asthma, of course, can be allergies, and is also strongly associated with stress.

Sometimes we just have to to the steroid thing
 

mani

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So fluid will show up on an x ray? But you make a good point, would bronchial inflammation show up on an x ray?

Flowerbelle
Probably not... it would need ultrasound, CT etc.
 
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ldg

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So fluid will show up on an x ray? But you make a good point, would bronchial inflammation show up on an x ray?

:vibes::vibes::vibes: Flowerbelle :heart3:

Probably not... it would need ultrasound, CT etc.
So I wonder what they were seeing on the x-ray in November 2011.

And when she had her cardiac ultrasound, they looked at her chest (and her abdomen). This was in .... April? (2012) May? I don't remember exactly when it was (I'll find out today). But at that time, there was no sign of any problem. :dk:

I'd better write down a list of questions for the vet. :lol3:
 

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Curious, how many views did they take for xray? Was a lateral view done?
 
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Doc explained why "mild" asthma often doesn't appear in imaging (and yes, x-rays DO see inflammation as well as fluid). The inflammation is occurring at the time of the attack. In a wheezy kitty, you can hear it and likely see it. But asthma can go undiagnosed via imaging unless it's a persistent inflammation, and it isn't necessarily a persistent inflammation.

All of that said, the video of Flowerbelle (and several more) to her seemed pharyngeal. Yet she looks clear and sounds clear, her breathing through her nose is not at all obstructed, and this breathing thing comes in episodes, which doesn't fit with (most) pharyngeal problems. THAT said ( :lol3: ) they can start this way, episodically (like a cyst forming or something).

So what we're going to do is give Flowerbelle a one week course of pred, despite her blood pressure issues. (Tested her BP today and it was basically the same as last time, so doing great! :clap: ). Obviously I'm to keep an eye on her, but also obviously, the vet doesn't think it'll be enough of a problem not to do it. If her coughing (that started again recently) and these episodes stop, we have a diagnosis of asthma.

If they don't stop, the next step is endoscopy.

If it's asthma, we decide if it even needs treatment (because the pred is contraindicated for her high blood pressure). If she has infrequent, sporadic, short episodes where she still has good air flow (as in this video), we probably don't treat it. The other option is to treat symptomatically, giving her a short course of pred when she seems to be going through a spot of flare-ups, working to find the lowest effective dose.
 

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Grey used to do a similar breathing thing, we don't know how much of it was asthma or thymoma. Glad to hear you're finding some sort of plan despite having other special needs to take into consideration.

I didn't want to hijack the other person's thread so I'll mention here about arthritis: with horses and cats I had limited success with feedthrus and much more success with Adequan. Cats we were advised to use it subQ instead of IM. Made the old Grey girl feel lots better!
 
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ldg

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Well, asking about adequan wasn't on the list of questions. :lol3:

She just had another episode of the breathing problem. At least they're short. Of course, she only had her first dose of pred mid-day.
 

otto

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Would an inhaler work for Flowerbelle, I wonder, for her occasional episodes? Isn't there someone else here who gives their cat nebulizer treatments?

I'm sorry to hear she's had another episode today. The prednisone should help pretty quickly, right?

Adequan..hmm I never would have thought of that for this type of problem. But it is an anti-inflammarory, might be worth looking into!

The comment about adequan though made me wonder if Laser Therapy might be used for bronchial inflammation.

From the website of the lite-therapy my vet uses:

http://www.litecure.com/companion/for-clinicians/common-uses/
 
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ldg

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Well, the adequen comment was in relation to her arthritis. :)

We discussed the pros and cons of inhalers. Her experience is that the side effects are the same, and the process of using the inhaler/learning to use it is stressful on the cats. She has one kitty that didn't tolerate the dose of pred he needed and is doing well with the inhaler. Of all the cats, I think it would be most stressful for her (and Tuxedo). But we're not at that decision point yet, is the way I'm looking at it. :lol3: Another thing to consider, although it's really expensive, is acupuncture, which is apparently quite effective for asthma. So we'll see.
 

otto

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Oh, LOL. Well, laser therapy is used for arthritis too. In fact I intend to go that route the next time I have a kitty who suffers from arthritis pain.

Still though.....both these treatments are for inflammation too....so I'm still wondering about them as asthma treatments........
 

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Is there any chance it could be stress induced?  Flower essences?
 

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I'm  just now seeing this.  I have no experience, but just wanted to send a few vibes Flowerbelle's way (what a cute name!)  I know she is in the best possible hands with you caring for her LDG. 
 
 
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ldg

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Thanks Misty! :hugs:


Is there any chance it could be stress induced?  Flower essences?
It doesn't seem to be. Today's happened when she woke up from a nap. She's a bundle of energy (usually), but doesn't stress much, other than when we want her to do something she doesn't want to do. :lol3: I don't have any trouble getting her into a carrier, and she's usually pretty relaxed at the vet (gives the Doc and vet techs kisses). Today she was purring and exploring around... but she's had SO many trips to the vet this past year because of her heart question, blood pressure, etc., I'm confident she knows the routine now, and knows she's coming home....
 
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