Daily cough and Aelurostrongylus abstrusus.

[PurPur]

Hello everyone, I appeal to you in the hope of gathering experiences that can help me understand and solve the problem that plagues Pur, a 6-year-old European male cat, castrated with long fur. Sorry in advance for the length of the post.

Pur lives with Tom, a 4-year-old neutered male cat: both were taken from the street when young kittens. They live in an apartment and during the summer they also have access to the private garden (where, on a couple of occasions, they came into contact with local strays).

For about 4 years (in any case, before Tom's introduction), Pur has had daily coughing episodes: most of the times single (lasting about a minute), sometimes repeated 2-3 times a day in a milder form. Cough with closed mouth, without "hunger for air".

Before these episodes appeared (and before contact with strays) Pur was negative to Fip, FeLv and Fiv. Now, despite the monthly use of Nexgard Combo (or Stronghold, or Broadline), from analysis of the stool, Pur is positive for Aelurostrongylus abstrusus (lung strongyles).

I therefore hypothesized that having already been infested before, in any case, all the treatments proposed by the vets who follow him have had an effect that may be limited to one or two months, in which the cough disappears completely, but then systematically returns.
In this case, during these years, we have tried cycles of:

Marbocyl (Marbofloxacin)
Praziquantel + Emodepside
Enrofloxacin
Amoxicillin/clavulanic acid + bromelain (Ananase)
Milbemax
Doxycycline
Nexgard Combo / Strongold / Broadline (pipette)
Ventolin (currently in cough, because asthma was also hypothesized)
Aerosol with hypersaline solution

The result does not change: well-being for one to two months and then cough again (which tends to become more and more grass, with noises during normal breathing).
We recently had chest x-rays (which I attach) and fortunately, there seems to be nothing relevant.

I ask you, kindly: have you had similar experiences with a cough that is difficult to eradicate? Were you able to trace the causes and find a cure? Have you found it difficult to cure lung strongyles?

The experiences I have found involve coughs or parasites that are eradicated simply with an occasional application of Nexgard, but in the case of Pur it all seems useless.

We are now in a phase where don't know what to do, but Pur still is positive and have daily cough.
Heartfelt thanks for those who want to share their experience.

 

[fionasmom]

Cat with lungworm started wheezing after treatment
Cat asthma/bronchitis/lungworms not responding to steroids..any help please
Colony cat drooling and loud breathing etc

F Farley’sMom ? Lungworm advice?
Meowmee ?

Welcome to The Cat Site! The above threads have some information about what members have done. I have personally never had to treat lungworms in a cat or dog, so have no first hand advice.

The information I searched seemed to recommend fenbendazole (Panacur) and ivermectin, along with albendazole, levamisole, and praziquantal. Some recommended emodepside, which you listed. I know that some of these meds come with cautions for cats.

I sympathize with you, as most information was hopeful that if medication was continued long enough, the problem would be solved.

As for the coughing, you have investigated asthma already. Could you be looking at two concurrent conditions?

 

[Meowmee]

Cat with lungworm started wheezing after treatment
Cat asthma/bronchitis/lungworms not responding to steroids..any help please
Colony cat drooling and loud breathing etc

F Farley’sMom ? Lungworm advice?
Meowmee ?

Welcome to The Cat Site! The above threads have some information about what members have done. I have personally never had to treat lungworms in a cat or dog, so have no first hand advice.

The information I searched seemed to recommend fenbendazole (Panacur) and ivermectin, along with albendazole, levamisole, and praziquantal. Some recommended emodepside, which you listed. I know that some of these meds come with cautions for cats.

I sympathize with you, as most information was hopeful that if medication was continued long enough, the problem would be solved.

As for the coughing, you have investigated asthma already. Could you be looking at two concurrent conditions?

Tragically poor Jezibel passed about 2 weeks after her enucleation, when I brought her to have her stitches removed I asked them to wash her sinuses out etc. they could not get a tube in her, did an xray and discovered she had cancer which had spread to the bone so I let her go without waking up since it was a very grim prognosis with more suffering.
I am not sure how much of her symptoms were from the oral cancer and how much from the lungworm. We only did one round of panacur as I recall.

I hope you figure out what is going in with Pur and he gets some relief, have they considered asthma as well? Sybil had asthma which showed up as little spots in her lungs on xray. She used inhalers and sometimes pills for that. It might help the lungworm too. Jez was treated with a few different antibiotics and and antifungal due to misdiagnosing the cancer, they thought she had an fhv infection which had caused eye damage.

 

[PurPur]

Hi fionasmom , thank you for the prompt reply and for the amount of valuable information.

I read the discussions carefully and I was saddened by the story of Jezibel. I am close to you Meowmee , I know the frustration of doing everything possible to be good, when all the good is still not enough. Keep going your way, proudly.

I had heard of Panacur and, recently, it had also been suggested to us by a new vet, to be administered in two 15-day cycles, in combination with cortisone Deltacortene 5mg (to be divided into two daily doses) for a week, and then 2.5mg per day in a single dose for the following week.
In truth, it initially seemed to me a somewhat "generic" cure, also because Panacur is mainly indicated on the leaflet for the treatment of gastrointestinal nematodes. I would like to hear direct evidence of the success of the double treatment, in order to feel safer.

As for ivermectin, as you anticipated, I read about strong toxicity on cats.

Among others, the only molecule specifically intended for the treatment of Aelurostrongylus abstrusus (adults) would seem to be emodepside, which however Pur has already used in the past, with 2 repetitions.
Again, I would like to hear also personal experiences because, as mentioned by you, it could also be a question of the duration of the treatment, be it this or Panacur as well.

Speaking of multiple concatenations of events: a vet had already quickly diagnosed asthma just by watching videos in which Pur coughed. But paying attention to his coughing fits, he does not seem to assume the position of someone who is "hungry for air", and in fact his mouth remains closed while he coughs. On the web, I have seen asthmatic cats who instead stand with their mouths open, but this is still my consideration.

Furthermore, I do not know if it can be indicative in one sense or another, it is possible to hear mucus (which sometimes expels in small quantities and is transparent) and noises of "constriction" when breathing in certain positions. In fact, he tends to sleep leaning his head to keep it up (like us people on the pillow).

Finally, the possibility of allergies was also suggested to us, but I would like to understand more about how to carry out any tests.

Thanks again, you are very kind: this place is a very precious resource!

 

[Meowmee]

Hi fionasmom , thank you for the prompt reply and for the amount of valuable information.

I read the discussions carefully and I was saddened by the story of Jezibel. I am close to you Meowmee , I know the frustration of doing everything possible to be good, when all the good is still not enough. Keep going your way, proudly.

I had heard of Panacur and, recently, it had also been suggested to us by a new vet, to be administered in two 15-day cycles, in combination with cortisone Deltacortene 5mg (to be divided into two daily doses) for a week, and then 2.5mg per day in a single dose for the following week.
In truth, it initially seemed to me a somewhat "generic" cure, also because Panacur is mainly indicated on the leaflet for the treatment of gastrointestinal nematodes. I would like to hear direct evidence of the success of the double treatment, in order to feel safer.

As for ivermectin, as you anticipated, I read about strong toxicity on cats.

Among others, the only molecule specifically intended for the treatment of Aelurostrongylus abstrusus (adults) would seem to be emodepside, which however Pur has already used in the past, with 2 repetitions.
Again, I would like to hear also personal experiences because, as mentioned by you, it could also be a question of the duration of the treatment, be it this or Panacur as well.

Speaking of multiple concatenations of events: a vet had already quickly diagnosed asthma just by watching videos in which Pur coughed. But paying attention to his coughing fits, he does not seem to assume the position of someone who is "hungry for air", and in fact his mouth remains closed while he coughs. On the web, I have seen asthmatic cats who instead stand with their mouths open, but this is still my consideration.

Furthermore, I do not know if it can be indicative in one sense or another, it is possible to hear mucus (which sometimes expels in small quantities and is transparent) and noises of "constriction" when breathing in certain positions. In fact, he tends to sleep leaning his head to keep it up (like us people on the pillow).

Finally, the possibility of allergies was also suggested to us, but I would like to understand more about how to carry out any tests.

Thanks again, you are very kind: this place is a very precious resource!

Thanks for your kind words
Maybe these links can help, I hope so
I would prolly try the panacur and the steroid and see if it helps at all. I have never heard of panacur causing bad reactions. I found one study of a kitten treated with panacur and imidaclopid moxydectin. I did read somewhere that it can be hard to treat in cats. It can also be asymptomatic.

Was he tested for heartworm and heart disease as well as other possibilities? It could be allergies too as you said. Have you tried an antihistamine? Asthma often needs regular treatment to stabilize. Sybil didn’t cough when she had her attacks, she would open mouth breath rapidly after exertion. She was on pills for attacks and she had one injection at first, then we started the inhaler, she was on a steroid inhaler.

Respiratory distress associated with lungworm infection in a kitten

Lungworm Infection in Animals - Respiratory System - Merck Veterinary Manual

Lungworms in Cats

Lungworm in Cats: All Your Questions Answered | Purina

I can’t access the full article here but this is a study of lungworm in 26 cats.

Single and mixed feline lungworm infections: clinical, radiographic and therapeutic features of 26 cases (2013-2015) - PubMed

 

[Christykitty]

My stray momma kitty was diagnosed with lungworm from a fecal test. We are on day 2 of Safeguard (which is the same as Panacur). I can update how it goes. She will be on it for 12-14 days. I don't know if I notice any breathing issues. She breathes heavy while nursing and was panting occasionally but I haven't noticed the panting in a while. I made her room cooler. She's in a small bathroom with heated floors so she was most likely hot. Sometimes it sounds like she snorts while eating, again I don't know if that is a respiratory symptom or not.

I hope your kitty improves. It seems like you've done so much already.

 

[PowderCat212]

If its any help, my cat Powder had a cough that developed around 2 years old. It would happen every couple of weeks but started to become more frequent. The vet said he didn't seem to have asthma and recommended we switch to PrettyLitter or something similar. We did and things calmed down. But one day, I had to use Pine because his litter shipment was late and the attack was so painfully obvious I requested he be tested for asthma.

Sure enough, the xray confimed that he had asthma. And he's stabilized since. We went on a steroid and have gradually weaned him off. He's on .2ml a day now. But there were a lot of household changes that needed to be made.

I won't burn any kind of candles or sage anymore. No fragrances unless I'll be gone for an extended period of time. Air purifier is on 24/7. When I vacuum or sweep, I put him in the bathroom until things have settled. Also, we're training him to use the cat inhaler but that's been an odyssey :/

Hope this helps and best of luck.

 

[PurPur]

Thanks for your kind words
Maybe these links can help, I hope so
I would prolly try the panacur and the steroid and see if it helps at all. I have never heard of panacur causing bad reactions. I found one study of a kitten treated with panacur and imidaclopid moxydectin. I did read somewhere that it can be hard to treat in cats. It can also be asymptomatic.

Was he tested for heartworm and heart disease as well as other possibilities? It could be allergies too as you said. Have you tried an antihistamine? Asthma often needs regular treatment to stabilize. Sybil didn’t cough when she had her attacks, she would open mouth breath rapidly after exertion. She was on pills for attacks and she had one injection at first, then we started the inhaler, she was on a steroid inhaler.

Respiratory distress associated with lungworm infection in a kitten

Lungworm Infection in Animals - Respiratory System - Merck Veterinary Manual

Lungworms in Cats

Lungworm in Cats: All Your Questions Answered | Purina

I can’t access the full article here but this is a study of lungworm in 26 cats.

Single and mixed feline lungworm infections: clinical, radiographic and therapeutic features of 26 cases (2013-2015) - PubMed

Hi Meowmee , thank you for this additional valuable information that helps us to have a more specific view of the situation.

At regular visits to the vet, no heart problems have ever been found (from external listening): also because Pur plays, runs, jumps, purrs, without any breathlessness or difficulties. Appetite is always present and Pur's life currently seems regular, apart from these daily coughing episodes (which often occur when he changes position, for example while resting and getting up to switch sides).

As for the hearthworms, I do not remember if a screening was made: but from the symptoms I read, apart from the cough I would not find a match with anyone else. I'll keep this other possibility in mind too, in case we don't have to solve the problem by curing lungworms. Thanks.

From what I have read so far, I think we might try a treathment with Panacur, even if I wanted to understand first whether or not it is appropriate to combine also steroids (which I knew can have a significant impact on the immune system). More than anything else, also to understand if these are to be used only to dry the excess mucus (which, it seems, is not increasing since we do the inhaler with hypersaline), or it would be used to reduce the inflammation of the bronchi. I would understand the risk / benefit ratio, first.
Thanks!

 

[PurPur]

My stray momma kitty was diagnosed with lungworm from a fecal test. We are on day 2 of Safeguard (which is the same as Panacur). I can update how it goes. She will be on it for 12-14 days. I don't know if I notice any breathing issues. She breathes heavy while nursing and was panting occasionally but I haven't noticed the panting in a while. I made her room cooler. She's in a small bathroom with heated floors so she was most likely hot. Sometimes it sounds like she snorts while eating, again I don't know if that is a respiratory symptom or not.

I hope your kitty improves. It seems like you've done so much already.

Hi C Christykitty , thank you for sharing your experience! Even Pur sometimes snorts while breathing, also while just resting. I guess it could be a symptom related to the problem, or to the mucus generated from it.
In any case, we will follow your story with interest, thanks, hoping that your kitty will recover as soon as possible! All the best!

 

[PurPur]

If its any help, my cat Powder had a cough that developed around 2 years old. It would happen every couple of weeks but started to become more frequent. The vet said he didn't seem to have asthma and recommended we switch to PrettyLitter or something similar. We did and things calmed down. But one day, I had to use Pine because his litter shipment was late and the attack was so painfully obvious I requested he be tested for asthma.

Sure enough, the xray confimed that he had asthma. And he's stabilized since. We went on a steroid and have gradually weaned him off. He's on .2ml a day now. But there were a lot of household changes that needed to be made.

I won't burn any kind of candles or sage anymore. No fragrances unless I'll be gone for an extended period of time. Air purifier is on 24/7. When I vacuum or sweep, I put him in the bathroom until things have settled. Also, we're training him to use the cat inhaler but that's been an odyssey :/

Hope this helps and best of luck.

Hi P PowderCat212 , thank you for telling your story, which gives me some interesting insights.

First, the age and frequency at which the first cough appeared is similar to Pur's.

I state that since Pur lived with us we have never used scented candles or essential oil diffusers, and that from the introduction of Tom he has been doing his needs on the sleepers (to prevent both from using the same litter, and to avoid that the micro powders could get worse the breathing problems); however, since both he and Tom are long-haired cats, there is the possibility that in the air (despite the daily cleaning) there may be allergens or substances that annoy their breathing.

We will follow the idea of locking Pur in a room during the cleaning and consider purchasing an air purifier, thanks.

As for the use of the inhaler: we bought a small battery-operated one (for children), very discreet and above all, silent. We try to make it look like a game. Although he is suspicious, initially we made him enter the carrier, covered, to "force" him to breathe while we played with him through the front opening anyway (so as not to make him feel closed). Now, every now and then he lets himself be treated on the sofa, but always pretending it's a game.

Thank you so much and all the best for Powder!

 

[Meowmee]

Hi Meowmee , thank you for this additional valuable information that helps us to have a more specific view of the situation.

At regular visits to the vet, no heart problems have ever been found (from external listening): also because Pur plays, runs, jumps, purrs, without any breathlessness or difficulties. Appetite is always present and Pur's life currently seems regular, apart from these daily coughing episodes (which often occur when he changes position, for example while resting and getting up to switch sides).

As for the hearthworms, I do not remember if a screening was made: but from the symptoms I read, apart from the cough I would not find a match with anyone else. I'll keep this other possibility in mind too, in case we don't have to solve the problem by curing lungworms. Thanks.

From what I have read so far, I think we might try a treathment with Panacur, even if I wanted to understand first whether or not it is appropriate to combine also steroids (which I knew can have a significant impact on the immune system). More than anything else, also to understand if these are to be used only to dry the excess mucus (which, it seems, is not increasing since we do the inhaler with hypersaline), or it would be used to reduce the inflammation of the bronchi. I would understand the risk / benefit ratio, first.
Thanks!

Yes the steroid would help the inflammation and maybe help him recover a bit from the cough and damage from the worms etc. It should help him breath more easily as well. Here is another study with info.

Lungworm Disease |

Heartworm in Cats

 

[Christykitty]

I hope Pur is doing well!

Just an update. My momma cat finished her 14 days of fenbendazole. She still snorts when eating but not panting or breathing heavy. When I rub her belly her purring used to be very loud but now sounds typical. We'll do another fecal in a week or so.

 

[PurPur]

Hi Meowmee , thanks for the explanation! And hi C Christykitty , thank you very much for the news!
I hope she fully recovers with these 14 days of cure!
Please, keep us updated!

Pur is as always. We are trying to improve the conditions of the environment by reducing exposure to dust and we are continuing with the inhaler. In a few days, we will do a fecal test on both Pur and Tom (even if he has no particular symptoms, just a rare light cough... but they live together and share all), so as to eventually begin the treatment for both at the same time.