Feline asthma and chronic bronchitis are the most common lower airway diseases in cats. Affecting approximately 1–5% of the feline population, they cause chronic respiratory distress that significantly impacts quality of life. Effective management can achieve good long-term welfare outcomes for most cats.
Pathophysiology
Feline asthma is characterised by eosinophilic airway inflammation, bronchospasm, and mucus hypersecretion in response to inhaled allergens or irritants. Bronchial smooth muscle hypertrophy develops with chronic disease, causing irreversible airway narrowing in severe cases. Feline chronic bronchitis involves neutrophilic inflammation without the allergic/eosinophilic component of asthma. Both conditions may coexist.
Clinical Signs
- Chronic coughing — often mistaken for hairball-related behaviour (vomiting posture with neck extended)
- Wheezing and expiratory effort
- Increased respiratory rate and effort
- Open-mouth breathing in severe acute episodes
- Cyanosis (blue-tinged mucous membranes) in severe bronchospasm — an emergency
Diagnosis
Thoracic radiography shows a characteristic peribronchial pattern ("train-lines" of thickened bronchial walls), hyperinflation, and sometimes air trapping. Bronchoalveolar lavage cytology distinguishes eosinophilic (asthma) from neutrophilic (bronchitis) inflammation. Heartworm and lungworm should be excluded. Airway culture identifies bacterial secondary infection requiring antibiotic treatment.
Treatment
Bronchodilators: Salbutamol (albuterol) via metered dose inhaler and aerosol chamber (AeroKat) provides rapid bronchodilation for acute episodes. Regular short-acting bronchodilators are not recommended as primary therapy.
Corticosteroids: First-line for reducing airway inflammation. Inhaled fluticasone is preferred for long-term management — minimises systemic side effects while providing local anti-inflammatory effect. Oral prednisolone is used for initial stabilisation or when inhalers are not tolerated.
Environmental management: Identifying and removing triggers is essential — dusty litters (replace with low-dust or silica), cigarette smoke, scented candles, air fresheners, aerosol sprays, and certain cleaning products are common triggers.
Inhaler Training
Training cats to accept inhaler/aerosol chamber use requires patience but is achievable in most cats. Gradual desensitisation — starting with handling the chamber without medication, then without the mask making a hissing sound, then applying to the face — over 1–2 weeks enables effective home treatment. Video resources from manufacturers and referral centres assist owner training.
Welfare Prognosis
Well-managed feline asthma carries a good long-term prognosis — most cats maintain good quality of life with appropriate treatment. Regular monitoring (annual or biannual clinical assessment, periodic radiographs) allows medication adjustment as disease progresses or improves. Cats with severe irreversible airway remodelling carry a more guarded prognosis.