Feline asthma Flashcards
What is the typical signalment?
4-6y, although can be as early as 5m
Siamese possibly increased risk
1-2% of cats have it
What would you see on imaging?
Rads - bronchial or broncho-interstitial
May see collapse of middle right ling lobe - thought to be due to secretions
May see air trapping - see lungs extend past where it should (flattening of the diaphragm)
Hyperlucency
May see sharp mineral densities - broncholithasis
Mineralised material in bronchial lumen
Can be seen in many bronchial diseases - if cats have these they have clinical signs ( o may not notice though)
In 25% cats there will be no radiographic changes
CT - airways around the bronchus may have increased attenuation
What can you see on bronchoscopy?
Non specific Airway changes
Epithelial irregularities
Collapsing bronchus
What can you see on bloods
Eosinophilia in quarter to a half of cases
What type of reaction is asthma?
type 1 hypersensitivity
What are the three hallmarks of asthma?
Inflammation
Hyperresponsiveness (shown as reversible bronchoconstriction)
Airflow limitiation
What do you see on BAL?
What should you also check on BAL?
N.B asthma is a diagnosis of exclusion
> 16% eosinophils suggestive (although get this in other things)
Do bacterial culture
mycoplasma PCR
Rule out aerulostrongylus - baeman or PCR or treat
Rule out toxocara - f+ flotation or tx
What is the mainstay of treatment for asthma?
steroids - 2mg/kg SID for 3 weeks, improvement = taper to LED
Can use bronchodilators for asthma attacks
Compare inhaled v oral steroids for asthma
Same effectiveness
More expesive inhaled
inhaled may not be tolerated - always takes a long time to train cats - search aerokat training for a video
Inhaled may be ineffective during an asthma attack
Outline the use of inhaled bronchdilators
Shown to cause airway inflammation
Not intended for chronic use
Very useful in acute setting - e.g. injectable terbutaline
How can you treat those that cannot have steroids (diabetics/ CHF)
Ciclosporin - reduce inflammatory response, no good evidence for this though
omega 3 FAs - decrease bronchoconstriction, no effet on eosinophilia, found in green lipped muscle extract
No evidence for mast cell degranulation inhibitors (e.g. serotonin antagonists/ anti histamines
What may be a treatment of the future?
ELISA for IgE
Skin tests
Then immunotherapy
How do you monitor treatment
Clinical signs
often BAL doesn’t change
What are the main ddx for asthma?
chronic bronchial dz
infection
diffuse neoplasia (e.g. bronchogenic carcinoma)
parasitic disease
What neutraceuticals can be used in treatement?
Omega 3 FAs may reduced airway hyperresponsiveness
