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ProAir HFA (albuterol sulfate) Inhalation Aerosol
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AeroKat Feline Aerosol Chamber for Cats with Feline Asthma, Bronchitis or Other Issues Requiring the Use of a MDI Inhaler, also known as a Puffer.
AeroKat Feline Aerosol Chamber ships the same weekday with quick delivery when ordered from VetRxDirect by 3PM CST.
Trudell Medical’s AeroDawg and AeroHippus are also available at VetRxDirect!
NOTE: Trudell Medical International does not endorse this protocol. It is provided as guidance for discussion with your veterinarian.
Dr. Phillip Padrid’s Protocols:
- INHALED STEROID FOR ASTHMA AND BRONCHITIS FELINE ASTHMA THERAPY
- INHALED BRONCHODILATOR
- DRUG Fluticasone Proprionate (Flovent)
- COMPANY GlaxoSmithKline
- DOSES 44, 110, 220 mcg per actuation
Why Use Flovent
- No side effects! The inhaled steroid is not absorbed into the bloodstream
- It is equally potent to oral prednisone 1mg/kg bid
INDICATIONS
- Chronic bronchitis in dogs
- Chronic bronchitis in cats (daily cough)
- Asthma with daily symptoms in cats
- Chronic sinusitis in cats
WHAT ARE POTENTIAL SIDE EFFECTS?
- Growth retardation in children with incomplete closure of growth plates was a concern; it turned out to be a false concern.
- Candida infection of the oropharynx in adults-I have not seen this in over 60 cats and 20 dogs in a 2 year period.
WHAT ARE POTENTIAL PROBLEMS?
- The drug takes about 7-10 days to reach full effect.
- The face mask needs to be properly fit for the animal to insure that the drug is being inhaled-it should snugly fit around the muzzle including the corners of the mouth.
- It is expensive.
- The owner may not be aware when the canister is empty, although, the dose counter on the product reduces this concern.
HOW TO USE
- Rx the 220 mcg. Dose as one puffs into AeroKat BID.
- Dog or cat should breathe through mask and AeroKat for 7-10 seconds.
- If the animal is currently symptomatic and can tolerate short term prednisone, begin 1mg/kg bid oral prednisone for 5 days concurrent with Flovent, then d/c the prednisone.
- Demonstrate how to use the mask/AeroKat/drug in front of the owner, with their pet.
- Have them demonstrate the same technique to you, in the office, with their pet, by themselves
- This is a one person job
- If the pet is doing well after two months on the 220 mcg dose, decrease to 110 mcg for another month.
- The canister holds enough drug for one month if two puffs twice daily is followed.
FELINE ASTHMA THERAPY
Why Use ALBUTEROL
- It is more rapidly acting than the oral or sq or i.m. form of terbutaline
- It is more effective than the theophylline compounds (theodur)
INDICATIONS
Asthma in cats
- Maybe be used daily or as needed for asthmatic cat already on daily steroids – if there is increased cough, wheeze, or increased respiratory rate and effort at rest
- Usually used only as needed for cats with intermittent signs of asthma (not daily signs)
WHAT ARE POTENTIAL SIDE EFFECTS?
- Musculoskeletal twitchiness
- Excitability, insomnia, anorexia
- THESE SIDE EFFECTS IN CATS ARE VERY, VERY UNCOMMON!
WHAT ARE POTENTIAL PROBLEMS?
This drug is very safe-with profound overdose (cat chews canister) there are reported problems with potassium regulation-I have never seen this.
HOW TO USE
- Rx the drug as the generic (albuterol MDI) - two puffs into AeroKat BID (GIVEN INDIVIDUALLY).
- Cat should breathe the drug through the mask and AeroKat for 7-10 seconds.
- Positive clinical effect should be seen within 5-10 minutes.
- Can be used every ½ hr for 2-4 hrs as needed in crisis.
The AeroKat FAC holds the puffer (corticosteroid or bronchodilator) medication in the chamber allowing your cat to inhale using multiple breaths. In addition, the chamber separates the coarse aerosol particles (which tend to deposit in the mouth and nose) so the finer, more beneficial particles are delivered deep into the lungs where they are needed.
Traditional oral corticosteroids (pills, injection or syrup) have many serious potential side‐effects for your cat including pancreatitis, insulin resistance (diabetes), polyuria, cystitis, inappropriate urination and behavioural changes.
There are no specific contraindications for the AeroKat* FAC in cats. The principle behind the AeroKat* FAC is based on aerosol (puffer) drug delivery currently used in humans, horses and dogs. The product should only be used if recommended by a veterinarian. Consult your veterinarian for advice and instructions. Shatterproof anti-static chamber ensures medication is delivered deep into the cat's lungs. Easy to use and clean. Accommodates all breeds and ages of cats. Side effects of other asthma treatments are minimized with this system. Intended Use For use with a metered dose inhaler as prescribed by your veterinarian.
Asthma in Cats
Obstructive and allergic respiratory diseases, sometimes called "asthma," "bronchitis," or "bronchial asthma", affect many cats. Unfortunately, these diseases are not easily classified, and probably represent a variety of airway disorders. These conditions do share a common finding of "hyper-responsive" or "over-reactive" airways.
If the airway of a cat is sensitive to certain stimuli, exposure to these agents leads to narrowing of the airways. The inciting agents are usually direct irritants to the airways or things that provoke an allergic response in the respiratory tract. Regardless of the cause, the end-result is the same: 1) muscle spasms in the bronchi, 2) increased production of mucus, and 3) the accumulation of cellular material in the airways. The inability to clear the bronchi of this material leaves the cat susceptible to secondary respiratory infections.
"With obstructive lung disease, the cat experiences the greatest breathing difficulty during expiration or breathing out."
With obstructive lung disease, the cat experiences the greatest breathing difficulty during expiration or breathing out. Air may become effectively trapped in the lungs, causing the lungs to over inflate. In some cases, this chronic trapping of air leads to the development of emphysema in the cat.
Are some cats more likely to get asthma?
Obstructive lung disease is most common in cats from two to eight years of age. Siamese cats seem to be at higher risk for developing asthma and bronchitis. Some reports indicate that it is more common in female cats. Overweight and obese cats are also reported to be at greater risk for developing respiratory disorders.
What are the clinical signs of asthma and bronchitis?
"Coughing is a significant finding since there are relatively few causes of coughing in the cat."
Coughing and respiratory distress (difficulty breathing, shortness of breath, open-mouth breathing, etc.) are the most commonly reported signs with obstructive lung disease. Coughing is a significant finding since there are relatively few causes of coughing in the cat. Many cats assume a squatting position with the neck extending during these coughing episodes (this is called an orthopneic posture). Wheezing is easily heard with the stethoscope and is sometimes so loud that it can be heard by the owners. Occasionally, sneezing and vomiting are noted.
Any episode of open-mouth breathing in cats should be considered a potential emergency and you should inform your veterinarian immediately if this occurs.
What causes asthma?
As mentioned above, this group of diseases is characterized by hyper-responsive airways. The small airways or bronchi and bronchioles can react to a number of stimuli, such as:
- Inhaled debris or irritants - dust from cat litter, cigarette smoke, perfume or hairspray, carpet fresheners, and perfumes in laundry detergent
- Pollens or mold, house dust mites, and dander (from other pets or even people)
- Infectious agents - viruses, bacteria
- Parasites - heartworms, lungworms
How is asthma diagnosed?
"These tests will assess the general health of the cat and may provide clues as to the underlying cause."
A series of tests may be required to diagnose allergic lung disease in the cat.
The minimum diagnostic tests include a complete blood count (CBC), blood chemistries, fecal exam and urinalysis. These tests will assess the general health of the cat and may provide clues as to the underlying cause. One particular type of white blood cell, the eosinophil, is commonly associated with allergic events or parasitic disease; its presence supports a tentative diagnosis of asthma. In some cases, special tests will be performed on stool samples, looking for evidence of lungworms.
Heartworm test - This depends on the geographical area, a cat experiencing breathing difficulty should be tested for feline heartworm disease.
Feline leukemia (FeLV) and feline immunodeficiency virus (FIV) tests - These tests are helpful in determining the overall health of the cat. FeLV and FIV are often associated with respiratory disease.
Thoracic radiography (chest X-ray) - Characteristic radiographic changes in the lungs are common in many cases of feline asthma or obstructive lung disease. X-rays can be suggestive of parasitic diseases such as heartworms or lungworms, and may be helpful to eliminate other types of heart and lung disease.
"Even when the underlying cause is not identified, many cats can achieve a reasonable quality of life with medical management."
Bronchoscopy, cytology and tracheal lavage- Bronchoscopy is a procedure that allows the veterinarian to look down the airways of the anesthetized cat with a small fiberoptic scope. After a visual examination of the airway is completed, samples of the mucus lining of the bronchi may be obtained with a small cytology brush. The mucus and cells can be examined under a microscope (cytology) or cultured. With tracheal lavage, a small amount of sterile saline can be flushed into the airways and retrieved, providing samples of material from deep in the lung. This material may be cultured for microorganisms and examined under the microscope.
In some cases, an underlying cause cannot be identified, despite a complete and thorough diagnostic work-up. Even when the underlying cause is not identified, many cats can achieve a reasonable quality of life with medical management.
Some owners decline the complete work-up for a variety of reasons. In such cases, it may be acceptable to treat the cat with a course of corticosteroids ("cortisone" or "steroids") since most asthmatic cats respond favorably to these medications with few side effects. However, this approach may create two problems:
1. Corticosteroids can worsen secondary bacterial infections; therefore, prophylactic antibiotics are reasonable in cases where a work-up cannot be performed.
2. Cats with heartworm infections often cough like cats with asthma and will respond temporarily to corticosteroids. Without an appropriate workup, cats that live in areas where heartworm disease is common may be misdiagnosed as having asthma when in fact they have heartworm disease.
How is asthma treated?
Successful management of feline allergic lung disease employs one or more of the following therapies.
Avoidance - Any factor known to trigger or aggravate breathing problems should be avoided. In some cases, this may mean trying different brands of cat litter, eliminating cigarette smoke from the home, etc. The previous list (see "Causes") details some factors that should be considered. It is important to pay close attention to environmental factors that may aggravate or worsen the condition.
Bronchodilators - These drugs are used to open up the airway and allow the cat to move air more freely. They should be used faithfully and as directed to obtain maximum effect.
Corticosteroids - Glucocorticoids, a class of steroids have a beneficial effect on decreasing inflammation, dilating the airway, and decreasing mucus production. In many cats, they are given daily. When the cat's temperament is a concern, long-acting injections can be given as an alternative to pills. These drugs have potential for some side effects and should not be withdrawn abruptly or given without careful monitoring through routine blood and urine tests.
Inhalers and Inhaler Breathing Devices - Human metered inhalation devices (inhalers) can be very helpful in the management of feline asthma. Inhalers deliver medicine directly to the affected airways, concentrating the effects of the medicine and reducing their side effects on the rest of the body. Bronchodilators and corticosteriods are prepackaged in the inhalers, but they must be attached to a breathing device attached to a mask to allow the cat to breath in the medicine comfortably. The AeroKat TM breathing device has been used very successfully in combination with human inhalers for the treatment and long-term preventive maintainence of feline asthma.
Emergency treatment of an asthmatic attack may require the use of bronchodilators, oxygen cage therapy, rapid-acting glucocorticoids, and epinephrine. If your cat has heart disease, the attending veterinarian should be advised since epinephrine should be avoided.
Will my cat be cured of asthma?
Cats with obstructive lung disease are usually manageable but are rarely cured. Sometimes a "cure" may be achieved if a specific underlying cause can be identified and treated. The goal of treatment is to lessen the severity and frequency of the "attacks" and improve the overall quality of life for your cat.
AeroKat Feline Aerosol Chamber for Cats with Feline Asthma, Bronchitis or Other Issues Requiring the Use of a MDI Inhaler, also known as a Puffer.
Inhalant Treatment for Feline Asthma
My cat has asthma. My veterinarian has suggested I switch from oral to inhalant medications. Why does my cat need an inhaler?
Asthma is a chronic disease that causes narrowing and swelling of the airways in the lungs. Most cats with asthma will experience coughing, difficulty breathing, open-mouth panting, and other respiratory distress. In severe cases, death may occur in severe cases that remain untreated.
For cats that have frequent and persistent symptoms, traditional treatment involves administering corticosteroids (steroids) or other drugs (bronchodilators) that open and reduce swelling in constricted airways. For cats that have only occasional symptoms, a metered dose inhaler (puffer) may be used whenever an asthma event occurs. Depending on the severity of the disease, an inhaler can be a lifesaver for cats suffering from asthma.
Inhaled steroids are associated with fewer side effects than oral steroids
Why is an inhaler better for my cat than oral medications?
Cats that experience daily asthma symptoms will require higher doses of medication. Because long-term steroid use can have undesirable side effects (such as increased chance of certain infections, poor wound healing and weight gain to name a few) and inhaled steroids are associated with fewer side effects than oral steroids, administering steroids by inhaler is preferred.
Is there a specific type of inhaler for cats, and how do I use it?
Sample Asthma Inhaler Instructions in Cats
1. Asthma puffer medications come in many sizes and medication concentrations. Verify that the inhaler you are using matches your veterinarian's current prescription.
2. Remove the safety cap from the asthma puffer medication.
3. Insert the asthma puffer into the AeroKat Feline Aerosol Chamber as instructed in the manual, and shake for 5 to 10 seconds
4. Place your cat in a safe and secure area on a towel or other soft surface.
5. Gently place the AeroKat Feline Aerosol Chamber inhaler mask around your cat's nose and mouth. Ensure that you have a good seal around your cat's face.
6. The AeroKat Feline Aerosol Chamber's special indicator, known as the Flow-Vu Indicator, alerts you when you have an adequate seal and when your cat is breathing in. This special inspiratory indicator will flutter when your cat is inhaling.
7. When your cat inhales, activate the puffer medication.
8. Continue to hold the AeroKat Feline Aerosol Chamber inhaler mask in place for an additional five to six breaths.
9. Follow your veterinarian's recommendations regarding frequency of administration.
10. Reward your cat with praise and a special meal as directed by your veterinarian.
11. Be sure you know when to replace your cat's inhaler medication. It can be difficult to determine when many inhaler medications are out of their active ingredient. With experience, it is easy to tell by weight when an inhaler is out of ingredient, but you can always give it a shake and test it before administering.
Many inhaler medications are equiped with a MDI, Metered Dose Inhaler, on the medication. This MDI counts down the number of actuations with every activation the puffer medication, giving the peace of mind of knowing when to order a refill of the medication.