(((Sam)))
He is going to be okay! It's only an emergency if the attacks are happening frequently and Ruben is struggling to breathe. Since this is just one of two attacks in several months, it's not an emergency. Best case scenario, it's just allergies and you won't even need inhaled steroids. Some people give their cats benadryl, zyrtec, or some other OTC anti-histamine.
They don't need to put the cat under for an x-ray. It's very quick and painless... the whole process took about 10 minutes.
When you go to the vet, describe the symptoms and the frequency. To make the diagnosis, they will need to perform an x-ray. In asthmatics, fluid shows up in the lungs on an x-ray, and they can often hear wheezing in the lungs with a stethoscope. Kismet has a mild case (his lungs looked really good, actually!) And he was having very frequent attacks. On the Fritz website, there is a table that describes the severity of asthma:
Distress Levels
James and Kathryn have categorized Fritz' symptoms into increasing levels of distress. These can be used as a guideline for your cat with adjustment to his or her particular symptoms:
Asymptomatic: I feel great, sleep well, eat really well, and have the best time playing with my toys and pals.
Minor Attack: I start coughing and have a tough time stopping. I hold my neck out straight and keep my head close to the ground while I cough. My lungs sound gurgly, and in a stethoscope sound "crackly".
Full-blown Attack: Breathing becomes labored and the volume inspired is low, my sides heave in and out (abdominal breathing), and I look puffy (my lungs have too much air trapped in them due to excess mucus). I am unable to do any of my normal activities.
Crisis: I pant, looking like a very frightened or very aggressive cat, but really it is just because it is hard to breathe. I start to get a lot of mucus in my lungs and start drooling big frothy drools. My heart races.
Praying This Isn't My Ninth Life: I sit up and try to stretch up high to get my breath but it is very hard, like sucking air through a flattened drinking straw.
Cardiopulmonary Collapse and Death. Not one of my symptoms, thank the Tuna Gods.
From your description, it sounds like Ruben would be Asymptomatic or Minor Attack at most if he even has asthma.
Another thing to ask the vet is to test for allergies. If it is just allergies, he may be able to just take the OTC drugs. If it is asthma, you will of course want to mention the history of diabetes to rule out oral medications. Worst case scenario, he gets on an inhaled treatment regimen. Albuterol is a rescue inhaler that is used to treat the attacks as they occur. Right now, Kismet only receives Albuterol for when he has an episode. Flovent is an anti-inflammatory that is given every day to prevent attacks, but this is only used in cats that have moderate to severe cases of asthma. Since Kismet doesn't have attacks frequently anymore, he doesn't get Flovent.
Breathe deeply. Ruben is going to be just fine
