Yearly vet appt for an asthmatic - what tests are needed

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Traci and Boomer

Traci and Boomer

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Merlin is due to go to the vet for his yearly appointment. He's got mild asthma and gets 2 puffs a day of Flovent in the lowest dose. I've had him for a year and he's 2. What tests should I get?

Should I get a chest x-ray to see if his lungs are the same or have gotten worse? The vet was of the opinion that he didn't need treatment. (she has an mildly asthmatic cat that she doesn't treat) I like her but I never seem to find a vet that is knowledgeable enough. I don't want to switch because Merlin loves her. When he was fist dx'd it was because he was panting. They had me put him an flovent and albuteral for a few weeks and then they wanted me to stop which seemed to make no sense. It did cure the panting but he does still cough sometimes. I've kept his asthma under control by researching it and getting him an inhaler and meds myself. Should I expect his chest x-ray to have stayed the same? Does it ever get better to the point that he won't need meds? I've noticed he has been coughing a little more in the summer.

The second issue is that since I got him he's had poop issues with most foods. The ONLY food that I've found that doesn't give him liquipoo is Wellness. The vet was totally not helpful with this problem at all. She didn't really know anything about nutrition. Do you think this may indicate that he's got some form of IBD? It's confusing because he has normal poop on Wellness but he doesn't love that food. I've had an IBD cat (Boomer) and the only way to definitively dx IBD is to have biopsies of the intestine. Is there any other way I'm not remembering? Should I just ignore it and continue feeding Wellness and assume he's just got a sensitive stomach?

Sorry for the length of this post. I am feeling nervous and want to make sure I do the right tests and take care of him the best I can.
 
Hi traci .. I don't really have any answers to your questions but I wanted to post that I think you do a wonderful job taking care of merlin and it's great you are asking all these questions and taking matter's into your own hands with his meds .. he is very blessed to have you as his bean!
 
Hi Devon-

That's very sweet of you. I'm still recovering from my past losses and paranoid about missing something in his care. It was scary to adopt a new cat and have him show symptoms of asthma right away - god I was a mess last year at this time. I'd like to get him a female (meezer) kitten friend but I'm going back and forth about it. Is Mocha a nice kitty? Can she be loving? I've never had a girl cat and I hear they aren't as sweet as boys - even tho the boy I've got right now is more of a maniac.
 
No answers to your questions....but I can sort of answer your question about female meezers. As I just adopted a blue-cream tortie point himalayan. And as you know I have and have had lots of meezers. My females have always been more cuddly than my males...across the boards regardless of breed. Now if you really want a snuggle bug I highly recommend either a Ragdoll siamese or a Himalayan. Himmies are a little more high maintance than a ragdoll because a himmie is basically a persian with siamese markings and blue eyes. You get the best of both worlds with them, you get the beautiful long fluffy double coat, and laid back personality of the persian, with the striking coloring and blue eyes of the meezer. Like the persian Himmies think of themselves as home decor...lol. But they are very loyal almost dog-like with their humans. They are famous for running to meet you at the door but aren't going to be swinging from the curtains.

Our new furry girl is just a dream, she is 11 years old and yes a sugarcat, but I couldn't ask for a better girl, she is sweet, cuddly and will start purring if you just look in her direction.

Mel, Maxwell, Musette & The Fur Gang
 
Hi Mel-

Thanks so much for your help on the meezer girl/meezer mix question. I need a girl who isn't shy for my boy who is gonna be ALL over her and want to PLAY. I want her to be the boss if possible, but i don't want a "sh*tten" if you know what I mean - I'd LOVE a cuddler and I'm glad you think it's possible to get a girl cuddler.

I follow the cats available on the Siamese Rescue board - the place I got Merlin. Right now there is a 9-month old Balinese girl but I think she's too shy. I'm lucky because it's kitten season and generally there will be a lot of kittens to choose from. I'll keep my eyes open for a ragdoll or himmie mix. What about a tortie meezer?

PS - They thought Merlin was a ragdoll mix at the shelter. He was very nice and laid back at there and with the catsitters - just not me! :roll:
 
Yes, mocha is a nice kitty .. she has an awesome personality .. I don't know if that is cause me and peter "talk" for her, as in, we decide what she says and how she says it and when she says it .. but, don't we all do that? :oops: Anyways, she really is a sweet girl .. she was a terror as a kitten .. we honest to goodness thought she was rabid .. took her back tot he vet and told him that .. he laughed at us and we've learned to live with her "ways" You of course, already have experience with a meezer so it won't be new to you .. We've heard in the past there are two kinds of meezers, lap meezers and shoulder meezers .. meaning, they prefer one over the other .. mocha loves loves loves to be high up on our shoulders .. with her butt near our cheeks .. the higher the better for her .. but at night, she loves to lay in my lap .. she can sleep on my legs for hours .. I guess that's just her split personality ..

Also, mocha is not a pure siamese kitty .. her momma and siblings were all torties ... The guy who was giving her away said that there was a siamese cat that came around every so often .. she obviously got her looks from her daddy!
 
Traci,

Musette is a tortie point himmie although she is the pastel version of tortie, she has tortie-tude in spades.. :lol: She is 11 years old, and only a little thing at 6.5lbs and a recent addition but she already rules this house with a velvet paw. She takes no guff from anyone, including cats three times her size. Well and even I can't get away with much from her, the other day I didn't get her treat to her after testing as quickly as she thought I should and she marched right up into my lap, stretched up, got in my face and Hissed! Her old vet records said that the other cat in the house she came from use to bully her, I would love to see that cat, because it must have been a Lion or Tiger at the very least. She is unfortunately declawed on the front paws but she will even stand her ground with the Sh*tten Myrrdin.

Now granted she is much older than someone that you would want for Merlin but a kitten of any breed is more than likely going to want to play, but rag dolls and himmies both are very much cuddlers as they age. Musette is the first tortie-point that I have had, and she is definitely different. By in large and of course every cat is different but what I have seen in the ones I have lived with, Blues and Lavendars are the mellowest, Flames are shy, Chocolates and Seals the most vocal and active. And now with a tortie point DIVA...lol. It will be interesting to see what Musette's personality develops into once she is truly healthy again. I thought Maxwell as a sick kitty when I adopted him, but Musette right now makes Maxwell look like the picture of health back then. So she may start swinging from the drapes when I get her back in the pink but I highly doubt it knowing Himmies.

There really about 5 purebreds that come with siamese markings all with their own "breed" personalities. Birman, Himalayan, Balinese, Burmese and of course the Siamese. If you want to read up on the general personality traits of each here is a good run down of what the CFA considers "standards" http://www.cfa.org/client/breeds.aspx

But whatever you pick will be one lucky little girl. :-D

Mel. Maxwell, Musette & The Fur Gang
 
Hi Traci

Curry has had the asthma for few years. Just went off the juice on june 23rd and "officially" yesterday. She is on the max dose of 220 x2 puffs twice daily. When I take her in for her annual vet doesn't do xrays. He did them to dx her but hasn't since. Its my understanding that the disease is chronic condition so the flovent can actually prevent progression of the disease and any damage to the lungs. I had joined the feline asthma yahoo group for awhile just to get info. I remember that once I tried to reduce her flovent last October and after 3-4 weeks she started to cough again. That's about the amount of time for the flovent to get into the body. So she's back on the flovent w/out any problems. I get my flovent at 4 corners pharmacy...meds come from New Zealand.

Hope this is helpful,

Tena
 
Hi Mel-

Thanks for all the info on this stuff. I wish I had cat friends in "real life" instead of just cyberspace. I've seen the pics of Musette but I didn't realize she's a dilute torti. She's really cute. I'm sure with your care she'll be feeling better soon just like with Maxwell.

I looked on the CFA site you sent and Merlin seems to look most like the Birman and Ragdoll but he's not laid back like Ragdolls or as big. He must be a mix of some kind.

I'm considering a tortie point because Mer may be a bully with another cat and I need a kitten with a strong personality who won't be overly sensitive to him.
 
Hi Tena-

I was hoping you'd reply. Congrat on Curry going OTJ; I saw her video. That's fabulous. I get my flovent from 4 Corners too, it's so easy and a great price.

I was wondering if I should request a chest x-ray to see if his lungs are any worse to determine if he needs a higher dose of the flovent. I too was on the feline asthma board for a while and it really helped me. I'm not on it anymore; I was hoping to get you and other beans of asthmatics to chime in.

So you just continue to give her the same dose over the years? Do you judge how she's doing on how much she coughs/doesn't cough?
 
Although my asthmatic has been gone for 2 years I will chime in- we did xrays every 3 yrs, unless there was a change in symptoms that we needed to check out. Otherwise his exams were just regular wellness, like the other furkids. After 4 years on inhaled meds, Clou's xrays actually IMPROVED, which was something neither his vet nor I expected! I based his dose on symptoms, upped if there was any wheezing or coughing and after a year or two I was able to find a pattern based on allergens (outdoor) and just automatically upped his dose in the spring and fall. From the time he went on inhaled in 2002 until his death in 2009 his asthma was stable.
 
Hi Sheryl-

Thanks for the info on your experience with Clou. I guess I don't need to get a chest x-ray this year. I'll ask the vet too but they seem to be pretty laid back about tests. I think they are not used to an educated and concerned owner who is willing to do whatever is best. His asthma seems under control. I noticed that he coughed a little more a couple weeks ago but it seems to have stopped.
 
Hi Traci! I wouldn't base flovent dosing decisions off of the x-ray. If he is coughing on occasion, then I'd up the dose. Can you remind me of what dose you have Merlin on right now?
 
Hi Kelly-

He gets 1 puff twice a day of flixotide 125 micrograms. He does cough on occassion. Should he not be coughing AT ALL while on this medication? Is it the coughing that causes the lungs to scar? He doesn't pant anymore like he did last year. Any opinions/experience/advice is appreciated.
 
Hi Tracy

I think it's helpful to take x-rays every few years, just to keep track of things, but wouldn't make it part of every annual visit.
I'm with Kelly -- I would let symptoms guide meds, not x-rays, for the most part. If the lungs look bad down the road, I'd actually switch to oral steroids. Flovent works as far as it is inhaled, so it's possible to not get the full benefit from Flovent that you would from systemic steriods. Since systemic steroids have such serious health consequences, however, I wouldn't do it for a cat that did not have serious lung disease or unless one didn't respond to inhaled meds.

How often does he cough? Does he get the zoomies, race around, etc. without any problem?
 
How often does he cough? Does he get the zoomies, race around, etc. without any problem?
Hi Jess-
He coughs a few times a month I'd say. It totally depends. It comes and goes. When summer started he seemed to do it more. Before that hardly ever. Last year's x-ray showed what my vet called "mild" asthma. They didn't think I needed to treat it after a few weeks of puffs since his panting stopped. I did some research and questioned them and they still thought I didn't need to treat him. I decided to anyway after being a member of the feline asthma message board. Since I've treated him he's done very well, no panting since last summer and some coughing here and there. He runs around like a maniac and will chase a feather toy up and down the couch and breathes fine. I hope I never have to give him steroid pills. That's what caused Boomer's diabetes. I'd try everything before doing that.
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Traci and Boomer said:
Hi Kelly-

He gets 1 puff twice a day of flixotide 125 micrograms. He does cough on occassion. Should he not be coughing AT ALL while on this medication? Is it the coughing that causes the lungs to scar? He doesn't pant anymore like he did last year. Any opinions/experience/advice is appreciated.
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Very few cats can actually be controlled on one puff of the 125 BID. Coughing a couple of times a month is too much imo. One cough every 2 months or so is what most on the asthma yahoo group deem acceptable. If they are coughing, then that means there is still inflammation in the lungs, which can lead to scaring. I personally suggest going up to 2 puffs of the 125 twice a day (the equivalent of 1 puff of the 250 twice a day). That is still considered a low dose btw. My Oscar is on 2 puffs 250 + 1 puff 125 BID and still coughs on occasion. We have now added Singluair to his asthma regimen since he is on the high end of the flovent dose. There is one kitty on the list that has to have 2 puffs 250 three times a day to keep the coughing at bay. That kitty is definitely a more serious case than your Merlin though. Before Oscar was put on meds, he might cough once a week but generally had no other symptoms. He would often have his mouth hanging open when purring or sleeping though. Since starting meds, his activity level has increased, and the addition of the singulair has cut down a lot on the open mouth breathing bit too.
 
Hi Tracy

It is the level of inflammation and disease that causes scarring in the airway; the cough is just a symptom. With my own asthmatic cat, Dillon, I've use the 250mcg inhaler and am able to do it once a day for most of the year. In the spring, he needs twice a day so there is some allergic component in his case. I basically go based on careful observation; if I hear any wheeze at all, we're back to twice a day, which is what happened this spring.

Kelly & Oscar said:
There is one kitty on the list that has to have 2 puffs 250 three times a day to keep the coughing at bay.
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That is a cat that should be on oral steroids instead, IMO. I know that is anathema to the yahoogroup's owner, but with very bad lungs, how deeply can that cat suck in meds? And why are things worsening?

My cat Dillon has become a little portly in his old age and, like most good street-bred cats, likes to hold on to as much fat as he can. I would desperately avoid having him on chronic steroids but if he needed double high-dose Flovent three times a day, we'd risk the diabetes and go for the pred. I have seen some horrific x-rays in cats that were untreated or undertreated for years and there's no going back.
 
That cat is actually controlled on 2 puffs three times a day. If that is controlling things then why risk the side effects of long term pred usage? I agree though that not fully controlling the symptoms and inflammation from asthma can lead to long term irreversable damage.. There are a few of us on the list that have high dose cats that are a.constant struggle to keep conrolled. A small handful of us are trying singulair as an add on on the chance that there is a strong allergy component to our cat's asthma. So far it is working well for all of us that are trying it.
 
Kelly & Oscar said:
That cat is actually controlled on 2 puffs three times a day. If that is controlling things then why risk the side effects of long term pred usage? I agree though that not fully controlling the symptoms and inflammation from asthma can lead to long term irreversable damage.
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My point would be that with severe asthma, you may be able to quash the cough while still having progressive inflammation. He/she *is* a cat that I would be doing repeat x-rays on. Again, keep in mind that the meds go only as far as they are inhaled and just plain can't control inflammation like something systemic. Also keep in mind that we're not talking 5mg BID pred here -- some cats are very well controlled on every other day single dosing, for example. The dose to control asthma, as opposed to the dose to control bad IBD or used for cancer, is very very small. I'd still avoid it for my kitty, if possible, but not take it off the table. My personal priorities are:
1. Give the kitty the best quality of life, with breathing easy a big part of that
2. Slowing the progression of the disease
3. Using an inhaled medication as opposed to systemic

If I can do 1 & 2 with 3, I'm very happy, as I am with my cat. 1 & 2 are fine goals on their own though. Giving an adult cat 2.5 or 5 mg pred every other day isn't going to dramatically increase the risk of diabetes or cardiac side effects.

I'd also keep an eye out, if that were my kitty with the 6 puffs a day, about things like thrush developing from pumping so much steroid into the nose and mouth. I also assume that the cat has been checked for heartworm and has had chest x-rays since things worsened? BTW -- all cats with asthma should be on HW prevention, IMO. Cats frequently successfully fight off HW on their own but doing so leaves them with lung damage that an asthmatic cat can't afford. Check out: http://heartwormsociety.org/pet-owner-r ... llery.html for a great explanatory video.

There are a few of us on the list that have high dose cats that are a.constant struggle to keep conrolled. A small handful of us are trying singulair as an add on on the chance that there is a strong allergy component to our cat's asthma. So far it is working well for all of us that are trying it.
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That's very interesting, have you been able to reduce the amount of Flovent?
 
He has only been on it for about 2 weeks now. Singulair is also something that needs to build up in the system, like flovent does, so we won't try any reductions until at least a month from now. So far, his mouth breathing has pretty much stopped, and I counted his sleeping breath rate the other night and it was 21 one time and 26 the next. He has NEVER been below 30, and is usually in the mid to upper 30s, so I am doing a happy dance already! He will always need flovent, I am sure, but I am glad that we have hopes of better controlling him without the use of pred.
 
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