Using an inhaler to treat feline asthma

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Asthma or chronic bronchitis in cats is often treated with a combination of anti-inflammatory drugs (steroids) and bronchodilator drugs (to make breathing easier). Traditionally these medications have been given by mouth (tablets or liquids), or by injection.

However, just as inhaled drugs are used to treat most humans with these conditions, so too inhaled drugs can be used to treat cats. Inhaled medications are delivered through a ‘metered dose inhaler’ – in adult humans we learn to breath in at the same time that a dose of the drug is delivered, so that the drug reaches the lungs.

This cannot be achieved in babies and young children, so in this situation a ‘spacer’ device is used – a chamber into which the dose of drug is delivered and then the baby or child breathes in the air (and the drug) from the chamber by using a face mask fitted to it. Inhaled therapy can be delivered to cats in exactly the same way.

Spacer devices (chambers) for use with cats

Cats can use inhalers to help with breathing problems

A special spacer device (or chamber) will need to be used for cats. It is possible to adapt some spacers designed for use in babies to be used in cats, but these are not ideal. In particular, some will have valves in them which will make it difficult for the cat to inhale the medication from the chamber, and it will often be difficult to fit an appropriate size face mask for a cat onto a human spacer device.

Spacer devices have now been made specifically for though (e.g., the Aerokat – www.aerokat.com) which are easy to handle and have a small face mask suitable for use with cats. If cared for properly, one of these devices will last for years.

Get your cat used to the spacer device first

Before you start to use the spacer to deliver inhaled drugs to your cat, it is a good idea to simply get them used to using the spacer and face mask first, without any drugs. Do this gradually and try to make it fun – play with your cat and spend time with them, ideally get the m used to the mask and spacer immediately before feeding them.

At first, you may just use the mask, and get the cat used to having this held on the face – just for 2-3 seconds at first, but as your cat gets used to it lengthen the time to 20-30 seconds. Once your cat is used to the mask, try attaching the small chamber as well, and repeat the process until your cat is used to having the whole apparatus held up to the face and will breath through the chamber. Once your cat is comfortable with this, you are ready to start using the chamber to deliver the drugs.

Administering drugs through the inhaler

Administering some human medications can be dangerous, so you should only ever use drugs with an inhaler that have been specifically prescribed by your vet. To administer a dose of inhaled therapy to a patient, first ensure the cat is accustomed to using the inhaler – see above – and then follow these steps:

  1. Shake the metered dose inhaler (MDI) according to the instructions supplied with it before each use
  2. Attach the MDI to the spacer unit
  3. Actuate a dose, by pressing down the MDI, to deliver a single dose into the chamber
  4. Immediately hold the unit over the cat’s face with the mask fitting snuggly and allow the cat to take 10-15 breaths (usually 10-20 seconds)

If your vet has told you to give deliver two ‘puffs’ of treatment, or to use two different drugs, these should be given as two separate administrations (ie, follow steps 1 to 4 and then repeat). Never give two puffs (of the same or different drugs) into the chamber at the same time as this is much less effective.

What bronchodilators are commonly used?

Bronchodilators such as salbutamol and albuterol are often used. These have a rapid speed of onset (5–10 minutes) but a relatively short duration of action (2–4 hours) meaning they are suitable for use ‘as needed’ including in emergency situations.

Some longer-acting bronchodilators (eg, salmeterol – onset of action 15–30 minutes, duration greater than 12 hours) are available and can be helpful given twice daily in those cats benefiting from long-term bronchodilator therapy.

What steroids are commonly used?

Fluticasone propionate given twice daily is a commonly recommended glucocorticoid, as it has high potency but is generally not absorbed well into the blood and so largely avoids unwanted side effects. Cheaper glucocorticoids (eg, beclomethasone dipropionate) can also be used but there may be a higher risk of side effects with long-term use. Often higher doses of steroids (higher strength MDIs) are used initially in a cat with asthma or bronchitis, and the dose (strength) may be decreased over time with good response.

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