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Dr. Deb
Dr. Deb, Cat Veterinarian
Category: Cat
Satisfied Customers: 9761
Experience:  I have been a practicing veterinarian for over 30 years.
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Dr Deb, You gave me some advice a month ago when I was

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Hi Dr Deb, You gave me some advice a month ago when I was trying to work out how best to help my cat who was having breathing problems which had been occurring over a year. Sadly, as I said in my last message I had to say goodbye to him as he was getting
worse and I wanted to spare him any more invasive testing. Unfortunately my reason for emailing now is for a second opinion on my other cat (14), who is from the same litter as my cat who died. I took her to the vet about two months ago as she had also coughed
once or twice and seemed lethargic. The vet heard crackling on her lung and asked me to bring her back in three weeks time. I was due to take her back but got overtaken by events with my cat who died. We took her back two weeks ago and the crackling was still
there. We took her again this week and the vet said the lung sounded better but that her breathing (exhale) sounded a bit restricted. I had been keeping a record of her resp rate too. It ranges from 20 (when sleeping) to 40 when awake/alert. Obviously I am
worried that she may have what my other cat had - given that they were brother/sister (genetic predisposition?) and also lived together (possible infectious/environmental causes). I asked the vet whether she could also have asthma (which her brother was diagnosed
with) and he said it was very unusual for a cat to be diagnosed with asthma at this age and they are usually diagnosed around age 7 or 8. She is 14. But this surprised me as my cat who died was diagnosed with asthma when he was 13 - which of course makes me
think that maybe he never had asthma at all and it was something else altogether. The vet wants to try antibiotics first - and if they don't work then to try steroids - and if that doesn't work to run tests. However, given that my other cat had a year of antibiotics
/ steriods / inhaler etc with a horrible outcome and no clear diagnosis I feel very torn about what to do. He prescribed Ronaxan / Doxycycline which is what I know you suggested for my other cat. However, he seems very uninterested in the fact that my other
cat died last month of similar symptoms after a year of various treatments. I have tried - and failed -over the last three days to give my cat this tablet. I've tried putting it straight into her mouth and she gags it up; mixing with water in a syringe - same
result - putting directly into food. She just becomes really distressed and foams at the mouth. I don't want to force her especially as she is already distressed at my other cat no longer being around. She is still looking for him and is also seeking our affection
much more. Also she is about 1/2 a kilo overweight but is now gradually losing weight as she used to eat my other cat's food but also since he died she is eating less anyway. And so I wanted to ask you - if you were in this situation how would you proceed?
- Would you think that the cats had an infectious/contagious disease? What could this be? - Could they both have (had) asthma or is it unlikely to be diagnosed so late? - Is 20-40 normal or is the 40 too high? - What is the easiest way to give a cat Doxycyclin.
The tablet I am supposed to give her half of is very big. At the moment I want to spare my cat any more distress than necessary. Would you think it it ok to wait until she has lost enough weight to make taking an x ray safer? (My vets will only do an x ray
under mild sedation). I would like to try and reduce her weight over the next month, monitor her breathing and then if there still seem to be problems then do tests. Would you have any other advice?
Submitted: 1 year ago.
Category: Cat
Customer: replied 1 year ago.
Apologies but the paragraph breaks have disappeared. I'm repeating the message here with paragraph breaks.Hi Dr Deb,You gave me some advice a month ago when I was trying to work out how best to help my cat who was having breathing problems which had been occurring over a year. Sadly, as I said in my last message I had to say goodbye to him as he was getting worse and I wanted to spare him any more invasive testing.Unfortunately my reason for emailing now is for a second opinion on my other cat (14), who is from the same litter as my cat who died. I took her to the vet about two months ago as she had also coughed once or twice and seemed lethargic. The vet heard crackling on her lung and asked me to bring her back in three weeks time. I was due to take her back but got overtaken by events with my cat who died.We took her back two weeks ago and the crackling was still there. We took her again this week and the vet said the lung sounded better but that her breathing (exhale) sounded a bit restricted. I had been keeping a record of her resp rate too. It ranges from 20 (when sleeping) to 40 when awake/alert.Obviously I am worried that she may have what my other cat had - given that they were brother/sister (genetic predisposition?) and also lived together (possible infectious/environmental causes). I asked the vet whether she could also have asthma (which her brother was diagnosed with) and he said it was very unusual for a cat to be diagnosed with asthma at this age and they are usually diagnosed around age 7 or 8. She is 14. But this surprised me as my cat who died was diagnosed with asthma when he was 13 - which of course makes me think that maybe he never had asthma at all and it was something else altogether.The vet wants to try antibiotics first - and if they don't work then to try steroids - and if that doesn't work to run tests. However, given that my other cat had a year of antibiotics / steriods / inhaler etc with a horrible outcome and no clear diagnosis I feel very torn about what to do. He prescribed Ronaxan / Doxycycline which is what I know you suggested for my other cat. However, he seems very uninterested in the fact that my other cat died last month of similar symptoms after a year of various treatments.I have tried - and failed -over the last three days to give my cat this tablet. I've tried putting it straight into her mouth and she gags it up; mixing with water in a syringe - same result - putting directly into food. She just becomes really distressed and foams at the mouth. I don't want to force her especially as she is already distressed at my other cat no longer being around. She is still looking for him and is also seeking our affection much more.Also she is about 1/2 a kilo overweight but is now gradually losing weight as she used to eat my other cat's food but also since he died she is eating less anyway.And so I wanted to ask you- if you were in this situation how would you proceed?
- Would you think that the cats had an infectious/contagious disease? What could this be?
- Could they both have (had) asthma or is it unlikely to be diagnosed so late?
- Is 20-40 normal or is the 40 too high?
- What is the easiest way to give a cat Doxycyclin. The tablet I am supposed to give her half of is very big.At the moment I want to spare my cat any more distress than necessary. Would you think it it ok to wait until she has lost enough weight to make taking an x ray safer? (My vets will only do an x ray under mild sedation). I would like to try and reduce her weight over the next month, monitor her breathing and then if there still seem to be problems then do tests.Would you have any other advice?
Customer: replied 1 year ago.
Also - when I said 'if you were in this situation' I meant as a vet if someone came with a second cat showing similar symptoms.
Expert:  Dr. Deb replied 1 year ago.
Thanks for the detailed information about your other cat but I'm sorry to hear that she's still grieving for her sibling:(
I'm also sorry that I was offline when you posted your question.
1. If I presented with this case, I'd take a chest x-ray without any hesitation. I'd really want to know what's going on in the chest and whether this appears to be primarily a lung issue or one involving the heart. If the latter, then I'd suggest an ultrasound...another procedure which rarely requires sedation.
I believe I mentioned that I rarely, ever have to sedate a cat for an x-ray and if I were you, I might consider finding a vet who also doesn't sedate but I realize that this may not be practical depending on where you live.
Certain breeds of cats and therefore siblings can experience inherited issues such as cardiomyopathy; I don't see enough related cats to say with certainty that respiratory issues are also likely to be inherited but I don't see why they wouldn't be.
2. Infectious respiratory conditions are fairly uncommon in cats although having said that Upper Respiratory Infections (aka the Feline Flu) can be contagious between cats. However, these infections don't typically invade the lungs; they primarily only affect the upper airways.
I suppose lungworms might be seen in more than one cat in a household especially if these cats go outdoors. But, this isn't a really commonly seen problem in cats (at least where I live) and it wouldn't be considered contagious.
3. I do agree with your vet that asthma is usually diagnosed in younger cats but bronchitis (which is somewhat similar) could be seen in older cats.
Initially asthma and bronchitis could look exactly the same and would be treated similarly but the differences are seen as the diseases progress.
Asthma patients typically respond quite rapidly to treatment while those with bronchitis are only minimally responsive (because significant respiratory distress only occurs with end stage disease).
So, could they both have asthma? It's possible but it does seem a little less likely given that your other cat hasn't had any previous respiratory issues...or I assume that this is the case.
4. Normal respiratory rate in cats at rest will be 20-30 breaths per minute. Active cats will have higher rates. I would consider 40 to be normal.
5. Doxy is a tough drug to get into cats as you're finding out but I will sometimes prescribe it if I'm trying to rule out a Mycoplasma infection or Bordatella. I often will have it compounded by a local pharmacy into a tasty treat or a flavored liquid which makes it much more palatable and easy to give. I don't believe it's available as a gel which can be rubbed into the ear for some reason.
6. I'm not sure that her weight is a relevant factor in whether or not an x-ray is taken now or later (after she's lost). It wouldn't impact my decision to take one....but then, I don't sedate them either!!!
If she's not in any acute respiratory distress like your other cat clearly was, then waiting one month doesn't sound unreasonable to me.
However, I'd feel more comfortable about waiting if she were a younger cat; given her age and the fact that there was never a clear diagnosis for her brother, I'd really like to narrow down the list of possibilities as much as I could....and in this case, that means an x-ray, unfortunately.
There is another condition which I haven't mentioned which could cause her signs which is Heartworm disease. This disease is transmitted by mosquitoes and depending on where you live and if your cats spend a good deal of time outdoors (although it can be seen in inside cats too), may be a possibility.
We do have a test for this disease which is often done in a vet's office. Unfortunately, we don't have an effective treatment for it in cats. This disease is different in a cat than in a dog and the coughing that's seen is related to inflammation in the lungs.
Cats can also develop a condition known as heartworm associated respiratory disease (HARD) which can result in significant damage to the lungs and resultant symptoms such as wheezing and compromised respiratory function. These cats are typically negative when an antigen test is done but often positive when an antibody test is run. Ultrasound is normal with no worms detected. Radiographic changes are usually detectable helping with the diagnosis but you have to know what you're looking for since those changes could be confused with changes secondary to lung worm or migrating rounds worms or possibly asthma.
Unfortunately, we don't have effective treatments for this condition although steroids can be effective in helping to reduce inflammation and the accompanying symptoms.
I understand every vet's approach is different and I, too, have treated patients on occasion (and for various reasons) with drugs before running diagnostic tests.
But in this case, I don't know that we can really get to a better understanding of what's going on in the chest without an x-ray...and since we never knew for sure what was going on with her brother, making a connection between the two will be much more of a challenge.
Deb
Dr. Deb, Cat Veterinarian
Category: Cat
Satisfied Customers: 9761
Experience: I have been a practicing veterinarian for over 30 years.
Dr. Deb and other Cat Specialists are ready to help you
Customer: replied 1 year ago.
Dear Dr Deb,Many thanks for your thoughtful and considered answer. Yes our household is definitely missing our other cat and it is very sad to see her still looking for him.An immediate x-ray makes sense to me and I'm going to ask if we can do that this week. I have a sense that they won't do it without sedation and wonder if this is the norm in the UK. But I'll have a quick look. I'm reluctant to start over again elsewhere however.In terms of heartworm I've had a quick look and it seems to be that cats in the UK are not yet affected by this. And so fingers crossed this is not what she has. Perhaps it is bronchitis although that doesn't seem like it would have a good prognosis either. Hopefully things will be clearer after an x-ray. I am really hoping that it's something we can treat.Yes she does go outdoors as did my other cat. But as they've got older they tend not to go much beyond the garden.Thank you again.
Expert:  Dr. Deb replied 1 year ago.
You're more than welcome (as always) although I'm sorry I was off my computer when you responded back.
And, thanks for the rating as well; it's greatly appreciated.
I understand your hesitancy about seeking out another vet but sometimes a fresh perspective isn't necessarily a bad thing....and if they can take xrays without sedation, that's an even bigger plus.
I don't see a lot of heartworm disease in cats since I live in New England (in the States) but just thought I'd mention it to be complete. It sounds as if HARD would be less likely.
I'll look forward to an update after an x-ray is taken; hopefully, it will provide much needed information as to what's causing her symptoms.
Deb

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