Today's Veterinary Practice

MAY-JUN 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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FEATURES 47 MAY/JUNE 2018 ‚óŹ TVPJOURNAL.COM FEATURES The Asthmatic Cat: Management Guidelines Tekla Lee-Fowler, DVM, MS, DACVIM (SAIM) Auburn University College of Veterinary Medicine INTERNAL MEDICINE Feline asthma is an inflammatory condition of the lower airways that manifests clinically as a chronic cough and, in some cases, intermittent exacerbations with expiratory distress. Airway inflammation is typically eosinophilic, but a neutrophilic component can be seen in severely asthmatic patients, particularly if a secondary bacterial infection is present. Eosinophilic airway inflammation is not specific for feline asthma, and during initial diagnostic work-up, other differential diagnoses, including parasitic bronchitis (eg, lungworms, heartworm-associated respiratory disease) should be considered. Bronchoconstriction is a key feature of feline asthma that results in increased airway resistance. This manifests as wheezes on thoracic auscultation and increased respiratory effort most noticeable on exhalation. This may also be accompanied by increased abdominal effort, known as an "abdominal push." Increased mucus production is also a prominent feature of feline asthma, and this may contribute to airway narrowing and increased respiratory effort. In acute exacerbations, feline asthma can be life-threatening and require emergent management. Acute management is focused on stabilization of the patient as required and addressing bronchoconstriction. Long-term management is aimed at addressing the airway inflammation and is often multimodal. When not addressed appropriately, chronic airway inflammation can lead to airway remodeling, which can further complicate the disease condition and affect prognosis. Therefore, inflammation must be appropriately addressed. This article reviews management of both the acute and the chronic asthmatic feline patient. ACUTE MANAGEMENT Emergent Management Asthmatic patients may present in respiratory distress, and these cases require quick and accurate patient assessment. However, complete physical examination may not be possible. Characterization of the respiratory pattern (eg, greatest effort on inspiration vs ASTHMA THERAPY Management of the actue and the chronic asthmatic feline patient must be addressed using a multi-modal, anti-inflammatory approach.

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