Treatment Hints

This page describes treatment hints useful in caring for an asthmatic cat. The above links in this section describe additional treatments and medications.

On this page you'll find:

• Learning How: Cat and Caregiver Compliance
• Learning How: Examples
• General Anesthesia Concerns
• Towel Treatment - Safe Cat Confinement

The average cat lover doesn't consider training their cat beyond the basics: cuddles are good as is using a litter box, scratching the furniture is not okay, nor is gnawing on that thawing roast. Many think it's the cat who trains us! However, keep this in mind: for all house members, the relationships continue to be adaptable for the life time you spend together.

Cats tend to be most content with a predictable daily pattern -- that assures them their home is a safe territory. Like us, cats prefer a choice in how things happen to and around them. As their guardian, we sometimes have to make decisions for them, such as medical care. Not many cats will hop into a carrier and insist on a veterinary visit when not feeling well.

The way we work with them during those necessary decisions makes all the difference. While a cat not accustomed to handling can be overpowered (with sturdy gloves and a cage), it will take time for that trust bond to re-establish. During an emergency, medical care and safety is, of course, the first priority. Incorporating daily long-term medication is a different situation and with some planning, patience and love, all things are possible.

To increase the trust bond, it's better to go in small steps for this new activity. Many of us, like concerned parents for a child, will be understandably anxious when our feline friend is ill. And, like a parent, expressing calmness and reassurance communicates safety.

Assuming that your cat has been medically stabilized enough to come home, you'll have new inhaled prescriptions, chamber device, and perhaps oral pills to use until the inhaled steroid is working at therapeutic levels. Now, what to do with it all?

You know your cat best. She or he may naturally have a temperament which trusts you in all matters and adapts to the medication routine immediately with happy purrs. On the other hand, you may be reading this imagining either you or the cat will be clinging to the ceiling or hiding under the bed. No matter where the two of you fall in this range, the goal is to associate the "med time" with what your cat finds routine and pleasurable.

The first step is to make a list of places and actives that the cat enjoys. Do they have a favorite spot in the house? What do you use for special reward? Verbal, cuddles and brushing, and/or food treats? Bed time? Your arrival home? When you settle down with the newspaper do they read, too? There's usually several things on your list and you can combine them in your strategy.

Many introduce their cat to the chamber. Perhaps let the cat sniff it, leave it at their favorite spot, put some food on the mask to lick off, brush them with verbal praise and stroke them with the chamber to get their personal scent on it. Detach the face mask and place it on the cat's nose area for just a second with a reward of happy fussing. Build up from there. Watch carefully for signals that they've had enough and stop there. Go about your own business like you would if you were only having a brushing session or play time etc. There are signals between cat and caregiver that communicate the start and stop of interactions - Carol Slater observed this with her Ernie (see below Examples).

The puff sound of an inhaler is a common concern for new inhaled users. Human asthmatics use inhalers daily without the cat bolting in terror - it all depends on the association. The sound can simply becomes just part of the happy activity, or at the least, the tolerated activity that gets the treat.

Since albuterol is an inexpensive medication with usually 200 actuations, some puffs can be used during this acquaintance period - but keep track of the puffs so you know when your MDI is nearing empty. Some have bought non-prescription MDIs solely for the sound desensitization, as Kari Winters did (see below Examples). Carry it around with you and activate a puff during your normal activities and it will become normal to them, too. Work up to getting it near them as you pet them or set down a food bowl. They may be startled at this new noise, but no harm was done and they move on to the next thing in their busy lives. By now, you may have a plan in mind for working with your cat.

Fritz is a severe asthmatic so we needed to start the inhaled meds as soon as possible. Prior to this we gave him pills several times a day and we at first used a very gentle "towel treatment", and lots of verbal praise. Afterward, he was given a fish treat - a strong motivator that he'll climb mountains for. (Ok, ok... a small hill is all he's really up to before needing a nap.) The towel treatment was needed to get him the medical care he needed and protected all of us from harm. Fritz quickly realized pills equalled fish! Within a week, the towel was no longer necessary, he would come for his treat and tolerate the pill part. Moving to inhaled was easier since we didn't need to open his mouth, and by singing silly songs, he wasn't bothered by the MDI puff.

An additional idea is to consult with a professional Animal Behaviorist who can offer advice to maintain peace while doing the very best for your cat or any animal in your household. The Animal Behavior Society website contains more information.

You know your cat best and with a plan, patience and lots of love, you'll have success. The key points are: predictable daily pattern, safety, choice, reward. In the beginning, it seems impossible to fathom our cats will come seeking us out to tell us what time it is - their med time!
 

Learning How: Examples

Here are more stories of how a caregiver and cat learned some new tricks.

Carol Slater and Ernie

People have commented that Ernie is exceptionally compliant, and they say that their cats would never sit still for it. This is a misconception that seems to be extremely common. Even my vet voiced this concern in the beginning, along with the idea that a cat would be put off by the sound and the smell of the flovent.

At his vet's office yesterday, Ernie demonstrated the ease with which he accepts his inhaled flovent as his vet and two vet techs observed. Flovent time at home has become pretty predictable. Mornings Ernie has a full agenda on his mind, so is a bit more anxious to get the inhaling over with. Evenings when he's more laid back, it's a bit different. He breathes long and slow. I never count breaths anymore. We have an understanding that he will breathe it as long as he can, and then he signals me by either lifting a paw or turning his head slightly. At that point, I have agreed that I will stop, and I do. I think he enjoys medication time in the evenings, as he knows he can trust me to give him some control. People seem to think that he's unusually compliant, but I think most of our cats have accepted their medications in a similar way. Obviously "Formerly Fat" Ernie receives only praise in the way of treats afterwards, plus lots of pats and kisses.

Kari Winters and King Tut
The following first appeared in The Pet Press in Los Angeles, "The Breath of Life - Part I & II" Jan-Feb 2004 and Feb-March 2004.

Now you're probably wondering how you can get your cat to use an inhaler....One suggestion that worked well for us was to go into the bathroom with the door closed and have King Tut eat wet food out of the spacer. Once he was used to that, I bought cheap, over the counter inhalers and would press them into the air while he was eating so that he'd become used to the "hissing" sound.

All of this helped, but there was still an interesting adjustment period during which I had to use patience, humor, and a lot of gymnastics to administer the medications. Some cats adjust more easily than others. I think Tut was in the middle range.

General Anesthesia Concerns

A cat with respiratory disease can be at higher risk when undergoing anesthesia. The general overall health of the cat helps in making anesthesia decisions. If anesthesia is deemed necessary, here's what Dr. Padrid recommends:

"I generally administer a bronchodilator, albuterol by inhalation for example-about 1 hr. prior to induction of anesthesia. I also strongly suggest monitoring with a machine called a "pulse oximeter" and an electrocardiographic monitor during the anesthesia. Ketamine is a commonly used drug in this setting and is usually very safe for asthmatic cats- it acts as a bronchodilator itself- but it is important to pretreat with atropine and readminister atropine during the procedure to minimize the mucus and saliva accumulation that will predictably occur." Padrid via personal email.

Towel Treatment - Safe Cat Confinement (also known as Swaddle Puss or Burrito)

Is your cat difficult to pill? It took time for Fritz to become relaxed and trusting with his medication. Here is a suggestion we call the Towel Treatment. It sometimes helps to have two people at first to use the Towel Treatment.

Get a large bath towel. Place cat on floor or bed, kneel down and have cat's rear facing towards you, head away. Place towel over cat's back and give lots of verbal reassurance. Wrap one end under cat and then the other, as if swaddling a baby. The goal is to get those paws safely tucked in and make the wrap snuggish around the neck. Now you have a "swaddle puss" with head exposed. Make sure the wrap is snug enough or they can wriggle free. It doesn't hurt them to be firmly wrapped like this. Adapt procedure for temperature readings. Towel can also be placed under the cat and wrapped up and around the cat's back. As with many training procedures, you can start slow, give praise and/or treat and work with the towel, at first, during times other than giving medication. The key is to have both cat and caregiver in a calm frame of mind.

The other person can help by being a barrier to prevent initial forward escape and passing meds, etc. The cat may be placed between the knees, the person leans over and has good visibility and control, or the cat on a sofa or table. Wrapping in a towel is a technique frequently used by veterinarians and their assistants. Don't forget a treat afterward. Ask your veterinarian for other ideas, they deal with a range of cat temperaments and medical needs daily. For very challenging cats or (former) ferals, an animal behaviorist can be an excellent resource.

 Continue Reading at Inhaled Medications