Breathing Difficulty in Cats -Cat Breathing Problems

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At a glance  Causes     Symptoms    Treatment

Breathing problems in cats


At a glance

About: Breathing disorders can come in several forms and for several reasons. Any breathing problem is a medical emergency requiring immediate veterinary attention.

Causes: Heart failure, fluid build-up in the abdomen or chest, a blockage in the pulmonary artery (embolism), infections, tumours, asthma, low oxygen levels in the blood.

Types: Rapid breathing, open-mouthed breathing, noisy breathing and laboured breathing.

Symptoms: This depends on the type of breathing problem but may include:

  • Open-mouthed breathing
  • Coughing
  • Elbows sticking out
  • Lethargy
  • Blue mucous membranes
  • Difficulty standing

Diagnosis: Baseline tests as well as imaging to evaluate the internal structures, electrocardiogram and thoracentesis.

Treatment: This depends on the underlying cause, but will include supportive care.


About

Cat respiratory system

Breathing is a part of the respiratory system which involves moving air into and out of the lungs. Oxygen is pulled into the lungs, which is then transported to all the cells within the body via the bloodstream, and carbon dioxide is expelled.

There are several causes of difficulty breathing in cats, and different types of breathing abnormalities, which we have listed below.

  • Polypnea/tachypnea – Rapid shallow breathing, sometimes open-mouthed (panting)
  • Sibilant rhonchi – Wheezing/noisy breathing
  • Hypopnea – Shallow breathing
  • Dyspnea – Shortness of breath

Normal feline respiration

At rest, a cat breathes approximately 20-30 times per minute which is approximately twice that of a human. The process of breathing begins with inhalation

Respiration should be smooth, quiet and without effort, this is known as eupnea. The suffix pnea meaning breath or breathing; you will note types of breathing difficulty end in pnea.

Causes

Hyperpnea – Rapid and heavy breathing

Tachypnea  – Rapid open-mouthed breathing and panting

  • Shock – Shock is a life-threatening condition defined as a lack of blood flow which results in the body not receiving enough oxygen and nutrients.   Any condition which affects the heart, vessels or blood volume can induce shock.
  • Diabetic ketoacidosis – A serious complication of diabetes in which ketones and blood sugar levels build up in the body due to insufficient levels of insulin which is required to move glucose into the cells for energy. As a result, the body uses fat as an alternate energy source which produces ketones causing the blood to become too acidic.
  • Heat stress – A precursor to heatstroke in which the cat is over-heating.
  • Heatstroke – A condition in which the body has over-heated and is not able to maintain a normal temperature. Heatstroke most often associated with exposure to extreme temperatures and has many catastrophic effects on the body.
  • Asthma – Acute constriction of the lower airways, which causes coughing and respiratory distress.
  • Heart disorders – Heartworm, heart disease, congestive heart failure.
  • Pleural effusion – A build-up of fluid in the pleural cavity which may be due to congestive heart failure, liver failure, hypoalbuminemia, fluid overload, pulmonary embolism, diaphragmatic hernia, cancer, lung lobe torsion, pancreatitis, drug reaction, penetrating trauma, abscess, infection or bleeding.
  • Pulmonary embolism – Blockage in the pulmonary artery or one of its branches, most often a blood clot but other causes may include gas bubble, broken off piece of dead heartworm or a fat globule (which may be due to hypercoagulability, blood clots, heartworms, vasculitis or tumours).
  • Pulmonary edema – Fluid in the lungs, which may be due to hypertrophic cardiomyopathy, airway obstruction, certain medications, pneumonia, lungworm, kidney disease, allergic reactions, seizures and head trauma.
  • Anemia – Low red blood cell count which can be caused by decreased production of red blood cells, increased destruction, blood loss, parasites, and tumours.
  • Low levels of oxygen in the blood – Due to heart disease, certain poisons, pyothorax, pleural effusion, pulmonary embolism, tracheal or laryngeal collapse, obstruction in the airway due to foreign object or cancer, pneumonia, hypoglycemia, hypotension, respiratory paralysis such as from tick poisoning.
  • Bronchitis – Inflammation of the lining of the bronchial tubes.
  • Hyperthyroidism – A hormone secreting benign tumour of the thyroid gland.
  • Pneumothorax (collapsed lung) – Air in the pleural cavity due to penetrating wounds, fractured ribs, trauma from a fall or hit by a car, lung infection, pulmonary bleb, cancer, parasites such as heartworm, lungworm, lung flukes, lung lesion due to cysts or abscess, grass awn migration, asthma, rupture of the bronchus, trachea, lung or esophagus.
  • Pyothorax (pus in the pleural space of the lungs) – Due to penetrating wounds or trauma, inhalation of foreign objects such as grass awn, bacterial infection, parasitic migration, tumours, ruptured abscess and lung lobe torsion
  • Feline infectious peritonitis – A viral infection caused by a mutation of the coronavirus.
  • Fever – Due to infection, endocrine disorders, certain medications and tumours.

Sibilant rhonchi – Wheezing and/or noisy breathing

  • Airway obstruction – Bone trapped in the airways etc.
  • Tumours – Abnormal growths in the windpipe or throat which block the airways.
  • Acromegaly – A hormone disorder, due to a hormone-secreting tumour of the pituitary gland which can cause an enlargement of soft tissues in the throat.
  • Upper respiratory infection – Caused by several viruses or bacteria. The symptoms of cat flu are similar to that of a human cold.
  • Asthma – Acute constriction of the lower airways, which causes coughing and respiratory distress.

Dyspnea – Difficult or laboured breathing

  • Pyothorax/pus in the pleural space of the lungs – Due to penetrating wounds or trauma, inhalation of foreign objects such as grass awn, bacterial infection, parasitic migration, tumours, ruptured abscess and lung lobe torsion
  • Ascites – Fluid in the abdominal cavity which may be due to feline infectious peritonitis, right-sided heart failure, cancer within the abdomen, hypoalbuminemia, bleeding disorders which spill blood into the abdomen, ruptured bladder which spills urine into the abdomen.
  • Pleural effusion – A build-up of fluid in the pleural cavity which may be due to congestive heart failure, liver failure, hypoalbuminemia, fluid overload, pulmonary embolism, diaphragmatic hernia, cancer, lung lobe torsion, pancreatitis, drug reaction, penetrating trauma, abscess, infection or bleeding.
  • Pulmonary embolism – Blockage in the pulmonary artery or one of its branches, most often a blood clot but other causes may include gas bubble, broken off piece of dead heartworm or a fat globule (which may be due to hypercoagulability, blood clots, heartworms, vasculitis, tumours).
  • Pulmonary edema – Fluid in the lungs which may be due to hypertrophic cardiomyopathy, airway obstruction, certain medications, pneumonia, lungworm, kidney disease, allergic reactions, seizures, head trauma.
  • Pneumothorax – Air in the pleural cavity due to penetrating wounds, fractured ribs, trauma from a fall or hit by a car, lung infection, pulmonary bleb, cancer, parasites such as heartworm, lungworm, lung flukes, lung lesion due to cysts or abscess, grass awn migration, asthma, rupture of the bronchus, trachea, lung or esophagus.
  • Heart disease – Any disease of the heart and heart valves which may be congenital or acquired.
  • Elongated soft palate – Also called brachycephalic respiratory syndrome, an elongated soft palate can cause upper airway obstruction as the tissues obstruct normal air flow. Brachycephalic breeds affected include Persians and Exotics.
  • Foreign object in the throat – A piece of bone etc.
  • Pneumonia – Infection or inflammation of the lungs.
  • Tick paralysis – The toxin causes paralysis of the muscles, which eventually progresses to the airways.
  • Hyperthyroidism – Hormone-secreting tumour of the thyroid gland.
  • Lung disease – Any disease affecting the lungs. Asthma is by far the most common lung disease to affect cats. Other lung diseases include pneumonia, trachitis (inflammation of the trachea), cancer and congestive heart failure.

Symptoms

Breathing difficulty in cats

Breathing difficulties can be acute or chronic depending on the underlying cause. Often symptoms are subtle, and pet owners may not immediately recognise there is a problem.

  • Breathing with the head and neck extended out in front of the body
  • Elbows sticking out (Bulldog stance)
  • Coughing
  • Pale or blue-tinged mucous membranes (cyanosis)
  • Difficulty standing
  • Noisy breathing
  • Panting, open-mouthed breathing
  • Rapid breathing
  • Lethargy
  • Restlessness and anxiety
  • Bright red tongue (possible heat stroke)
  • Flared nostrils
  • Hiding
  • Reluctance to move


Image Karen, Flickr

Any signs of difficulty breathing, no matter how small, require urgent veterinary attention.

Diagnosis

The veterinarian will perform a physical examination which will include listening to the heart and lungs.

Medical history:

  • Known medical conditions
  • Duration of symptoms
  • Do any other household cats have similar symptoms
  • Is the cat indoors/outdoors?
  • Any other symptoms?

Diagnostic workup:

  • Biochemical profile, complete blood count, and urinalysis to evaluate the overall health of your cat. These can help to diagnose hypercalcemia, anemia, and infection.
  • Xray or ultrasound to look for tumours, blockages, pulmonary embolism, pleural effusion and evaluate the heart and lungs.
  • Electrocardiogram to evaluate the heart.
  • Endoscope to evaluate the nasal passages and airways. Biopsies may be taken during this procedure.
  • Thoracentesis is a procedure in which a needle is inserted into the pleural space to remove excess fluid, which is not only diagnostic but will also give relief to your cat.

Treatment

The goal is to address the cause, provide treatment to improve the cat’s ability to breathe and offer supportive care.

Emergency care:

The priority is to stabilise a cat who is having difficulty breathing, as they are extremely fragile.

  • Oxygen therapy administered via a mask or in an oxygen tent.
  • Sedation and emergency intubation for a cat who is in respiratory distress. If it is not possible to intubate the cat, then emergency tracheostomy will be necessary.
  • If air or fluid is present in the pleural cavity, an emergency thoracocentesis can be performed. A needle is placed into the thorax and air or fluid are removed.

Cat flu:

In most cases, supportive care which can include fluid therapy, nutritional support, remove discharge to assist breathing and in some cases, antibiotics, which won’t work for a viral infection but will be necessary if a secondary bacterial infection develops.

Heat stroke:

Treatment for heat stroke includes bringing the cat’s body temperature down, providing oxygen and treating for dehydration (where necessary).

Asthma:

Bronchodilators to open up the airways and steroids to reduce inflammation.

Heartworm:

There are no medications safe to treat heartworms in cats. Most veterinarians will recommend a wait and see approach. Severe cases, medications will require off-label medications to kill the worms. This comes with its own risks so should be carefully weighed up.

Airway obstruction:

Surgery to remove the blockage.

Pleural effusion:

Treat the underlying cause, as well as oxygen therapy to stabilise the cat followed by thoracentesis to remove fluid which allows the lungs to expand.

Hyperthyroidism:

Low iodine diet which results in a decreased production of thyroid hormone, surgery to remove the tumour or radioactive iodine treatment to kill the tumour.

Pulmonary edema:

Treat the underlying cause as well as diuretics to remove excess fluids by increasing urine output, oxygen therapy, vasodilators to open up the airways, sedatives and cage rest.

Hypocalcemia:

Treat the underlying cause as well as diuretics to remove excess fluids by increasing urine output, oxygen therapy, vasodilators to open up the airways, sedatives and cage rest.

Anemia:

Address the underlying cause as well as blood transfusion; erythropoietin is a hormone produced by the kidneys to stimulate red blood cell production, cats with kidney disease often have low levels of this hormone, oxygen therapy in severe cases.

Diabetic ketoacidosis:

Intravenous fluids and electrolytes to correct dehydration and electrolyte imbalances and frequent administration of short-acting insulin.

Shock:

Stem blood loss if it has occurred, fluid therapy, oxygen therapy, and supportive care.

Tick paralysis:

Antiserum which contains antibodies against the tick toxin, oxygen therapy, intravenous fluids and cage rest.

Pneumonia:

Treat the underlying cause such as antibiotics for bacterial infection, as well as fluid therapy to treat dehydration, oxygen therapy and cage rest.

Pneumothorax:

Thoracocentesis to remove larger volumes of trapped air or a tube thoracostomy where recurrent thoracocentesis has occurred. Oxygen therapy and pain relief if necessary.

Acromegaly:

Surgery to remove the pituitary gland, this treatment will require lifelong administration of hormones.  Radiation therapy to kill the tumour, or medications to inhibit the production of growth hormones.

Elongated soft palate:

Conventional or laser surgery to correct the palate.

Tumours:

Surgery to remove tumours where possible as well as radiation therapy and/or chemotherapy.

Bronchitis:

Treat the underlying cause where possible as well as bronchodilators to open the airways.

Feline infectious peritonitis (wet form):

There is currently no cure for FIP and treatment is palliative although there is a potential new treatment on the horizon with a small trial showing a high success rate. The treatment is a broad-spectrum anti-viral drug GC376.

Low levels of oxygen in the blood:

Treat the underlying cause as well as supportive care such as painkillers, oxygen therapy, fluid therapy, nutritional support and blood transfusion where necessary.

Heatstroke:

Decrease body temperature by introducing cool fluids intravenously or by enema, oxygen therapy and in some cases corticosteroids to reduce swelling in the throat.

Pulmonary embolism:

Cage rest, oxygen therapy, fluid therapy, thrombolytics which are medications to break down the clot, and possibly anticoagulants to reduce the occurrence of blood clots forming. Unfortunately, the prognosis is poor for cats with this condition.

Pyothorax:

Treat the underlying cause as well as oxygen therapy, bronchodilators or nebulisers may be necessary to help your cat breath. Thoracic drainage tubes to remove fluids from the pleural cavity. Supportive care including pain medications, intravenous fluids, and nutritional support.

Ascites:

Treat the underlying cause as well as the removal of fluid from the abdomen (abdominocentesis), diuretics to promote the production of urine and dandelion extract to prevent fluid build up.

Heart disease:

Surgery where possible but in many cases treatment is supportive, which may include exercise reduction, medications to remove fluid build up, low sodium diet.

Upper airway infection:

These are usually self-limiting in healthy adult cats. Supportive care will be given including fluid therapy if necessary, and nutritional support, removal of nasal and eye discharge as well as steam therapy. If the cause is bacterial, antibiotics will be prescribed.