Evaluation of long-term therapy in cats with feline asthma and chronic bronchitis

Abstract

Objective Feline asthma (FA) and chronic bronchitis (CB) are common inflammatory diseases of the bronchial tree in cats. Even though both conditions are characterized by infiltration with different types of inflammatory cells, therapeutic measures are often similar. Little is known about potential differences in therapeutic management of these 2 airway diseases. Therefore, aim of the study was to compare initial and long-term treatment, therapeutic success, side effects, and owner satisfaction between cat with FA and those with CB.

Material and methods Thirty-five cats with FA and 11 cats with CB were included in the retrospective cross-sectional study. Inclusion criteria were compatible clinical and radiographic signs and cytological evidence of eosinophilic inflammation (FA) or sterile neutrophilic inflammation (CB) in bronchoalveolar-lavage fluid (BALF). Cats with CB were excluded if evidence of pathological bacteria was present. Owners were contacted to fill out a standardized questionnaire on therapeutic management and response to treatment.

Results Comparing treatment in both groups, no statistical significance was detected. Most cats were initially treated with corticosteroids as oral (FA 63%/CB 64%, P=1), inhaled (FA 34%/CB 55%, P=0.296) or injected formulations (FA 20%/CB 0%, P=0.171). In addition, oral bronchodilators (FA 43%/CB 45%, P=1), and antibiotics were given in some cases (FA 20%/CB 27%, P=0.682). For long-term management, 43% of cats with FA and 36% of cats with CB received inhaled corticosteroids (P=1), oral corticosteroids (FA 17%/CB 36%, P=0.220), and oral bronchodilators (FA 6%/CB 27%, P=0.084) as well as courses of antibiotics (FA 6%/CB 18%, P=0.238). Treatment-related side effects (polyuria/polydipsia, facial fungal infection, and diabetes mellitus) were reported in 4 cats with FA and 2 cats with CB. The majority of owners stated to be extremely or very satisfied with the response to treatment (FA 57%/CB 64%, P=1).

Conclusion Significant differences regarding management and response to therapy for both diseases could not be detected.

Clinical relevance Based on owner survey, chronic bronchial diseases as feline asthma and chronic bronchitis could be managed successfully with similar treatment.

Zusammenfassung

Gegenstand und Ziel Felines Asthma (FA) und chronische Bronchitis (CB) sind häufige entzündliche Erkrankungen der Atemwege der Katze. Obwohl beide Krankheitsbilder durch eine Infiltration mit unterschiedlichen Entzündungszelltypen gekennzeichnet sind, sind die therapeutischen Maßnahmen oft ähnlich. Über mögliche Unterschiede im therapeutischen Management dieser beiden Atemwegserkrankungen ist wenig bekannt. Ziel der Studie war es daher, bei Katzen mit FA und CB die Erst- und Langzeitbehandlung, Therapieerfolg, Nebenwirkungen und Besitzerzufriedenheit zu vergleichen.

Material und Methoden 35 Katzen mit FA und 11 Katzen mit CB wurden in die retrospektive Querschnittstudie eingeschlossen. Einschlusskriterien waren kompatible klinische und radiologische Befunde sowie der zytologische Nachweis einer eosinophilen Entzündung (FA) oder einer sterilen neutrophilen Entzündung (CB) in der bronchoalveolären Lavage-Flüssigkeit (BALF). Katzen mit CB wurden ausgeschlossen, wenn Hinweise auf pathologische Bakterien vorlagen. Besitzer wurden gebeten einen standardisierten Fragebogen zum therapeutischen Management und Ansprechen auf die Behandlung auszufüllen.

Ergebnisse Im Gruppenvergleich wurden keine statistisch signifikanten Unterschiede der Therapie festgestellt. Die meisten Katzen wurden anfänglich mit Kortikosteroiden mittels einer oralen (FA 63%/CB 64%, p=1), inhalativen (FA 34%/CB 55%, p=0,296) oder injizierbaren Applikationsform (FA 20%/CB 0%, p=0,171) behandelt. Zusätzlich wurden in einigen Fällen orale Bronchodilatatoren (FA 43%/CB 45%, p=1) und Antibiotika (FA 20%/CB 27%, p=0,682) verabreicht. In der Langzeittherapie erhielten 43% der Katzen mit FA und 36% der Katzen mit CB inhalative Kortikosteroide (p=1), orale Kortikosteroide (FA 17%/CB 36%, p=0,220) und orale Bronchodilatatoren (FA 6%/CB 27%, p=0,084) sowie phasenweise Antibiotika (FA 6%/CB 18%, p=0,238). Behandlungsbedingte Nebenwirkungen (Polyurie/Polydipsie, Pilzinfektion im Gesicht und Diabetes mellitus) wurden bei 4 Katzen mit FA und 2 Katzen mit CB registriert. Die Mehrheit der Besitzer gab an, mit dem Ansprechen auf die Behandlung äußerst oder sehr zufrieden zu sein (FA 57%/CB 64%, p=1).

Schlussfolgerung Signifikante Unterschiede hinsichtlich des Managements und des Therapieansprechens konnten bei beiden Erkrankungen laut Besitzerbefragung nicht festgestellt werden.

Klinische Relevanz Laut Besitzerumfrage können chronische Bronchialerkrankungen der Katze wie Asthma und chronische Bronchitis können mit einer ähnlichen Behandlungsstrategie erfolgreich therapiert werden.

Key words

Feline bronchial disease - respiratory distress - cough - corticosteroids - bronchodilator

Schlüsselwörter

Feline Bronchialerkrankungen - Atemnot - Husten - Kortikosteroide - Bronchodilatatoren

Publikationsverlauf

Eingereicht: 18. August 2022

Angenommen: 01. Februar 2023

Artikel online veröffentlicht:
25. Mai 2023

• References

• 1 Adamama-Moraitou KK, Patsikas MN, Koutinas AF.. Feline lower airway disease: a retrospective study of 22 naturally occurring cases from Greece. J Feline Med Surg 2004; 6: 227-233
• 2 Taylor S.. Feline lower airway disease: asthma and beyond. The Veterinary Nurse 2017; 8: 17-23
• 3 Dear JD, Vernau W, Johnson EG. et al. Clinicopathologic and radiographic features in 33 cats with aspiration and 26 cats with bronchopneumonia (2007-2017). J Vet Intern Med 2021; 35: 480-489
• 4 Lee EA, Johnson LR, Johnson EG. et al. Clinical features and radiographic findings in cats with eosinophilic, neutrophilic, and mixed airway inflammation (2011-2018). J Vet Intern Med 2020; 34: 1291-1299
• 5 Johnson LR, Bay JD.. Feline Bronchial Disease/Asthma. In: King LG, Hrsg. Textbook of Respiratory Disease in Dogs and Cats. 1. Aufl. St. Louis, Mosby: Saunders; 2004: 388-398
• 6 Foster S, Allan G, Martin P. et al. Twenty-five cases of feline bronchial disease (1995–2000). J Feline Med Surg 2004; 6: 181-188
• 7 Venema C, Patterson C, Venema CM.. Feline asthma: what's new and where might clinical practice be heading?. J Feline Med Surg 2010; 12: 681-692
• 8 Corcoran B, Foster D, Fuentes VL.. Feline asthma syndrome: a retrospective study of the clinical presentation in 29 cats. J Small Anim Pract 1995; 36: 481-488
• 9 Padrid P.. Feline asthma: diagnosis and treatment. Vet Clin North Am Small Anim Pract 2000; 30: 1279-1293
• 10 Reinero CR.. Advances in the understanding of pathogenesis, and diagnostics and therapeutics for feline allergic asthma. Vet J 2011; 190: 28-33
• 11 Tizard IR.. Veterinary Immunology – E-Book. In. 9th ed. St. Louis, Missouri: Elsevier Health Sciences; 2017: 339-341
• 12 Nafe LA, DeClue AE, Lee-Fowler TM. et al. Evaluation of biomarkers in bronchoalveolar lavage fluid for discrimination between asthma and chronic bronchitis in cats. Am J Vet Res 2010; 71: 583-591
• 13 Reinero C, DeClue A.. Feline tracheobronchial disease. In: Fuentes VL, Johnson L, Dennis S, Hrsg. BSAVA Manual of Canine and Feline Cardiorespiratory Medicine, BSAVA. 2. Aufl. Quedgeley: Wiley; 2010: 280-284
• 14 Chung-Hui L, Pei-Ying L, Huey-Dong W. et al. Association between indoor air pollution and respiratory disease in companion dogs and cats. J Vet Intern Med 2018; 32: 1259-1267
• 15 Grotheer M, Hirschberger J, Hartmann K. et al. Comparison of signalment, clinical, laboratory and radiographic parameters in cats with feline asthma and chronic bronchitis. J Feline Med Surg 2020; 22: 649-655
• 16 Mardell E.. Investigation and treatment of feline chronic bronchial disease. In Pract 2007; 29: 138-146
• 17 Vientós-Plotts AI, Ericsson AC, McAdams ZL. et al. Respiratory dysbiosis in cats with spontaneous allergic asthma. Front Vet Sci 2022; 9: 930385
• 18 Dye JA, McKiernan BC, Rozanski EA. et al. Bronchopulmonary disease in the cat: historical, physical, radiographic, clinicopathologic, and pulmonary functional evaluation of 24 affected and 15 healthy cats. J Vet Intern Med 1996; 10: 385-400
• 19 Paulin MV, Caney SM, Cosford KL.. Online survey to determine client perceptions of feline chronic lower airway disease management: response to therapy, side effects and challenges encountered. J Feline Med Surg. 0. 1098612X211070988
• 20 Reinero CR, Byerly JR, Berghaus RD. et al. Rush immunotherapy in an experimental model of feline allergic asthma. Vet Immunol Immunopathol 2006; 110: 141-153
• 21 Reinero CR, Decile KC, Byerly JR. et al. Effects of drug treatment on inflammation and hyperreactivity of airways and on immune variables in cats with experimentally induced asthma. Am J Vet Res 2005; 66: 1121-1127
• 22 Reinero CR, Lee-Fowler TM, Dodam JR. et al. Endotracheal nebulization of N-acetylcysteine increases airway resistance in cats with experimental asthma. J Feline Med Surg 2011; 13: 69-73
• 23 Schooley EK, McGee Turner JB, JiJi RD. et al. Effects of cyproheptadine and cetirizine on eosinophilic airway inflammation in cats with experimentally induced asthma. Am J Vet Res 2007; 68: 1265-1271
• 24 Cieslewicz G, Tomkinson A, Adler A. et al. The late, but not early, asthmatic response is dependent on IL-5 and correlates with eosinophil infiltration. The. Journal of clinical investigation 1999; 104: 301-308
• 25 Leemans J, Kirschvink N, Bernaerts F. et al. Salmeterol or doxycycline do not inhibit acute bronchospasm and airway inflammation in cats with experimentally-induced asthma. Vet J 2012; 192: 49-56
• 26 Baral RM.. Lower Respiratory Tract Disease. In: Little S, Hrsg. The Cat-E-Book: Clinical Medicine and Management. 2. Aufl. St. Louis, Missouri: Elsevier Health Sciences; 2011
• 27 Reinero CR, Brownlee L, Decile KC. et al. Inhaled flunisolide suppresses the hypothalamic-pituitary-adrenocortical axis, but has minimal systemic immune effects in healthy cats. J Vet Intern Med 2006; 20: 57-64
• 28 Trzil JE.. Feline Asthma: Diagnostic and Treatment Update. Veterinary Clinics: Small Animal Practice 2020; 50: 375-391
• 29 Mortensen J, Groth S, Lange P. et al. Effect of terbutaline on mucociliary clearance in asthmatic and healthy subjects after inhalation from a pressurised inhaler and a dry powder inhaler. Thorax 1991; 46: 817-823
• 30 Leemans J, Kirschvink N, Bernaerts F. et al. A pilot study comparing the antispasmodic effects of inhaled salmeterol, salbutamol and ipratropium bromide using different aerosol devices on muscarinic bronchoconstriction in healthy cats. Vet J 2009; 180: 236-245
• 31 Leemans J, Kirschvink N, Clercx C. et al. Effect of short-term oral and inhaled corticosteroids on airway inflammation and responsiveness in a feline acute asthma model. Vet J 2012; 192: 41-48
• 32 Allerton FJW, Leemans J, Tual C. et al. Correlation of bronchoalveolar eosinophilic percentage with airway responsiveness in cats with chronic bronchial disease. J Small Anim Pract 2013; 54: 258-264
• 33 Padrid P, Feldman B, Funk K. et al. Cytologic, microbiologic, and biochemical analysis of bronchoalveolar lavage fluid obtained from 24 healthy cats. Am J Vet Res 1991; 52: 1300-1307
• 34 Schulz BS, Richter P, Weber K. et al. Detection of feline Mycoplasma species in cats with feline asthma and chronic bronchitis. J Feline Med Surg 2014; 16: 943-949
• 35 Buscho RO, Saxtan D, Shultz PS. et al. Infections with viruses and Mycoplasma pneumoniae during exacerbations of chronic bronchitis. J Infect Dis 1978; 137: 377-383
• 36 Cherry JD, Taylor-Robinson D, Willers H. et al. A search for mycoplasma infections in patients with chronic bronchitis. Thorax 1971; 26: 62-67
• 37 Hong S-J.. The Role of Mycoplasma pneumoniae Infection in Asthma. Allergy Asthma Immunol Res 2012; 4: 59-61
• 38 Nisar N, Guleria R, Kumar S. et al. Mycoplasma pneumoniae and its role in asthma. Postgrad Med J 2007; 83: 100-104
• 39 Lee-Fowler T.. Feline respiratory disease: What is the role of Mycoplasma species?. J Feline Med Surg 2014; 16: 563-571
• 40 Foster SF, Martin P.. Lower respiratory tract infections in cats: Reaching beyond empirical therapy. J Feline Med Surg 2011; 13: 313-332
• 41 Cocayne CG, Reinero CR, DeClue AE.. Subclinical airway inflammation despite high-dose oral corticosteroid therapy in cats with lower airway disease. J Feline Med Surg 2011; 13: 558-563
• 42 Adams SG, Anzueto A.. Antibiotic therapy in acute exacerbations of chronic bronchitis. Semin Respir Infect 2000; 15: 234-247
• 43 Stefan MS, Shieh M-S, Spitzer KA. et al. Association of Antibiotic Treatment With Outcomes in Patients Hospitalized for an Asthma Exacerbation Treated With Systemic Corticosteroids. JAMA Internal Medicine 2019; 179: 333-339
• 44 Kurai D, Saraya T, Ishii H. et al. Virus-induced exacerbations in asthma and COPD. Front Microbiol 2013; 4: 293
• 45 Padrid P.. Use of Inhaled Medications to Treat Respiratory Diseases in Dogs and Cats. J Am Anim Hosp Assoc 2006; 42: 165-169
• 46 Kettner F.. Feline Asthma. In Chronic Disease Management for Small Animals 2017; 285
• 47 Galler A, Shibly S, Bilek A. et al. Inhaled budesonide therapy in cats with naturally occurring chronic bronchial disease (feline asthma and chronic bronchitis). J Small Anim Pract 2013; 54: 531-536
• 48 Byers CG.. Feline bronchial asthma: treatment options for the emergency patient. In. 2003
• 49 Ellepola A, Samaranayake L.. Inhalational and topical steroids, and oral candidosis: a mini review. Oral Dis 2001; 7: 211-216
• 50 Trzil JE, Reinero CR.. Update on feline asthma. Vet Clin North Am Small Anim Pract 2014; 44: 91-105
• 51 Ettinger S.. Diseases of the trachea and upper airways. In: Ettinger SJ, Feldman EC, Hrsg. Textbook of Veterinary Internal Medicine: Diseases of the Dog and the Cat. 7. Aufl. Philadelphia: Elsevier Saunders; 2010: 1067-1072