How to Handle Respiratory Distress in Cats

Liz Rozanski, DVM, associate professor of emergency and critical care at the Cummings School of Veterinary Medicine at Tufts University, talks about respiratory distress in cats and how to handle these tough cases.

"Why is respiratory distress in cats scary? Well, the biggest thing is cats are really good at hiding their disease. So owners might notice that the cat is not eating or is hiding a little bit more, and by the time they get to the veterinarian they're breathing really hard, or they might notice them breathing really hard at home, but that's much harder than it is for dogs. And the challenge with the cat is that cats tend to be very fragile. So you can't kind of hold them down and do an x-ray, it's hard to get blood work from them, you can stress them very easily—and a stressed cat could be a dead cat. So veterinarians are scared of that; they don't want to hurt the patient by trying to help them. And so we get really nervous when we see a cat that has respiratory distress.

What do we do for them? We will put them in some supplemental oxygen, and all practices will have a little oxygen, make it a little bit easier for them to breathe, let them calm down a little bit, do an exam. But in contrast to a healthy animal, will do an exam more in piecemeal. We might not look deeply in the ears, we might not check the toenails. We're gonna really look at and focus on the cardiopulmonary system, listen to them, talk to the family and see if they heard something before. Sometimes the vet has heard a heart murmur. You've heard a heart murmur, your colleagues has heard a heart murmur, but maybe it was gone and now it's back, so could it be heart disease?

Sometimes we'll see cats that have been what people perceive to be technically vomited up, they come from the stomach and sometimes people don't find hairballs, but they just think it's that. And that's actually airway disease. So talk to the people a little bit. Do they live in a risky situation? And sometimes a risky situation is living in a family with 3 boys and 2 Labradors; that might be risky for the cat. Or maybe he goes outside and is somewhere he could get injured when he is outside. So is there anything in his history that could have helped? And then in our exam, do you think it could be his upper airway? Could he have a tumor or growth in his throat? Could he have an infection in his nose or upper airways? Could have airway disease, so like the feline asthma? Could he have heart disease, or less commonly, cats rarely get pneumonia, but sometimes they can. Could they have pleural effusion or infection of their chest?

So as a veterinarian you're kind of scared of looking at these cats, but you know you have to do something for them. And so what do we do? Look at them slowly ,try to form an opinion. What do I think, is happening? When we have access to ultrasound In our practice, using that to look for fluid or look for evidence of an enlarged left atrium at the heart can be really helpful. If you don't have that, an X-ray can be really helpful to point you to what test you should be treating. How can I help this cat? I think the key thing for respiratory distress in cats is sometimes people worry that all cats do badly with it and a lot of cats are treated and go on and live for years and years after having a bout it, so it's not necessarily a death sentence it's something we just need to get to the bottom of what's happening."