Cat Won't Stop Coughing, 3 Vets Stumped

[Onomoniapoea]

My cat is 14-years-old. He's had a cough for a year. It used to sound a bit like a hairball. Since the winter, it's been more wet sounding. His regular vet, a radiologist, and an internal specialist can't figure out why he keeps coughing.

Timeline:

• A year ago, I took him to the vet. The vet stressed that I give him very small amounts of the steroid pills due to his kidneys. The cough persisted.
• In January, I took him back with a video of his cough. The vet felt a little more confident that it might be asthma. But he didn't prescribe any changes other than adding a humidifier.
• In late June, his cough suddenly worsened. On the other hand, he's now extra hungry and much more active than he was before. He continues to slowly lose weight despite his ravenous appetite.

What tests show:

• His thyroid and kidneys are stable.
• Urine is a little concentrated.
• ProBNP test was 6x higher than normal.

What the vets say:
The vet was concerned that he was working towards heart failure with his ProBNP numbers. A radiologist disagreed that his heart was of concern. Instead, they suggested the x-ray of his lung showed a solid spot. When I took my cat for an ultrasound, they looked at the x-ray (3rd review) and said the heart wasn't of concern. They declined to do the ultrasound. Instead, they suggested testing for asthma ($1400) and an echocardiogram ($$$$). They think he has asthma or just some inflammation of his lungs which won't go away.

I'm overwhelmed. These tests are adding up. I just want him to feel better. When he gets a cold, it hits him hard and he'll squeak when he breathes. I feel like at this point, the vet and specialists are just throwing darts at the wall. My latest guess is that he's developed an allergy, but I can't uncover anything that changed in his environment at the beginning of the cough. I'd put him in a hotel room for a week if that wasn't very expensive here.

Things to know:

• He has mild chronic kidney disease -- been stable for 3 years w/little change
• He was treated for hypothyroidism -- vet says he still looks good

 

[Draco]

Take a look around the home.. is there anything possibly triggering his cough? it doesn't have to be since the start of the coughing, it could be long before and it just began to irritate him at that point.

Any smokers in the house? How about spray products (Cleaners, air fresheners, so on)? Candles? Another pet? think what could irritate you if you were sensitive.

He could be having irritation from dust in the air too.. Try an air purifier in the rooms, maybe that will help.

 

[Onomoniapoea]

Thank you! He spent the first half of his life living in a smoker's house, but nothing since. I burn candles once every few months, but stopped. We don't use air fresheners. His "sibling" also lives in the house. They've spent their entire lives together. Both are indoor.

 

[JMJimmy]

I think this is a case of information overload. The sole symptom you've described is wet coughing. Evidence of what might cause it is two things, the proBNP test or the solid spot in the lung. The first one which could indicate heart issues would be accompanied by other symptoms, also you need to be careful with the proBNP test values as they are tested differently at different labs so the "normal" value will change depending on the lab. The solid spot in the lung could indicate a non-cancerous mass starting to form or it could simply be a mucus plug forming around a foreign object in the lung. There are other rarer things but this would be my thought. The former would be $$$$$ to deal with, the latter may resolve on its own or may persist and may or may not have consequences depending on how much of the lung is affected.

I'd have to see the x-ray to say more (could you post it?) but from my limited knowledge that's what immediately comes to mind

 

[foxxycat]

if it's asthma all that's needed are xrays

 

[foxxycat]

fritzthebrave.com is a good site about asthma and with video to show what it looks like.

my girl used to cough and now we got xrays and started inhaled steroids. it's been 3-4? years since she's been puffing on her Aerokat with flovent 220/250 mcg strength 2 puffs in the morning and 2 more in the evening. once in awhile use albuterol as a rescue inhaler.

your vet is picking your pockets. find one who is experienced in asthma. they can do a long term shot for pred that lasts a month-the thing is if the coughing stops after administration of the shot in 24-48 hours then most likely it COULD be asthma. then get an aerokat and learn to teach cat to allow mask to touch face.

It's information overload and I can guide you to how=but for now-get simple chest xrays.

asthma looks like tramlines or donuts on the xray. the donuts are inflammation and traps air=which is why they cough.

let me know what the xrays show!

 

[foxxycat]

also ultrasound of heart to rule out cardiac issues=cats don't usually cough when cardiac issues start-but I would do the ultrasound before administer the long term pred injection.

in the meantime ask about albuterol and get an aerokat chamber...this would be given at coughing fits=it last 6 to 8 hours-its only a bronchodialator not for inflammation-the inhaled steroids-flovent-would help reduce the swelling=which should reduce coughing and allow breathing to be easier.

when your cat is sleeping=count how many breathes-it should be 20 to 30. my girl was 45 breathes a minute before we started treatment of inhaled flovent. it only took a week to see changes in breathing. we also give albuterol if she coughs/wheezes.

 

[PushPurrCatPaws]

Has your cat been tested specifically for lungworm and/ or heartworm?
These can be causes for coughing in cats.

Heart worm- worm infection of the arteries, heart, lungs.
Lungworm- worm infection of the lungs.
Lungworms in Cats | petMD

Heartworms, spread by mosquitoes, are less likely to reach adulthood in cats (dogs are more susceptible to having heartworms reach adulthood inside their bodies than cats), but I think cats' bodies react to the worm larvae by putting forth increased inflammation, which can also cause coughing, etc.

My vet had my own cat tested specifically for lungworm when we were trying to diagnose her allergies/ asthma/coughing, in order to rule it out. The test for lungworm is called the Baermann Test.

 

[abyeb]

All my fellow posters have made excellent points. My question may now seem painfully simple, but it is something I'd like to ask about, just to check. Does your kitty wear a collar? Sometimes, a collar that is too tight will press on the trachea, eventually causing damage, triggering coughing.

 

[Onomoniapoea]

Thank you. I don't have a copy of the x-ray.

My vet and the two specialists are just stumped as to what is causing the cough. Each cough is about a minute in-length and he does it sporadically, when he jumps off a chair, or when he's startled. So that's about...20 times a day that I'm aware of. He looks miserable, but doesn't appear to be in pain.

 

[Onomoniapoea]

Thank you! It's a good point. He hasn't worn a collar in years. He fully rejected it. Thankfully, he's terrified of outdoors and won't make a beeline to the door. :-)

 

[Onomoniapoea]

This is awesome. Thank you! We counted his chilling-and-relaxing-but-not-asleep breaths last night. He was at 25/minute.

His coughs look very much like asthma. I've thought that for a year, but the vet didn't think it was likely. I'll press them on that point and see if they'll hand over the x-rays. They cautioned me about treating him for asthma because of some bad reaction with the kidneys and asthma medications.

 

[PushPurrCatPaws]

Thank you. I don't have a copy of the x-ray.

My vet and the two specialists are just stumped as to what is causing the cough. Each cough is about a minute in-length and he does it sporadically, when he jumps off a chair, or when he's startled. So that's about...20 times a day that I'm aware of. He looks miserable, but doesn't appear to be in pain.

That is a LOT of coughing, and each episode a long time to cough. If he's been doing that kind of coughing for 6 mos-1 year, that can really take its toll on the respiratory system. Even cause its own "catch-22" inflammation, leading to more coughing.

My cat is 14-years-old. He's had a cough for a year. ...

They declined to do the ultrasound. Instead, they suggested testing for asthma ($1400) and an echocardiogram ($$$$). They think he has asthma or just some inflammation of his lungs which won't go away.

I'm overwhelmed. These tests are adding up. I just want him to feel better. ...

Things to know:

• He has mild chronic kidney disease -- been stable for 3 years w/little change
• He was treated for hypothyroidism -- vet says he still looks good

The goal is to get the coughing under control as soon as you can, and if they think it's likely asthma, or lung inflammation (both), maybe they and you could just forgo the testing because of his age and his severe coughing bouts, and just try to get him on Flovent using an Aerokat (since they don't feel his kidneys can handle a larger dose of oral or injectible steroids)??

 

[Onomoniapoea]

I appreciate your advice. Thank you. My new plan of action:

* Get the x-rays
* Take him + x-rays to another place which specializes in just cats

Hopefully they'll be able to figure it out. The bronchoscopy just sounds so invasive for his age.

 

[foxxycat]

I would get a script for albuterol and get the aerokat-you don't want to have him have a coughing fit and run out of breathe. Very important!! he probably won't cough as much if you give albuterol per vets doses-
for honeybee it's once every 8 hours-be warned-it SMELLS horrible to them-so hold tight to kitty=the cat only needs to breathe one or two breathes of albuterol vS 10 breathes for Flovent.

The vet that said meds hard on kidneys only has half the information-they were talking about pred. But in this case that vet is WRONG. The goal is breathing-that's most important-if the cat can't breathe then nothing else matters.
The lung worm test is also necessary=the treatment is out of my realm of knowledge but an ultrasound COULD show the worm in the heart/lungs...so press for Xrays and ask to see them-look at the lungs-you should see all black in the lungs=that's air- any grey/white areas are non air areas. You will see the trachea and other branches of lungs on there-that's normal. It's the round donuts at the end of the branches you will need to look for. Also listening to him breathing-do you hear wheezing/popping? Put your ear right over his lungs or use a stethoscope.

In my unofficial medical knowledge the vet is wrong and the cat should be started on pred before too much time passes OR inhaled steroids. But the albuterol will slow down the coughing-you can't use this long term because it doesn't fix the inflammation=it only opens the airways but the inflammation will still be there. Sorry your vet is being a poopoo head.

 

[csts]

I saw that nobody has mentioned this yet, but it could be possible that your cat has a fungal infection like cryptococcus. There are certain regions of the world where the cryptococcus fungus is more common and it's mainly contracted by the cats inhaling the spores. My parents' cat Fry has a crypto infection which started out as him coughing and the veterinarian initially thought he had an URI (Upper Respiratory Infection) or asthma, but the coughing went away after a few months. We only found out that he had the fungal infection when one of his claws on his back foot suddenly fell off one day and the toe became massively swollen. The vet didn't find the crypto when we first took him in for the coughing because it doesn't show up on any other tests and they have to order a very specific test for it, as well as that he had no other symptoms (the symptoms also tend to be the same as other conditions like asthma) and they hadn't seen a whole lot of cases of it until recently. I think it's worth asking if the vets can test your cat for cryptococcus.

Here's the article from PetMD about cryptococcosis in cats for more information, in a way better than I could ever describe it: Fungal Infection (Yeast) in Cats | petMD

Edit: Thought I'd mention that I'm in San Diego, and it turns out that crypto is very common in Southern California.

 

[foxxycat]

that's a good idea...my gf in next state over had a cat who came down with a stubborn fungal infection. Not uncommon to see these types of infections-I don't remember how they found this out-I think they did a scoping of nasal passages and pulled material out and sent out for testing.

 

[PushPurrCatPaws]

I saw that nobody has mentioned this yet, but it could be possible that your cat has a fungal infection like cryptococcus. There are certain regions of the world where the cryptococcus fungus is more common and it's mainly contracted by the cats inhaling the spores. My parents' cat Fry has a crypto infection which started out as him coughing and the veterinarian initially thought he had an URI (Upper Respiratory Infection) or asthma, but the coughing went away after a few months. ...

Here's the article from PetMD about cryptococcosis in cats for more information, in a way better than I could ever describe it: Fungal Infection (Yeast) in Cats | petMD

Edit: Thought I'd mention that I'm in San Diego, and it turns out that crypto is very common in Southern California.

That's a good point, csts , and good to see you around again!
How are your kitties doing?

 

[kashmir64]

I'm not sure where you live. But if you live in the SW United States, have they tested for Valley Fever?

 

[MoonRockyMistyMuffin]

You should get him tested for Lungworm and Heartworm, which can both cause coughing, and it could be asthma or URI. Let me know what happens when you get the x-rays!