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Newsman
November 10th 05, 01:17 AM
Hi. My cat has asthma that's getting worse. I just ordered an AeroKat
inhaler. Now I need to buy the medications. Here are the particulars for
those in the know:

Albuterol: 90ucg/puff; quantity: 6.7g #1
Flovent: 220 ucg/puff; quantity: 7.9g #1

As sources for these medications, my vet suggested Drs. Foster & Smith
(they're calling me back with a quote tomorrow), Vetcentric (my vet will
obtain the quote for me), and PetCareRx (they don't carry these
medications).

I'd appreciate it if someone can direct me to other good, but relatively
inexpensive, online source for these medications. I just got a quote of
$311 for 120 doses of Flovent! And I'm supposed to give it to my cat
twice a day. That's over $1800/year. Excuse me, but that's a lot of
money! So any help would be most appreciated.

Thanks.

No More Retail
November 10th 05, 01:57 AM
are you sure about the ucg? I did a web search and looked them up under
wholesale. I use www.webferet.com for searches it has an exact phrase
search
Flovent it comes in 25 mcg 50mcg 125mcg 250mcg and
albuterol comes in 100 mcg
let me ask a question is the inhaler for the cat just like one for a
human I think it so myself and the gentleman name Phil P. His website
recommends using this http://www.aerokat.com/ to deliver the dose with ease
to a cat

If these doses sizes are not right I will keep checking around
below are links to order from Canada
alberterol prices are between 10 and 20 for 100 mcg 200 doses
and flovent is about 80 for 220 doses of 250 mcg

http://www.buylowdrugs.com/prices.php
http://www.getcanadiandrugs.com/index.php
http://www.canadapharmacy.com/cart/index.cfm?fuseaction=product_detail&producturlname=Flovent.inhaler.Fluticasone&productid=1530&campaignid=469&ovchn=GGL&ovcpn=google&ovcrn=flovent&ovtac=PPC

Newsman
November 10th 05, 02:59 AM
No More Retail wrote:
> are you sure about the ucg?

I heard the person say ucg. Maybe I mis-heard her. I guess I did. I just
got off the phone with a doctor friend. He said it's \mu cg
(micrograms), not ucg.

I did a web search and looked them up under
> wholesale. I use www.webferet.com for searches it has an exact phrase
> search
> Flovent it comes in 25 mcg 50mcg 125mcg 250mcg and
> albuterol comes in 100 mcg

Also, my doctor friend told me that there is no reason that Al (my cat)
has to take Flovent. He said there are alternatives such as
Beclomethisone, Triamcinelone, and Fluticasone. Like Flovent, all of
these other drugs are steroids. That will pose some problem for
management of Al's diabetes, but shouldn't be too bad since the steroid
is in the form of an aerosol. At least that's my understanding. The
bottom line is that I'm not spending $1900/year on one drug. I'm already
spending a lot of money on Al. The Flovent is definitely over the top.
Sometimes these vets write prescriptions as if we have wallets with
endless supplies of money. I don't know about you, but that's not the
case for me. And I do have other expenses. Sorry to vent, but I'm quite
frustrated.

> let me ask a question is the inhaler for the cat just like one for a
> human I think it so myself and the gentleman name Phil P. His website
> recommends using this http://www.aerokat.com/ to deliver the dose with ease
> to a cat

I purchased an AeroKat inhaler today.

>
> If these doses sizes are not right I will keep checking around
> below are links to order from Canada
> alberterol prices are between 10 and 20 for 100 mcg 200 doses
> and flovent is about 80 for 220 doses of 250 mcg
>
> http://www.buylowdrugs.com/prices.php
> http://www.getcanadiandrugs.com/index.php
> http://www.canadapharmacy.com/cart/index.cfm?fuseaction=product_detail&prod
ucturlname=Flovent.inhaler.Fluticasone&productid=1530&campaignid=469&ovchn=GGL&ovcpn=google&ovcrn=flovent&ovtac=PPC

Thanks for the alternative sources. I'll check them out for Flovent as
well as for the other drugs mentioned by my friend.

-L.
November 10th 05, 07:45 AM
Newsman wrote:
> No More Retail wrote:
> > are you sure about the ucg?
>
> I heard the person say ucg. Maybe I mis-heard her. I guess I did. I just
> got off the phone with a doctor friend. He said it's \mu cg
> (micrograms), not ucg.

The confusion stems from the fact that the greek symbol for micro is
sometimes typed as a "u". It is actually a lower-case mu symbol (a "u"
with a long front tail). The person on the phone simply didn't
understand the symbol, or it was typed as a "u".

One thing to keep in mind about abuterol and Flovent is that there are
two types of solvents used as carriers - CFC and HFA. It has been my
experience (and that of many asthmatics) that the HFA is the less
irritating formulation of the two, if you are buying them in the
"propellant system" formulation (not liquid). You might want to check
with your vet to make sure the HFA formulation is ok to use, if that's
the case.

HTH,
-L.

Phil P.
November 10th 05, 11:19 AM
"Newsman" > wrote in message
news:[email protected]
> Hi. My cat has asthma that's getting worse. I just ordered an AeroKat
> inhaler.


Remember, the AeroKat doesn't have a one-way valve between the chamber and
mouthpiece like the AeroChamber and OptiChamber. So, if the cat moves or
struggles and breaks the seal between the mask and her face before she
inhales the medication will be lost. The AeroChamber and OptiChamber have a
one-way valve that holds the medication in the chamber until the cat
inhales. That means you can actuate the inhaler away from the cat's face
and then place the mask on her face. If she struggles or moves the
medication won't be lost.

http://www.maxshouse.com/inhalation_therapy_for_airway_disease.htm

http://www.maxshouse.com/feline_asthma_and_bronchitis.htm


Now I need to buy the medications. Here are the particulars for
> those in the know:
>
> Albuterol: 90ucg/puff; quantity: 6.7g #1
> Flovent: 220 ucg/puff; quantity: 7.9g #1


Are you sure about those quantities? They sound like (free) physician sample
sizes. Flovent 220 mcg/120 dose inhaler only comes in 13 g sizes for $156,
and albuterol 90 mcg/200 dose inhaler comes in 17 g sizes.


>
> As sources for these medications, my vet suggested Drs. Foster & Smith
> (they're calling me back with a quote tomorrow), Vetcentric (my vet will
> obtain the quote for me), and PetCareRx (they don't carry these
> medications).
>
> I'd appreciate it if someone can direct me to other good, but relatively
> inexpensive, online source for these medications. I just got a quote of
> $311 for 120 doses of Flovent!


That's ridiculous! I buy Flovent 220 mcg/120 doses for $156 and Albuterol
90 mcg/200 doses for $20 at CVS. Just get a script from your vet and fill
it at CVS or Eckhart's Pharmacy.

Phil

Phil P.
November 10th 05, 11:23 AM
"Newsman" > wrote in message
news:[email protected]
>
> Also, my doctor friend told me that there is no reason that Al (my cat)
> has to take Flovent. He said there are alternatives such as
> Beclomethisone, Triamcinelone, and Fluticasone.

(Fluticasone is Flovent)

Like Flovent, all of
> these other drugs are steroids. That will pose some problem for
> management of Al's diabetes, but shouldn't be too bad since the steroid
> is in the form of an aerosol.

No, no, no. Flovent is the *best* steroid for use in diabetic cats because
its more efficacious and only
0.17% of the drug is absorbed systemically. Beclomethisone and
Triamcinelone are much older drugs and absorbed systemically to a much
higher degree. I've use Flovent (fluticasone propionate) in diabetic cats
with absolutely no adverse effects on their diabetes.



At least that's my understanding. The
> bottom line is that I'm not spending $1900/year on one drug. I'm already
> spending a lot of money on Al. The Flovent is definitely over the top.
> Sometimes these vets write prescriptions as if we have wallets with
> endless supplies of money. I don't know about you, but that's not the
> case for me. And I do have other expenses. Sorry to vent, but I'm quite
> frustrated.

Which state do you live in? I may know a source for Flovent at a
significantly lower price.

Phil

Newsman
November 10th 05, 12:07 PM
Phil P. wrote:
> "Newsman" > wrote in message
> news:[email protected]
>
>>Hi. My cat has asthma that's getting worse. I just ordered an AeroKat
>>inhaler.
>
>
>
> Remember, the AeroKat doesn't have a one-way valve between the chamber and
> mouthpiece like the AeroChamber and OptiChamber. So, if the cat moves or
> struggles and breaks the seal between the mask and her face before she
> inhales the medication will be lost. The AeroChamber and OptiChamber have a
> one-way valve that holds the medication in the chamber until the cat
> inhales. That means you can actuate the inhaler away from the cat's face
> and then place the mask on her face. If she struggles or moves the
> medication won't be lost.
>
> http://www.maxshouse.com/inhalation_therapy_for_airway_disease.htm
>
> http://www.maxshouse.com/feline_asthma_and_bronchitis.htm
>
>
> Now I need to buy the medications. Here are the particulars for
>
>>those in the know:
>>
>>Albuterol: 90ucg/puff; quantity: 6.7g #1
>>Flovent: 220 ucg/puff; quantity: 7.9g #1
>
>
>
> Are you sure about those quantities? They sound like (free) physician sample
> sizes. Flovent 220 mcg/120 dose inhaler only comes in 13 g sizes for $156,
> and albuterol 90 mcg/200 dose inhaler comes in 17 g sizes.
>
>
>
>>As sources for these medications, my vet suggested Drs. Foster & Smith
>>(they're calling me back with a quote tomorrow), Vetcentric (my vet will
>>obtain the quote for me), and PetCareRx (they don't carry these
>>medications).
>>
>>I'd appreciate it if someone can direct me to other good, but relatively
>>inexpensive, online source for these medications. I just got a quote of
>>$311 for 120 doses of Flovent!
>
>
>
> That's ridiculous! I buy Flovent 220 mcg/120 doses for $156 and Albuterol
> 90 mcg/200 doses for $20 at CVS. Just get a script from your vet and fill
> it at CVS or Eckhart's Pharmacy.
>
> Phil
>
>
>
Phil,

Thanks so much for your help! The quote of $311 came from a pets-only
pharmacy in Maryland. I live in DC. So if you know of a place that has
Flovent for even less than $156, I'd appreciate knowing about it. And
I'm very irritated with my vet for not even mentioning the other two
inhalers that you mentioned. As I stated, I already ordered the AeroKat.
I'm going to call them today to see if I can cancel and/or return the
unit. I want to look into getting the one of the other two inhalers you
mentioned.

cybercat
November 10th 05, 03:25 PM
"Phil P." > wrote in message
...
>
> "Newsman" > wrote in message
> news:[email protected]
> > Hi. My cat has asthma that's getting worse. I just ordered an AeroKat
> > inhaler.
>
>
> Remember, the AeroKat doesn't have a one-way valve between the chamber and
> mouthpiece like the AeroChamber and OptiChamber. So, if the cat moves or
> struggles and breaks the seal between the mask and her face before she
> inhales the medication will be lost. The AeroChamber and OptiChamber have
a
> one-way valve that holds the medication in the chamber until the cat
> inhales. That means you can actuate the inhaler away from the cat's face
> and then place the mask on her face. If she struggles or moves the
> medication won't be lost.
>
> http://www.maxshouse.com/inhalation_therapy_for_airway_disease.htm
>
> http://www.maxshouse.com/feline_asthma_and_bronchitis.htm
>

Really good to know, Phil.

Phil P.
November 10th 05, 04:07 PM
"Newsman" > wrote in message
news:[email protected]

> Thanks so much for your help! The quote of $311 came from a pets-only
> pharmacy in Maryland. I live in DC.

Was that price for one inhaler? If it is, its beyond a rip-off and closer
to consumer fraud.


So if you know of a place that has
> Flovent for even less than $156, I'd appreciate knowing about it.


I think I do, but you would probably have to buy a six-month supply (6
inhalers) and your vet would have to write the script for that amount. IOW,
"Flovent, 78 g #6" (6 x 13 g). When I bought quantity, I think I paid
about $125-7- somewhere around there. I'm absolutely sure it wasn't more
than $127 ea. I'll get the details and email you if your email addy is
working.



And
> I'm very irritated with my vet for not even mentioning the other two
> inhalers that you mentioned.


Its possible that he doesn't know about them because they're human
areochambers. Also, some vets think cats can't produce enough inhalation
force to activate the one-way valve, but this is not true. I've used the
AeroChamber on several asthmatic cats with no problems whatsoever. Since
the cat's face is covered, his natural instinct is to gasp for air- which
produces more than enough force. Remember, the valve is extremely sensitive
because during an asthmatic attack, an infant can't produce much inhalation
force. The same AeroChamber is used on human infants and adults- the *only*
difference is the size of the face mask and color trim.

If you look at this picture of using an AeroKat, you'll see that you need
one hand to hold the AeroKat against the cat's face and the other hand to
hold the back of the cat's neck. How do you activate the metered dose
inhaler if you don't have another person (or hand)? You can't activate the
MDI before you place the AeroKat against the cat's face because the
medication will escape through the mask.

http://www.maxshouse.com/Illustrations/Aero+Cat.jpg


The only it will work is if you hold the AeroKat by the MDI with your middle
finger on the MDI and wrap your thumb and forefinger around the AreoKat.
Like so:

http://www.maxshouse.com/Illustrations/AreoChamber_Grip.jpg

The MDI is then activated by your middle finger and your other hand can hold
the back of the cat's neck against the facemask. This is actually how I hold
the Aerochamber while I'm medicating a cat.

With the AeroChamber, you can activate the MDI into the chamber away from
the cat's face and then use one hand to hold the AeroChamber against the
cat's face and the other hand to hold the back of the cat's neck. Its a 3
second procedure. Even if the cats moves and struggles a little, the
medication will remain in the chamber until the cat inhales. The seal
between the MDI and AeroChamber is very tight- but if you wait too long,
some medication can escape- the AeroKat has the same seal.


As I stated, I already ordered the AeroKat.
> I'm going to call them today to see if I can cancel and/or return the
> unit. I want to look into getting the one of the other two inhalers you
> mentioned.


Since you've already ordered it, try it. I've known people that haven't had
problems using AeroKats on their cats- but that might be because they had
another person to hold the cat or AeroKat and activate the MDI or they use a
technique similar to mine- which is not according to the instructions.
Otherwise, one person can't do it.

If you decide to get an AeroChamber, make sure you get the *infant* model-
it comes with an infant mask already attached. The adult AeroChamber
doesn't come with a face mask- its sold separately.

You can tell when the canister is empty or almost empty by putting it in a
glass of water. If it floats horizontally, its empty. Otherwise the bottom
of the canister will sink and it will float straight up in the water.


This is about the best site on feline asthma http://www.fritzthebrave.com/
http://www.fritzthebrave.com/meds/inhaled.html --- -- even better than mine!



Phil

Lumpy
November 10th 05, 04:11 PM
"Newsman" > wrote > Phil,
>
> Thanks so much for your help! The quote of $311 came from a pets-only
> pharmacy in Maryland. I live in DC. So if you know of a place that has
> Flovent for even less than $156, I'd appreciate knowing about it. And
> I'm very irritated with my vet for not even mentioning the other two
> inhalers that you mentioned. As I stated, I already ordered the AeroKat.
> I'm going to call them today to see if I can cancel and/or return the
> unit. I want to look into getting the one of the other two inhalers you
> mentioned.

This kind of thing happens time and again and is one reason why
Phil, for all his crankiness [>:)] contributes more to this group than
anyone with regard to medical issues. Now when my vet tells me
something I ask Phil before I make any decisions. He's really good
about keeping up with the latest information, not to mention
generous about taking the time to share the information his
love of cats has moved him to seek out and absorb. Way to
go, Phil.

No More Retail
November 10th 05, 05:51 PM
Heck Phil I added your website to our link preferred sites; ps you need a
search engine on it.
Which on is better to use for the inhalers

-L.
November 10th 05, 06:37 PM
Lumpy wrote:
>
> This kind of thing happens time and again and is one reason why
> Phil, for all his crankiness [>:)] contributes more to this group than
> anyone with regard to medical issues.

He's also the only one who has never given you any **** for being an
asshole.

BTW, do you always slurp him twice when he makes a post, cybercat, er,
I mean, Lumpy? Or is it Mary today? or Topaz?

-L.

opalmirror
November 10th 05, 09:47 PM
Hi all... a little commentary.

We find prices routinely in the 100-125 USD for the Flovent (aka
fluticasone) that Fritz receives (120 metered doses, 220ug). Note that
the 220ug is the US labeling which requires measuring the dose at the
plastic boot, in other countries the same exact product is labeled
250ug which is the dose delivered to the plastic boot - 30ug is either
deposited in the interior or escapes around the boot.

Optichamber and AeroChamber were on the market first. Cat owners and
veterinarians (even Dr. Philip Padrid) routinely modified them or to
improve the dose delivery efficiency by a number of means, including:
replacing the mask with a more cat-friendly one, by cutting out the
valving, by adding tape around the mask/chamber connection where losses
occurred.

Aerokat overcame all these deficiencies. It was designed for cats, not
humans. All three products (Optichamber, aerochamber, aerokat) were
evaluated by the Aerokat manufacturer using a 'live' physical model of
a cat's respiratory system (shape of face and nostrils and
constrictions in upper airway, lung tidal volume, flow rate,
respiration rate). The size of respirable particles and their deposited
dose in the 'lungs' of the mechanism were compared. Guess, even with
modifications, which product was the most efficient in delivering the
dose? Aerokat.

A cat's lungs are much weaker in comparison to a similar sized human (a
baby), and much less strong than the equivalent weight dog. Cats are
made for waiting and pouncing, humans are made for long walks, and dogs
for jogging for hours at a time. So you'll see the cat has the least
going for it in lung strength.

Most cats *can* use optichamber and aerochamber, but the losses on the
way to the lungs are greater than aerokat and the delivered dose lower.

As for alternative inhaled steroids to fluticasone/Flovent? There
aren't any that are as effective and this is supported both through
research and the biochemical and physical properties of fluticasone.
Important measures here are the respirable particle size (must be very
small to penetrate to the lung tissue), the therapeutic efficacy on the
lung tissue, and the flushing through the excretory process of the
steroid which doesn't make it into the lungs. From an individual
testing perspective with Fritz and several other cats on the Yahoo!
Feline Asthma Inhaled Meds group, who have tried alternatives, the
therapeutic response has been disappointing. (Thanks Phil your
information here was accurate!)

We have photos and videos of delivering the dose of Flovent with Fritz
on www.fritzthebrave.com -- take a look and you can see it takes one
hand to operate the dispensing (thanks again Phil). There are many
other ways of holding the cat than we show, as well.

Cheers,
James
coauthor, http://www.fritzthebrave.com, Feline Asthma with Fritz the
Brave!

Phil P.
November 11th 05, 02:45 AM
"opalmirror" > wrote in message
ups.com...
> Hi all... a little commentary.
>
> We find prices routinely in the 100-125 USD for the Flovent (aka
> fluticasone) that Fritz receives (120 metered doses, 220ug). Note that
> the 220ug is the US labeling which requires measuring the dose at the
> plastic boot, in other countries the same exact product is labeled
> 250ug which is the dose delivered to the plastic boot - 30ug is either
> deposited in the interior or escapes around the boot.
>
> Optichamber and AeroChamber were on the market first. Cat owners and
> veterinarians (even Dr. Philip Padrid) routinely modified them or to
> improve the dose delivery efficiency by a number of means, including:
> replacing the mask with a more cat-friendly one, by cutting out the
> valving, by adding tape around the mask/chamber connection where losses
> occurred.
>
> Aerokat overcame all these deficiencies. It was designed for cats, not
> humans. All three products (Optichamber, aerochamber, aerokat) were
> evaluated by the Aerokat manufacturer using a 'live' physical model of
> a cat's respiratory system (shape of face and nostrils and
> constrictions in upper airway, lung tidal volume, flow rate,
> respiration rate). The size of respirable particles and their deposited
> dose in the 'lungs' of the mechanism were compared. Guess, even with
> modifications, which product was the most efficient in delivering the
> dose? Aerokat.
>
> A cat's lungs are much weaker in comparison to a similar sized human (a
> baby), and much less strong than the equivalent weight dog. Cats are
> made for waiting and pouncing, humans are made for long walks, and dogs
> for jogging for hours at a time. So you'll see the cat has the least
> going for it in lung strength.


With all due respect to Dr. Padrid, that's the marketing gimmick used to
promote the AeroKat. The AeroChamber with the infant face mask is perfectly
suitable for use in cats. The sensitivity and resistance of the valve
system does not restrict or limit inhalation. We have used the AeroChamber
on many cats with excellent results- IMO, much better results than with the
AeroKat since the cats receive the entire dose with no loss of medication.



> Most cats *can* use optichamber and aerochamber, but the losses on the
> way to the lungs are greater than aerokat and the delivered dose lower.

Actually, the valve and baffle system of the AeroChamber enhances fine
particle dose delivery to the lungs and reduces inhaling larger particles
that will be deposited in the cat's mouth or nasal passages and subsequently
absorbed systemically. Without the valve system, the AeroKat is little more
than a hollow tube with a mask and is as efficient as a cardboard toilet
paper core (no offense-just making an accurate analogy).

The major flaw in AeroKat is that the medication is lost if you don't get it
right on the first try or if you're medicating an uncooperative cat. At
about a $1.00 a dose, failures can quickly cause a caretaker to resort to
systemic steroids or even relinquish the cat.




>
> As for alternative inhaled steroids to fluticasone/Flovent? There
> aren't any that are as effective and this is supported both through
> research and the biochemical and physical properties of fluticasone.
> Important measures here are the respirable particle size (must be very
> small to penetrate to the lung tissue), the therapeutic efficacy on the
> lung tissue, and the flushing through the excretory process of the
> steroid which doesn't make it into the lungs. From an individual
> testing perspective with Fritz and several other cats on the Yahoo!
> Feline Asthma Inhaled Meds group, who have tried alternatives, the
> therapeutic response has been disappointing. (Thanks Phil your
> information here was accurate!)
>
> We have photos and videos of delivering the dose of Flovent with Fritz
> on www.fritzthebrave.com -- take a look and you can see it takes one
> hand to operate the dispensing (thanks again Phil). There are many
> other ways of holding the cat than we show, as well.

The other methods might work, assuming you're medicating a cooperative cat.


You have a great site!

Phil

>
> Cheers,
> James
> coauthor, http://www.fritzthebrave.com, Feline Asthma with Fritz the
> Brave!
>

Phil P.
November 11th 05, 04:16 AM
"Lumpy" > wrote in message ...

> This kind of thing happens time and again and is one reason why
> Phil, for all his crankiness [>:)] contributes more to this group than
> anyone with regard to medical issues. Now when my vet tells me
> something I ask Phil before I make any decisions. He's really good
> about keeping up with the latest information, not to mention
> generous about taking the time to share the information his
> love of cats has moved him to seek out and absorb. Way to
> go, Phil.

What do you mean by "crankiness"? LOL! I'm not cranky, I just have a low
tolerance for assholes.

Newsman
November 11th 05, 05:53 PM
opalmirror wrote:
> Hi all... a little commentary.
>
> We find prices routinely in the 100-125 USD for the Flovent (aka
> fluticasone) that Fritz receives (120 metered doses, 220ug). Note that
> the 220ug is the US labeling which requires measuring the dose at the
> plastic boot, in other countries the same exact product is labeled
> 250ug which is the dose delivered to the plastic boot - 30ug is either
> deposited in the interior or escapes around the boot.

[Rest of message deleted]

Hi. I appreciate all the information. What's your source that you're
able to pay $100-125? The cheapest price I've been able to get is
$133.67 (and that's if you buy 6 inhalers at $800 up front).

Thanks.

yngver
November 17th 05, 07:04 PM
Newsman wrote:
> opalmirror wrote:
> > Hi all... a little commentary.
> >
> > We find prices routinely in the 100-125 USD for the Flovent (aka
> > fluticasone) that Fritz receives (120 metered doses, 220ug). Note that
> > the 220ug is the US labeling which requires measuring the dose at the
> > plastic boot, in other countries the same exact product is labeled
> > 250ug which is the dose delivered to the plastic boot - 30ug is either
> > deposited in the interior or escapes around the boot.
>
> [Rest of message deleted]
>
> Hi. I appreciate all the information. What's your source that you're
> able to pay $100-125? The cheapest price I've been able to get is
> $133.67 (and that's if you buy 6 inhalers at $800 up front).
>
> Thanks.

Your best source for advice on all issues related to using inhaled
medication for cats with asthma would be
http://groups.yahoo.com/group/felineasthma_inhaledmeds/

We have one cat with asthma and she's been on Flovent 110 administered
with the AeroKat for about three years, no problems at all. We just buy
the Flovent at Walgreens, but it's a little more expensive there than
if you look at the sources suggested by members of the feline asthma
inhaled medication group. They show, for example, that you can get
three units of the Flovent 220 for about $332 from drustore.com. Our
cat only needs one puff once a day so it lasts longer for us, but many
cats need the higher dosages.
-Yngver