HRFL Tiger UPDATE.

Howard Berkowitz wrote:
In article , Julie Cook
wrote:


Lots of purrs on the way for Sabra to breathe easier very soon. Sam
started coughing this afternoon for the first time since the end of
January. I had taken it on myself to try to reduce the dosage of
Flovent (steroids) that he's taking and that combined with nasty
thunderstorms last night apparently was just too much for his fragile
lungs. I gave him a couple of puffs of Albuterol and he seems to be
doing better tonight. I've gone back to two puffs of the Flovent twice
daily at least until he sees the vet at the end of March.

Purrs and gentle headbutts for Sabra as well as you.

Julie, Hobbes, Selena, Lacey, Sam and Barnabus


Remember that corticosteroids (at least in people) take at least 8 hours
to have any real effect, and may take several days. For asthma, they are
either preventive drugs, or part of a long intensive treatment.
Albuterol, however, can help in minutes, and should be your first choice
if there are any visible symptoms.

I had tried to drop his Flovent from 440 mcg bid to 220 mcg bid. It
didn't work. As soon as I heard him coughing he received two puffs of
Albuterol which helped. As I understand it, most people who are giving
prednisone orally slowly taper off the prednisone as they add the
Flovent so that after 2 weeks the cat is on inhaled steroids only. In
Sam's case, he'd had enough injected steroids that they didn't want to
add systemic steriods and just started him on the Flovent. I doubt
he'll ever be able to come off the Flovent entirely but I'm hoping one
day he won't need as much. I wonder what this stuff tastes/feels/smells
like to him?

Julie

In article , Julie Cook
wrote:

Howard Berkowitz wrote:
In article , Julie Cook
wrote:


Lots of purrs on the way for Sabra to breathe easier very soon. Sam
started coughing this afternoon for the first time since the end of
January. I had taken it on myself to try to reduce the dosage of
Flovent (steroids) that he's taking and that combined with nasty
thunderstorms last night apparently was just too much for his fragile
lungs. I gave him a couple of puffs of Albuterol and he seems to be
doing better tonight. I've gone back to two puffs of the Flovent twice
daily at least until he sees the vet at the end of March.

Purrs and gentle headbutts for Sabra as well as you.

Julie, Hobbes, Selena, Lacey, Sam and Barnabus


Remember that corticosteroids (at least in people) take at least 8
hours
to have any real effect, and may take several days. For asthma, they
are
either preventive drugs, or part of a long intensive treatment.
Albuterol, however, can help in minutes, and should be your first
choice
if there are any visible symptoms.

I had tried to drop his Flovent from 440 mcg bid to 220 mcg bid. It
didn't work. As soon as I heard him coughing he received two puffs of
Albuterol which helped. As I understand it, most people who are giving
prednisone orally slowly taper off the prednisone as they add the
Flovent so that after 2 weeks the cat is on inhaled steroids only. In
Sam's case, he'd had enough injected steroids that they didn't want to
add systemic steriods and just started him on the Flovent. I doubt
he'll ever be able to come off the Flovent entirely but I'm hoping one
day he won't need as much. I wonder what this stuff tastes/feels/smells
like to him?

In humans, a maximum dose of inhaled corticosteroids is roughly equal to
5mg oral prednisone per day, with much lesser side effects since the
inhaled corticosteroid is gnerally not absorbed in the body. It may or
may not be possible to replace oral corticosteroids with inhaled.

No, it is unlikely an asthmatic will ever be able to come off
anti-inflammatory drugs such as corticosteroids or cromolyns. While
there may be some reduction after an acute episode, you generally find a
maintenance dose and keep it there indefinitely.

What criteria are you using to decide when to reduce the Flovent dosage?
Is this a cost consideration, or based on symptoms?

Howard Berkowitz wrote:


In humans, a maximum dose of inhaled corticosteroids is roughly equal to
5mg oral prednisone per day, with much lesser side effects since the
inhaled corticosteroid is gnerally not absorbed in the body. It may or
may not be possible to replace oral corticosteroids with inhaled.

No, it is unlikely an asthmatic will ever be able to come off
anti-inflammatory drugs such as corticosteroids or cromolyns. While
there may be some reduction after an acute episode, you generally find a
maintenance dose and keep it there indefinitely.

What criteria are you using to decide when to reduce the Flovent dosage?
Is this a cost consideration, or based on symptoms?

Purely emotional. He looks so pitiful when its time for his medication
that I promised him I'd do what I could to make it easier for him. That
and he hadn't had a coughing spell since the end of January. What I
need to keep reminding myself is that its only been about 5 weeks since
he crashed. That is not such a very long time ago. Certainly not enough
time to have recovered completely from a collapsed lung lobe, fluid
buildup around his lungs, etc. I'm planning to board him in March when
we go out of town for 4 days to make sure he gets his meds. I'm going to
ask the vet to do another lung x-ray at that time to see where we are.
Until then ... he gets the prescribed 2 puffs bid - no matter what kind
of sad eyes he gives me.

Julie

In article , Julie Cook
wrote:

Howard Berkowitz wrote:


In humans, a maximum dose of inhaled corticosteroids is roughly equal
to
5mg oral prednisone per day, with much lesser side effects since the
inhaled corticosteroid is gnerally not absorbed in the body. It may or
may not be possible to replace oral corticosteroids with inhaled.

No, it is unlikely an asthmatic will ever be able to come off
anti-inflammatory drugs such as corticosteroids or cromolyns. While
there may be some reduction after an acute episode, you generally find
a
maintenance dose and keep it there indefinitely.

What criteria are you using to decide when to reduce the Flovent
dosage?
Is this a cost consideration, or based on symptoms?

Purely emotional. He looks so pitiful when its time for his medication
that I promised him I'd do what I could to make it easier for him. That
and he hadn't had a coughing spell since the end of January. What I
need to keep reminding myself is that its only been about 5 weeks since
he crashed. That is not such a very long time ago. Certainly not enough
time to have recovered completely from a collapsed lung lobe, fluid
buildup around his lungs, etc. I'm planning to board him in March when
we go out of town for 4 days to make sure he gets his meds. I'm going to
ask the vet to do another lung x-ray at that time to see where we are.
Until then ... he gets the prescribed 2 puffs bid - no matter what kind
of sad eyes he gives me.

I know it's hard to medicate our furkids -- especially when they are
brave about it. Chatterley (RB) would ask me if I was feeling lucky when
it was time to squirt ointment into her eyes. Mr. Clark, however, is far
more brave, both for eye and ear ointment. He rather quickly recognized
the tube, and would watch me pick it up, not move when I positioned the
nozzle in his ear, and only give an obviously automatic flinch when I
squirted.

He's a very tolerant cat, which is good since he's a very large and
powerful cat. With him, and with Clifford (RB), there's a great deal of
bonding and trust. I don't know if it's just that they felt that I
wasn't going to hurt them, or was actually trying to help, but I
appreciate their attitudes.

I will admit that Chatterley had reason to be suspicious of all
treatments after my ex-wife, for reasons she cannot explain to this day,
chased Chatterley with a flea spray, giving a demented laugh all the way
up the stairs and under the bed.

To return to asthma, the great breakthrough leading to the enormous
strides made in treating it in all species is realizing that it is a
disease of inflammation in which the inflammation leads to constricted
breathing passages, as opposed to a disease that is basically about
breathing difficulty. Control the inflammation, and, ideally, there are
never breathing problems.

Drugs such as corticosteroids, cromolyns, and leukotriene inhibitors are
anti-inflammatory, and have no immediate effect on breathing. There are
some long-lasting drugs to help breathing (e.g., salmeterol (Serevent))
that have no place in an acute attack, but still are not
anti-inflammatory. Things that do help in acute attacks are
short-acting beta-agonists like albuterol, sometimes anticholinergics
like ipratropium (Atrovent), epinephrine in emergencies, and possibly
caffeine-related drugs like aminophylline and theophylline. The last
two, I suspect, are toxic in cats.

The reality is that unless you can remove the cause of the inflammation,
which could be an allergy, changes in air temperature, exercise, or just
things we don't understand, you can't stop or reduce the
anti-inflammatory drugs. The good news is that the anti-inflammatories
prevent the need for the quick-acting bronchodilators. Bronchodilators
are probably a little more scary, as they can cause rapid heartbeat, dry
mouth, and other immediate symptoms.

On Wed 23 Feb 2005 06:27:20p, Howard Berkowitz wrote in
rec.pets.cats.anecdotes
):

The reality is that unless you can remove the cause of the
inflammation, which could be an allergy, changes in air
temperature, exercise, or just things we don't understand, you
can't stop or reduce the anti-inflammatory drugs.

Not WRT asthma, but isn't it possible for an allergy to be
"outgrown"? (An allergy that causes skin outbreaks rather than
respiratory distress)

--
Cheryl
/hoping!

In article , Cheryl
wrote:

On Wed 23 Feb 2005 06:27:20p, Howard Berkowitz wrote in
rec.pets.cats.anecdotes
):

The reality is that unless you can remove the cause of the
inflammation, which could be an allergy, changes in air
temperature, exercise, or just things we don't understand, you
can't stop or reduce the anti-inflammatory drugs.

Not WRT asthma, but isn't it possible for an allergy to be
"outgrown"? (An allergy that causes skin outbreaks rather than
respiratory distress)

Sometimes. In humans, that's most likely to be associated with puberty
-- I don't have any idea what spaying and neutering will do.

As something of an aside, there are childhood "reactions" that are not
true allergies. Certainly until I was in my late teens, if I tried to
swallow cooked egg white, I'd always gag and frequently vomit. As an
adult, I don't particularly like egg white, but it doesn't have this
effect. When I discussed it with an allergist, he said things like this
were often observed but not understood. They definitely were not
allergies.

Some of it may be the "acquired taste" mechanism, which also is poorly
understood. Coffee is something, for example, that few children like,
along with strong-tasting food in general.

As a child, I don't think I ever tried raw shellfish. Oysters and such
gag many adults. I've just never understood raw oysters, as I detect no
real flavor, but I love sea urchin (uni) sushi.

in article , Howard
Berkowitz at wrote on 2/23/05 7:48 PM:

In article , Cheryl
wrote:

On Wed 23 Feb 2005 06:27:20p, Howard Berkowitz wrote in
rec.pets.cats.anecdotes
):

The reality is that unless you can remove the cause of the
inflammation, which could be an allergy, changes in air
temperature, exercise, or just things we don't understand, you
can't stop or reduce the anti-inflammatory drugs.

Not WRT asthma, but isn't it possible for an allergy to be
"outgrown"? (An allergy that causes skin outbreaks rather than
respiratory distress)

Sometimes. In humans, that's most likely to be associated with puberty
-- I don't have any idea what spaying and neutering will do.

As something of an aside, there are childhood "reactions" that are not
true allergies. Certainly until I was in my late teens, if I tried to
swallow cooked egg white, I'd always gag and frequently vomit. As an
adult, I don't particularly like egg white, but it doesn't have this
effect. When I discussed it with an allergist, he said things like this
were often observed but not understood. They definitely were not
allergies.

Some of it may be the "acquired taste" mechanism, which also is poorly
understood. Coffee is something, for example, that few children like,
along with strong-tasting food in general.

As a child, I don't think I ever tried raw shellfish. Oysters and such
gag many adults. I've just never understood raw oysters, as I detect no
real flavor, but I love sea urchin (uni) sushi.

That is broccoli for me. It would make me throw up as a child, but I like it
as an adult. I think it had to do with texture.

On Wed 23 Feb 2005 08:48:56p, Howard Berkowitz wrote in
rec.pets.cats.anecdotes
):

Sometimes. In humans, that's most likely to be associated with
puberty -- I don't have any idea what spaying and neutering will
do.

I keep hoping that it will diminish with time. He's now 3, and has
had the skin problems since I got him at the age of 6 months
(though I really think he was older than that then - 2 years ago
Mar 16, hence his name Shamrock. ) It honestly has gotten
better. He used to break out on his back, the sides of his torso,
the backs of his rear legs and the base of his tail. Now it's
mostly just his back and the base of his tail, but sometimes still
maybe one leg.

As something of an aside, there are childhood "reactions" that
are not true allergies. Certainly until I was in my late teens,
if I tried to swallow cooked egg white, I'd always gag and
frequently vomit. As an adult, I don't particularly like egg
white, but it doesn't have this effect. When I discussed it with
an allergist, he said things like this were often observed but
not understood. They definitely were not allergies.

Some of it may be the "acquired taste" mechanism, which also is
poorly understood. Coffee is something, for example, that few
children like, along with strong-tasting food in general.

As a child, I don't think I ever tried raw shellfish. Oysters
and such gag many adults. I've just never understood raw
oysters, as I detect no real flavor, but I love sea urchin (uni)
sushi.

For me as a kid it was milk. I can remember having to sit at the
table until it was gone, and it would get so warm and stinky. I'd
"down" it just to get away from the table, then get sick. I still
can't drink a plain glass of milk.

--
Cheryl

Julie Cook wrote:


In the Atlanta area I paid around $50.00 for the Albuterol and it has
200 doses per canister. I give two puffs as needed in emergency. I've
only used about 10 puffs of this. The Flovent in the Atlanta area is
$150.00 for 120 doses (for us this is a one month supply, I give 2 puffs
twice daily). I found it from a Canadian supplier for $90.00/month
which includes postage and handling. In a stable cat people are giving
1 puff twice daily so that the canister would last two months. Also, I
give a high dose at the moment because Sam's so recently had a crisis
and we're still trying to get him stable. I give 220 mcg of Flovent (2
puffs/twice daily). I would think 110 mcg 1 puff/twice daily wouldn't
cost as much. I suppose it depends on how stable your cat is. A good
resource for all of this is www.fritzthebrave.com. I use the Aerocat
chamber and haven't had any trouble with it at all. Sam is a pretty laid
back cat, however. I'm not sure I could do this with Selena or Lacey.

You're really selling me on the idea of inhaled meds, Julie, but I
wonder if I'd be able to administer them to Nikki. When we visited the
vet last week, she did talk of some toher medication, but that was oral
as well, not inhaled. I wonder if I could find a vet here who would
prescribe the inhaled stuff for a cat. I'll have to look around. Nikki
seems to be doing fine on the Prednisone, but I am worried about the
complications of long-term use. AAMF, we are having a bout of very cold
weather, and Nikki was being difficult the other night so I only got a
fraction of her meds into her, but she hasn't wheezed at all. Maybe in
cold weather, she doesn't need so much of it.


--
Marina, Frank and Nikki
marina (dot) kurten (at) pp (dot) inet (dot) fi
Pics at http://uk.pg.photos.yahoo.com/ph/frankiennikki/
and http://community.webshots.com/user/frankiennikki

Marina wrote:


You're really selling me on the idea of inhaled meds, Julie, but I
wonder if I'd be able to administer them to Nikki.

The main thing is to get her used to the mask that covers her nose and
mouth. I bought a infant chamber and mask initially until I could order
the Aerokat mask, which is specifically designed for cats. The Aerokat
web site is http://www.aerokat.com/overview.htm and has some good
information about giving inhaled meds. If you'd like I could send you
the infant chamber/mask and you could see if Nikki will let you use it
on her. It only takes about 15 seconds to administer two puffs of the
drug so it doesn't have to stay there long. Some of the web site
suggest rewarding with treats but Sam likes to be loved on so I get him
in my lap or I kind of crouch over him so that he can't back away from
me and administer the inhalant and then spend a minute or two just
scritching his ears and chin. He adores this special time between the
two of us.

When we visited the
vet last week, she did talk of some toher medication, but that was oral
as well, not inhaled. I wonder if I could find a vet here who would
prescribe the inhaled stuff for a cat.

There is a copy of the accepted protocol for inhaled meds for felines
with asthma at www.fritzthebrave.com written by Dr. Philip Padrid. You
could take this to your vet along with some of the other information
found at this site that supports inhaled meds and even discusses other
treatment options. I think primarily vets are uninformed about the
inhaled meds and reluctant to prescribe them because they're unsure
about their effectiveness. Overall I think any vet wants to do what is
best of their patient and there's no doubt that the inhaled steroids are
better in this application than the systemic steroids. The cost could
keep vets from recommending this option although I would think that
should be a personal decision, not one the vet would make.

I'll have to look around. Nikki
seems to be doing fine on the Prednisone, but I am worried about the
complications of long-term use. AAMF, we are having a bout of very cold
weather, and Nikki was being difficult the other night so I only got a
fraction of her meds into her, but she hasn't wheezed at all. Maybe in
cold weather, she doesn't need so much of it.


We're having a lot of rain right now and for the first time since the
end of January Sam is having coughing attacks. I like being able to
give him a couple of puffs of the Albuterol and seeing how quickly it
seems to work. That's another advantage of the inhaled meds over the
others is having a quick acting medication when they actually have an
attack.

Good luck Marina and if I can be of any help let me know. Send me your
address (or do I have it from the holiday card list?) and I'll be happy
to send you the infant mask/chamber to see if Nikki will accept it.

Julie