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Dyspnea in Cats

It is unusual to see a cat pant or breathe through his mouth, but it does occur when a cat is having trobule breathing (dyspnea). A panting cat does not look that different from a panting dog. Often, the cat will stand or crouch with his elbows bent away from his chest and with head and neck stretched out.

There are many different reasons a cat may have trouble breathing. This article will focus on fluid in the chest (hydrothorax) and enlarged heart (cardiomyopathy). There is an associated article on asthma and heartworm disease, which affect the lungs directly.

What to Watch For

• Labored breathing
• Standing or crouching with elbows pulled away from the body, and head and neck stretched out
• Loss of appetite
• Lethargy or reluctance to move
• Hiding
• Coughing (in some cases)
• Bluish or purplish gums

Primary Cause

Fluid in the chest or hydrothorax refers to the accumulation of fluid in the space between the lungs and ribs (pleural cavity). Common causes for hydrothorax include Feline Infectious Peritonitis (FIP), ruptured thoracic duct, and congestive heart failure due to cardiomyopathy.

1. FIP is a viral disease that the body cannot eliminate, and that causes fluid to accumulate in the chest and abdomen.
2. Among other things, the lymphatic system collects excess fluid from throughout the body and some of the fat absorbed from the intestines. This fluid is returned to the main circulation by the thoracic thoracic duct connecting to one of the large veins near the heart. If this duct ruptures, then the fluid spills into the chest (called chylothorax), which in turn causes breathing difficulties. The duct may rupture from trauma and other less clear causes.
3. Cardiomyopathy, or enlarged heart, often leads to congestive heart failure. This is inadequate pumping action by the heart, resulting in fluid accumulation in the chest and/or lungs.

Immediate Care

There is little to be done at home when your cat has trouble breathing. He needs to get to your veterinarian as soon as possible. During transport:

1. Minimize stress as much as possible.
2. Transport your cat in a carrier or box so his breathing is not compromised by being held.

Veterinary Care

Diagnosis

If your cat is in distress, your veterinarian will put your cat on oxygen right away and wait for your cat to calm down. The veterinarian will then conduct a thorough physical exam, paying special attention to heart and lung sounds. Chest X-rays are often necessary.

If there is evidence of fluid accumulation in the chest, the fluid will be removed and analyzed, followed by another battery of X-rays. Blood tests will also be done. If the primary problem seems to be the heart, an electrocardiogram and possibly an echocardiogram will be recommended.

Treatment

Treatment is focused on removing fluid from the chest and preventing it from returning so that your cat can breathe easily. Fluid will initially be removed by placing a needle into the chest and manually removing as much fluid as possible. Most cats tolerate this well. Preventing the fluid from accumulating in the chest again is the difficult part, depending on the underlying cause of the breathing difficulties.

1. FIP – There is no treatment that will eliminate the virus that causes FIP. Once the symptoms of the infection appear, there is little that can be done. The effects of the virus can be suppressed with glucocorticoids (steroids) for a short while, but eventually the cat will succumb to the virus.
2. Ruptured thoracic duct – This not always treatable. Some success has been had with both medical and surgical treatment options.
3. Congestive heart failure – Fluid can be held in check with medications like furosemide (a diuretic or “water pill”) and enalapril (improves heart function).

Additionally, the goal of treatment is to have your cat feeling well enough to eat and drink on his own. Your cat will most likely be hospitalized for a few days until all these goals are achieved. He may be put on intravenous fluids and receive injectable medication beyond those already discussed to ease his breathing. He may need to be on oxygen for an indefinite amount of time as well.

Other Causes

Other things that can cause difficulty by affecting the chest (pleural cavity): trauma, tumors, hiatal hernia, diaphragmatic hernia, bleeding (hemothorax), and infection (pyothorax and pleurisy).

Living and Management

Most of the diseases that affect the chest will require prolonged or life-long care to keep your cat breathing easy. These diseases generally do shorten your cat’s life span. The worst is FIP, which usually proves fatal in 1 to 2 months. Follow-up visits and tests will be necessary to monitor your cat’s condition. The long-term goal for most of these diseases is quality of life, not cure.

Prevention

There is little to be done to prevent these diseases. Some cases of cardiomyopathy are due to deficiencies of taurine, an amino acid. Commercial cat foods are formulated to supply your cat with a sufficient amount of taurine; you can buy supplements that contain taurine as well. There is a vaccine available for FIP, but the use of this vaccine is highly controversial, and should be discussed with you veterinarian.