This article is part of our Cat Asthma series. 

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Corticosteroids, also referred to as glucocorticoids or steroids, are important medications used to treat lower airway diseases in cats. These medications are available in systemic (oral/injected) or inhaled forms.

Steroids are used for daily disease management and must be used regularly in order to be effective—even in the absence of symptoms. Although commonly prescribed together, these medications are different than bronchodilator medications used when a cat is in need of immediate symptom relief.

 

How Do Steroid Medications Treat Respiratory Conditions?

Corticosteroids are used to treat the underlying causes of feline lower airway disease. These conditions include:

• Feline asthma
• Chronic bronchitis

In either condition, chronic inflammation in the lungs causes irritation, swelling, and muscular constriction of the airways. This can lead to symptoms such as coughing, wheezing, and laboured breathing in your cat.

Corticosteroids are used to reduce this underlying inflammation. It is important to continue administering the corticosteroid to your cat as directed by your veterinarian even in the absence of symptoms. These medications keep the symptoms under control. If stopped, the inflammation and symptoms will return and your cat will be at an increased risk for an attack.

In an emergency (such as a severe asthma attack), your vet may administer a high-dose systemic steroid to get the attack under control. At home, steroids are not used to treat respiratory emergencies as they do not have an immediate effect to reduce symptoms. In these cases, bronchodilators should be used instead.

The Difference Between Inhaled & Systemic Steroids

Inhaled steroid medications deliver the medication directly to where it is needed: your cat’s lungs.

Conversely, systemic steroid medications need to be first processed by the body before entering the bloodstream and reaching the lungs.

Unfortunately, there are many side effects associated with oral or injected steroid use because these systemic steroids affect other areas of the body, not just the lungs.¹

 

Side Effects Of Systemic Steroids

The side effects of systemic steroids can be both short-term and long-term. Short-term side effects of systemic steroids are expected soon after your cat begins to take the medication.

Some of these short-term side effects include:

• Weight gain
• Vomiting
• Diarrhea
• Panting
• Frequent urination
• And more

Long-term side effects of systemic steroids are seen over time with prolonged use. Some of these long-term side effects include:

• Lethargy/fatigue (no energy to play)
• Change in behaviour (such as aggression)
• Suppressed immune system function
• Increased risk of bacterial/fungal infections
• And more

Inhaled steroids have little to no side effects associated with their use compared to systemic steroids because they target the lungs directly using much lower doses of medication. This makes them a safer option for treating respiratory conditions in cats.

 

How Are Inhaled Steroids Given To Cats?

It’s important to understand how to properly administer a feline metered dose inhaler to your cat so they get the medication needed to manage their condition.

Since cats cannot be trained to inhale, a feline inhaler spacer device (such as the AeroKat* Chamber) is needed to ensure your cat inhales the dose of medication in several breaths. These devices include a mask and a chamber to hold the medication while your cat passively breathes.

 

Types Of Corticosteroids Used To Treat Respiratory Conditions

Inhaled Steroids

Inhaled steroids for use in cats are the same medications used in humans. When delivering inhaled medications, cats must use the pressurized metered dose inhaler (MDI) format of these human drugs and not the dry powder inhaler (DPI) format.

1. Fluticasone Propionate

Also referred to as brand names Flovent or Flixotide, fluticasone is the most commonly used inhaled corticosteroid². Fluticasone for cats is used to treat both feline asthma and bronchitis and is administered using a metered-dose inhaler.

2. Other Inhaled Steroids

There are several other inhaled corticosteroid options that are available, though none are as commonly used as fluticasone. Other options include beclomethasone, budesonide, ciclesonide (brand name Alvesco HFA), and mometasone (brand name Asmanex HFA).³

3. Combination Inhalers

Some inhaled corticosteroids combine a steroid and a long acting bronchodilator into a single inhaler. With these medications, the steroid is intended to address the inflammatory response while the bronchodilator helps reduce constriction of the smooth muscles in the airways. Examples of these include combinations of fluticasone and salmeterol (brand names Advair, Seretide, Sirdupla, Sereflo, Serroflo, Salmeterol/Fluticasone Cipla), budesonide and formoterol (brand name Symbicort), and mometasone and formoterol (brand name Dulera).

Systemic Steroids

1. Dexamethasone

Also referred to as brand names Decadron and Dexasone, dexamethasone is a systemic corticosteroid. Dexamethasone is used for acute management of an asthma or bronchitis flare-up and is usually administered by a veterinarian as an injection.⁴

2. Prednisolone

Also referred to as brand names Orapred, Pediapred, and Prelone, prednisolone is a systemic corticosteroid. Prednisolone is used to treat both asthma and bronchitis. Prednisolone for cats is available in pill form and sometimes administered via injection. The goal of using this drug is to only use as little as possible for a short amount of time.

3. Methylprednisolone Acetate

Also referred to as Depo-Medrol, methylprednisolone is a systemic corticosteroid that is administered via injection. These injections are likely to result in adverse effects so they are considered a “last-resort” treatment for both asthma and chronic bronchitis in cats.⁵

 

Inhaled Steroid Dosage For Cats

Fluticasone inhalers for cats are available in three different strengths. Treatment guidelines and dosage depends on the cat and the severity of the condition:

• Mild to moderate disease: One puff twice daily (morning and night) of the 125 µg (110 µg per actuation) strength fluticasone inhaler.
• More severe disease: One puff twice daily (morning and night) of the 250 µg (220 µg per actuation) strength fluticasone inhaler.
• Inhalers with strengths of 50 µg (44 µg per actuation) are also available but may not be sufficient for treating asthma or bronchitis in cats.⁶

Each inhaler holds 120 puffs of medication and will typically last two months. Your vet will indicate when the medication is to be used and how many puffs to give your cat for each treatment.

Where To Get Feline Inhalers

Once your veterinarian has prescribed an inhaled steroid for your cat’s condition, you can purchase an inhaler. Fluticasone inhalers for cats may be available through your veterinarian, online, or at a pharmacy.

Some examples of online pharmacies** where Fluticasone can be purchased include:

• • Vet Rx Direct ($230 per inhaler, $125 monthly for treatment)
  • Canada Pharmacy Online ($85 per inhaler, $43 monthly for treatment)
  • In House Pharmacy ($39 per inhaler, $20 monthly for treatment)

^{**The links to online pharmacies are being provided as a convenience and for informational purposes only; they do not constitute an endorsement or support of the drug product or content of those sites.}

Depending on the country, the cost of Flovent/Flixotide inhaler can be as low as $35. In many countries, the inhaler may be available for around $80. One inhaler typically lasts around two months if used as indicated. In addition to the inhaler, you will also need to purchase a spacer device to administer your cat’s medication.

 

Inhaled Steroids Are A Critical Part Of Disease Management

Inhaled steroids are important medications needed to help manage your cat’s respiratory condition. Talk to your vet about using inhaled steroid medications and the AeroKat* Chamber to help keep your cat’s condition under control.

For additional information about treating feline asthma or bronchitis, check out the following resources:

How To Use A Cat Inhaler To Treat Feline Asthma

Treating Asthma In Cats: Medications, Efficacy, & Side Effects

 

 

¹Claire Sharp, BSc, BVMS (Hons), MS, Diplomate ACVECC, Today’s Veterinary Practice, “Treatment of Feline Lower Airway Disease” (https://todaysveterinarypractice.com/treatment-of-feline-lower-airway-d…)

²Phillip David, DVM, ACVIM, 2008, “Inhaled Steroids to Treat Feline Lower Airway Disease: 300 Cases 1995-2007” (https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11262&id=38656…)

³Elizabeth Rozanski, DVM, Diplomate ACVIM (Small Animal) & ACVECC, Clinician’s Brief, “Inhaled Corticosteroids & Airway Disease” (https://www.cliniciansbrief.com/article/inhaled-corticosteroids-airway-…)

⁴Claire Sharp, BSc, BVMS (Hons), MS, Diplomate ACVECC, Today’s Veterinary Practice, “Treatment of Feline Lower Airway Disease” (https://todaysveterinarypractice.com/treatment-of-feline-lower-airway-d…)

⁵Claire Sharp, BSc, BVMS (Hons), MS, Diplomate ACVECC, Today’s Veterinary Practice, “Treatment of Feline Lower Airway Disease” (https://todaysveterinarypractice.com/treatment-of-feline-lower-airway-d…)

⁶Phillip David, DVM, ACVIM, 2008, “Inhaled Steroids to Treat Feline Lower Airway Disease: 300 Cases 1995-2007” (https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11262&id=38656…)