What are Inhaler Medications?
Inhaler medications are a specific type of prescribed drug whose route of administration is through the lungs, as opposed to oral (pill), intravenous, intramuscular, or subcutaneous routes. The advantages of inhaler medications may include:
- not having to pass through the stomach;
- faster absorption into the bloodstream;
- directly targeting where the medication is needed, and;
- easier administration.
Inhaler medications are the preferred option for humans with respiratory conditions such as asthma, Chronic Obstructive Pulmonary Disease (COPD), bronchitis, and emphysema (ginasthma.org, goldcopd.org). With Trudell Animal Health chambers, they can be the preferred option for cat asthma, dog bronchitis, horse asthma, and other animals and respiratory conditions as well.
There are 4 types of delivery device formats for inhaler medications
Metered Dose Inhalers (MDI), or puffers, are one of the oldest forms of inhaled medications and are often associated with people who have asthma. When activated, these inhalers emit a specific unit dose of medication that is pushed out of the device and into the patient with a propellant.
MDIs can be used with animals only when used in combination with a valved holding chamber like the Trudell Animal Health devices. Without a chamber, most of the dose would likely be lost because animals cannot follow the proper MDI technique, which requires coordination of inhalation with MDI activation followed by a long slow deep breath. Our chambers capture and hold the medication eliminating the need for proper coordination, and giving your animal enough time to inhale multiple times through the chamber to empty the device.
Soft Mist Inhalers (SMI) are similar to MDIs in that the aerosol is generated by the action of the device, not the patient. One of the primary differences between the devices is the speed of the aerosol plume that is emitted from a SMI. In humans, the slower speed may make it easier for a patient to properly use the device.
In animals, SMIs would still require the use of a Trudell Animal Health chamber to capture and hold the aerosol plume in order for the animal to have a chance at getting the dose.
Not for use with animals
Dry Powder Inhalers (DPI) come in a variety of different formats. In general, the primary difference with DPIs compared to the other formats, is that the aerosol plume is generated based on the inspiratory effort of the patient. This is because the medication in a DPI is not in a liquid solution or suspension like the other formats, but is actually a powder. The powder may be in a pill that gets crushed, or a block that gets shaved when activated. How fast the patient inhales is a key determinant how small the particles get when inhaled.
This type of medication is not considered appropriate for animals because they cannot be trained to perform the inhalation maneuver required to use the device.
Caution: some medications are available in both MDI and DPI formats. Make sure your health care provider dispenses the MDI format for your animal.
Examples of this type of inhaler include Aerolizer†, Diskus†, Ellipta†, Flexhaler†, Handihaler†, Neohaler†, Pressair†, Rotahaler†, Turbuhaler†, and Twisthaler†.
†Trade-marks or registered trade-marks of their respective owners.
Nebulizers are the most involved type of inhaled medication requiring three different components; a controller or compressor, a nebulizer cup that holds the medication and includes the patient interface (often a mask), and the medication itself. The medication typically comes in nebules which must be emptied into the medication cup. The medication cup includes mechanisms to convert the liquid into an aerosol. These mechanisms may be driven by compressed air, electrically powered vibrating mesh, or other technology.
One of the advantage of nebulizers is that many different medications can be made into nebules. They can even be used to deliver saline to simply moisten the airways. But, nebulizers can be more challenging to use with animals because the treatment times can be long (15-20 minutes) and it is difficult to maintain animals' compliance to wearing a mask for such a long time, particularly in small animals. In addition, compressor based nebulizers tend to be loud, which can frighten cats, dogs, and horses. Electronically driven devices are quieter but can be very expensive.
Nebulized therapy may be an option to investigate with your veterinarian for those medications not available in metered dose inhaler format.
Types of Inhaler Medication
There are two main types of inhaler medication that are prescribed if a cat, dog, or horse has been diagnosed with asthma, bronchitis or COPD: corticosteroids and/or bronchodilators. These are the same medications used to treat respiratory disease in humans, but require different doses and administration in animals. ALWAYS consult and follow the instructions of your veterinarian before giving your animal any medication! Only use inhalers as prescribed by your veterinarian.
Short Acting Bronchodilators
Bronchodilators are medications used to expand the airways. They are commonly referred to as rescue medications because they are usually administered in the event of an asthma attack.
- Opens airways by relaxing muscle constriction
- Effects usually only last 4-6 hours
- Does not treat underlying inflammation
NOTE: The effectiveness of bronchodilators in dogs is minimal and has not fully been studied
Save a Visit to the Vet!
Inhaled short acting bronchodilators could help your pet regain control at home giving you more time to talk to your vet.
Corticosteroid inhalers (or glucocorticoids) are anti-inflammatory medications used to treat and manage the underlying causes of asthma and bronchitis symptoms.
- Reduces airway inflammation and mucus production
- Used for ongoing management of condition even in the absence of symptoms
Often a combination of a corticosteroid inhaler and a special bronchodilator that acts over a longer period of time.
- Reduces inflammation and helps prevent airway constriction
- Used for disease management, not rescue
- Fluticasone Cipla†
Where to Buy Inhaler Medications for Cats, Dogs, and Horses
Only use inhalers as prescribed by your veterinarian.
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Canadian Pharmacy World
Inhaled medications can be purchased from your veterinarian, a regular human pharmacy, or from online veterinary pharmacies with a prescription from your licensed veterinarian or health provider.
Did You Know?
Some medications can have different names in different countries. For example, GSK's branded fluticasone proprionate MDI inhaler goes by the trade name Flovent† in Canada and USA, and Flixotide† in most of the rest of the world.
These are the same medications, owned by the same company, marketed with different names.
Did You Know?
The listed strength of these medications can also change depending on how the local regulatory authorities chose to measure the amount of medication delivered. For example, GSK offers Flovent† HFA in three labelled strengths in Canada (50 mcg, 125 mcg, and 250 mcg) that are equivalent to the three labelled strengths in USA (44 mcg, 110 mcg, and 220 mcg), respectively. The difference is that in Canada, the strength was measured at the valve of the inhaler whereas in USA the strength was measured at the mouthpiece (actuator).
The same device measured in two different ways creates a different, but equivalent set of strengths.