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30 Feline Bronchial Asthma 303

are necessary before allergen‐specific immunotherapy improvement involves “cough counts” performed by
VetBooks.ir can be employed standardly in clinical practice. owners at home prior to and after starting therapy. Due to
permanent airway remodeling, radiographic manifesta-
Several novel therapies have been investigated using
cats with experimentally induced asthma and may be
ment, limiting the use of repeated thoracic radiography to
applicable to the management of patients with naturally tions of asthma may not change significantly with treat-
occurring disease. Specifically, the antiinflammatory monitor response to therapy. The exception is radio-
effects of omega‐3 polyunsaturated fatty acids (ω3 graphic evidence of atelectasis of the right middle lung
PUFAs) extracted from New Zealand green‐lipped mus- lobe, which is expected to resolve with antiinflammatory
sel have been evaluated in artificially sensitized cats. and mucolytic therapy. The limited availability of pulmo-
Airway responsiveness but not eosinophilic inflamma- nary function testing prohibits its practical application as
tion decreased following treatment, suggesting that ω3 a means of assessing response to treatment, but it may
PUFAs may have some benefit as adjunctive therapy in prove useful for this purpose in the future.
the management of feline asthma. Masitinib, a tyrosine
kinase inhibitor, has been demonstrated to reduce eosin-
ophilic airway inflammation and improve respiratory Prognosis
compliance in cats with experimental asthma and may
emerge as an effective treatment strategy for patients Most asthmatic patients that receive appropriate treat-
with glucocorticoid intolerance or refractory disease. ment demonstrate a favorable response with a good
Stem cell therapy has also been investigated as a means of long‐term prognosis. However, continuing antiinflam-
reducing airway remodeling, one of the hallmarks of matory therapy for life is crucial to prevent further per-
feline asthma. Administration of allogenic mesenchymal manent airway remodeling unless the inciting allergen
stem cells to cats experimentally sensitized to a common can be identified and exposure prevented. Severe, refrac-
aeroallergen resulted in attenuation of changes consistent tory forms of feline asthma do exist and can present
with chronic lung remodeling based on computed tomog- management challenges. Moreover, even patients with
raphy. Nebulized lidocaine has been evaluated in cats apparently well‐controlled asthma are at risk for poten-
with experimentally induced asthma and was shown to tially life‐threatening episodes of severe, acute broncho-
reduce airway hyperresponsiveness without adverse constriction. The adverse effects associated with
effects, indicating that it may be effective as palliative systemic glucocorticoid therapy can complicate progno-
therapy when used in combination with glucocorticoids. sis and lead to the development of life‐limiting complica-
tions, including congestive heart failure and diabetes
Monitoring mellitus. Long‐term treatment can be further impaired
by patients that will not tolerate oral administration of
Response to therapy is most effectively evaluated by medications or placement of the facemask required for
assessing clinical signs. Due to the intermittent nature of administration of inhalant therapy. In addition, the
clinical signs in some patients, overall improvement in expense associated with inhaled medications may pre-
clinical condition should be judged after at least a few vent their use in some patients. Despite these challenges,
weeks of therapy. Decreased frequency of episodes of feline asthma is a readily manageable condition, and suc-
coughing and/or dyspnea is the expected outcome of suc- cessful treatment can prevent acute death and signifi-
cessful treatment. A more objective assessment of clinical cantly improve quality of life in the majority of patients.