Many common respiratory diseases in dogs and cats are primarily inflammatory in nature. These include lymphocytic-plasmacytic rhinitis, chronic bronchitis, asthma and eosinophilic bronchopneumonia.

Historically, the treatment of choice for these diseases included systemic corticosteroids given chronically to control these chronic conditions. Practicing veterinarians are all too aware of the significant side effects of chronic corticosteroid administration given to canine and feline patients, including increased thirst and urination, changes in behavior, and immune system suppression. Because of these side effects, it is common for clients to withhold treatment. Thus, patients continue to suffer from these diseases and experience exacerbations related to lack of proper consistent therapy.

Inhaled steroids are administered to our patients similarly as they are administered to infants and children with inflammatory respiratory disorders. This webinar will review the diagnosis and treatment of these inflammatory disorders in dogs and cats, with special reference to the appropriate use of inhaled drugs to replace systemic medications. With this approach, the side effects of systemic steroids are avoided, and long-term client compliance in treating their pets increases.

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Inhaled medications

Aerosol delivery

The most effective means of using an MDI requires that inhalation be purposefully coordinated with actuation of the device. In dogs and cats, this method involves the use of a spacer device and a mask specifically designed for them (Aerokat). The MDI fits on one end of the spacer, and the other end of the spacer has an attachment for the face mask. The MDI supplies precise doses of the aerosol drug, and the holding chamber contains the aerosol so it can be inhaled when the patient breathes. The mask is designed to cover the nose/snout of the patient (cat or dog).

Inhaled Corticosteroids

Fluticasone propionate (Flovent)

Flovent is a large molecule and acts topically within the airway mucosa. Because there is poor absorption across gut epithelium there is minimal oral systemic bioavailability.

Dosage and administration of Flovent

Flovent comes in three strengths; (US) 44/110 and 220 ug per actuation. For cats and small dogs, 110 ug given twice daily frequently results in clinical responses equivalent to that achieved by administration of oral doses of prednisone 5 mg PO BID. Patients with more serious disease may require 2-4X this dose, or 220-440 ug inhaled BID.

Conclusion

The use of inhaled medications to treat inflammatory respiratory disorders is considered the standard of care in humans and is now widely recommended for our patients as well. This approach avoids many of the side effects previously seen in patients treated with systemic medications.

 At the end of the webinar the participant will:

1. Be familiar with the pathophysiology and treatment approach to lymphocytic plasmacytic rhinitis.

2. Be familiar with the pathophysiology and treatment approach to canine and feline chronic bronchitis.

3. Be familiar with the pathophysiology and treatment approach to feline asthma

4. Be comfortable developing a treatment plan using inhaled steroids at variable doses and chronicity.

5. Appreciate and be able to distinguish between, the various inhaled steroid preparations and inhaled medicine delivery devices.

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