r/catcare • u/number_1son • 1h ago
Advice on my cat with confusing case of “asthma”
My 5-year-old male Bengal has had respiratory issues since he was young. Before I adopted him, he had **multiple documented pneumonias**, chronic cough, and recurring respiratory infections that improved with antibiotics (Clavamox, Veraflox, doxycycline, azithromycin). FeLV/FIV, heartworm, and multiple respiratory PCR panels have all been negative.
About 2 weeks after I adopted him (he was 4 at the time), he started having strange “attacks.” The attacks are the same now as they were a year ago. They last about a minute and involve extending his neck low to the ground with snake-like head movements and noisy/gunky breathing. No typical coughing or wheezing but ya it’s probably an asthma attack.
Prednisolone stopped the attacks completely, but they return when steroids are stopped. Chest X-rays have consistently shown a bronchial pattern, and my vet diagnosed asthma. He’s now on inhaled fluticasone 2 puffs a day, but still has intermittent attacks despite treatment. Also have tried OTC stuff like lysine chlorpheneramine and cerenia. I’ve also changed litter like 10 times and have an air filter.
What confusing is on top of this he has:
\- Chronic sneezing
\- Green/yellow nasal discharge and boogers
\- Occasional high-pitched whistling when breathing through his nose
\- Symptoms that improve dramatically on doxycycline and or steroids but recur a few weeks after stopping it
He’s otherwise doing well:
\- Active and playful
\- Normal resting respiratory rate (20-30)
\- Attacks are brief and self-resolve
\- Never open-mouth breathes
\- Maintains his weight around 8 lb (vet says mildly underweight but stable)
My primary vet isn’t overly concerned because he sounds better on exams than he used to, but I feel like we’re treating “asthma” while something else may also be going on.
Some possibilities I’ve wondered about are:
Asthma plus chronic rhinitis
Chronic bacterial infection
Bronchiectasis from previous pneumonias
Structural upper airway problem
Something rarer like primary ciliary dyskinesia
My guess is an internal medicine consult with CT and bronchoscopy/BAL would likely the next step, but currently difficult financially right now.
Would CT or bronchoscopy actually change the diagnosis or treatment?
Does this sound like something that can remain stable for years, or should I be pushing for advanced diagnostics as soon as possible?
I’d appreciate any experiences or advice.