You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.

Acute dyspnoea requires emergency treatment while a detailed examination is undertaken to identify the underlying cause

Acute dyspnoea is a potentially life-threatening situation. Drugs and equipment that might be needed for treating acute dyspnoea should be included on any emergency "crash cart" in a practice.

Initial treatment includes :

• Oxygen - administer as soon as possible - use the least stressful method for the cat. Cats will often fight mask delivery.
• If upper airway obstruction is present sedation/general anaesthesia and removal of any foreign body or a low tracheostomy to by-pass the obstruction should be performed as soon as possible.
• Glucocorticoids (dexamethasone - 0.2-1mg/kg by slow intravenous injection) are administered if allergic bronchitis/asthma is suspected
• Bronchodilators are given if bronchospasm is present -slow intravenous aminophylline (10mg/kg body weight) and atropine (15 micrograms/kg body weight by intravenous injection)
• Epinephrine (adrenaline) injection (0.1 mg subcutaneously) is given for acute allergic or anaphylactic reactions, or if pleural fluid is present. However, adrenaline will increase anxiety in the patient.
• Thoracocentesis - if free thoracic fluid is present - for diagnosis, and to improve lung function ...remove as much fluid as possible, from both sides of the chest
• Diuretics (frusemide intravenously at a dose rate of  2.5-5.0 mg/kg body weight) - if pulmonary oedema is present (eg cardiogenic)
• A potent vasodilator (Nitroglycerine - applied topically) -  if severe cardiac problem
• ACE inhibitors or calcium channel blockers in some cases
• Vitamin k if cat has had access to rodenticide or been seen to catch a rodent

Initial physical examination has to be performed rapidly with minimal stress for the cat. The aim is to localise the problem to :

• Upper airway
• Lower airway
• Lung tissue
• Pleural space

so that emergency treatments (see above) can be given to stabilise the patient. Once stable, a detailed clinical  work-up can be carried out.

• Observation - respiratory rate, depth of chest movement, colour of visible mucous membranes. Remember that chest wall movements may not reflect lung movements
  • Is difficulty in breathing during inspiration, expiration or both ? 
  • Cats with cardiorespiratory stress often mouth-breath and pant.
  • Pulmonary oedema often results in shallow fast respirations
  • Pulmonary infiltrates often result in shallow fast respirations
  • Allergic bronchitis results in slow, laboured breathing with wheezing and coughs
  • Fluid effusions in the chest cause inspiratory and expiratory difficulty in breathing
  • Upper airway obstruction causes extreme stress during inspiration
  • End expiratory dyspnoea is associated with tracheal collapse, masses obstructing the airways (eg cancer), emphysema and feline asthma.
  • Other causes of inspiratory and expiratory dyspnoea include airway stenosis following trauma , and parasites (eg Filaroides osleri) - rare.
• Auscultation is helpful to 
  • Identify (or not) the areas of the lung where respiratory sounds can be heard
  • Crackles on inspiration suggest restrictive lung disease
  • Identify normal and abnormal cardiac sounds, or muffling
• Characterisation of the pulse is helpful to determine cardiac function
• Manual compression of the cranial thorax may reveal a firm mass if there is a mediastinal mass

Nursing is important. Cats with dyspnoea are highly stressed. They should be kept quiet, possibly in the dark, and away from the normal hustle and bustle of the practice. Great care is needed during handling as they can suddenly panic and go into a frenzied period of excitation, so gentle talking and comforting is needed during treatment. 

Cats with dyspnoea should be positioned carefully during radiography ...it may not be advisable to sedate or anaesthetise them, and it may not be advisable to try to force the cat to lie on it's side, as this might precipitate acute respiratory arrest.

Updated January 2016