Help for a Cat Who Has Asthma and Ringworm CatChannel veterinary expert Arnold Plotnick, DVM, discusses medication that can be administered while on a
prednisolone regime.

Q: My 3-year-old cat Spaz has been diagnosed with asthma. For two years, we have treated him with prednisolone everyother day and theophylline every other day; if he starts coughing, we increase the dose for a few days. We have triedseveral times to wean him completely off his prednisolone, but he starts coughing. I have been researching somethingcalled "immune balance" for pets that contains plant sterols and claims to help immune-compromised cats like Spaz. He also has ringworm that we have been treating for several months. I know the ringworm won't resolve because he’s onprednisolone. Do you believe that this product may be worth trying and, if so, can it be taken with all his other medication? I have foundfew testimonials on the product. A product similar to it is called "transfer factor" for pets. I am scared to try him on somethingnew but really would like to get him off the prednisolone and get rid of the ringworm. I have discussed with my vet possiblytrying inhaled medications, but he thought it would be too much of an expensive gamble. I would really like to try a morenatural approach. A: I’m sorry to hear that your cat is having so much trouble with his asthma. I confess that I am not a big proponent of“natural” or “holistic” therapies, especially when it comes to serious illnesses such as asthma. If your cat did not have ringworm, I would tell you not to worry about weaning your cat off his prednisolone. In some cats, theallergy season lasts a few weeks, and they require medication only during those few weeks. In other cats, the allergic triggerfor the asthma is present in their environment continuously, and these cats require long-term medication. The most effectivemedication for asthma is a steroid, such as prednisolone. The goal of therapy is to control the coughing on the lowest dose of prednisolone possible, ideally every other day therapy.
You have your cat on every other day therapy, and that’s great. An occasional flare-up is expected (therapy rarelycompletely eliminates the cough; rather, it reduces the frequency and severity), and during flare ups, you may need toincrease the medication for a few days. So, you’re doing everything right, in that regard. Prednisolone does suppress the immune system, and cats on prednisolone are at increased risk for infection. I’m surprised,however, that your cat is battling ringworm while he’s on an every-other-day dosage. When given every other day,prednisolone is anti-inflammatory rather than immunosuppressive. I wish I knew how you were treating the ringworm. Ifyou only use shampoos or creams/ointments, you’ll never get rid of it. Your cat needs to be on oral anti-fungal medication.
I’d recommend terbinafine or itraconazole. Your cat needs to be bathed with an anti-fungal shampoo twice a week, as well. I disagree with your vet about the inhaled medication. I think you should give it a try. The advantage of inhaled steroids isthat they work in the lungs only, and are not absorbed systemically. They control the inflammation in the lung, but shouldnot suppress the immune system in the body. That’s the theory. Inhaled steroids should control the asthma, while allowingthe body’s immune system, in combination with anti-fungal therapy, to defeat the ringworm. I have many patients on inhaledsteroids for asthma, and the majority do very well. As for the holistic/natural therapies you asked me about, I have noexperience with them and therefore don’t feel qualified to comment about them.


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