Awwww, poor Pearl indeed.  I don't know anything about asthma meds for cats,
sorry.  Purrs for Pearl to feel better.

Jill

The medicine is similar (or the same as) to theophyllin.  Related to
caffeine.  It kept me alive for years.

Jo

The lady came into the doctors office remembering the vet's instructions
"and no breakfast!". After the tests finished, she said "glad that's done,
I'm starving".

In asking the vet to replace the pred, she is suggesting aminophylline.
It is two times a day. Has anyone here tried that? They seem resistant
to trying the aerokat for some reason. I will be talking to her more in
detail next week. Poor Pearl had blood drawn today, but the blood
machine wasn't working right and the person making the appt. didn't
tell me she should fast, so it was pretty much a wasted effort. Poor
Pearl.

Aminophylline is injectable only, and is considered obsolete in humans.
Theophylline is still used orally, but is definitely a third-line drug,
with a narrow range between therapeutic and toxic levels.

It depends, of course, how practical inhalers are. Again, do remember
that I'm extrapolating from human medicine.  Pretty much the mainstay
of prevention is a mixed inhaled corticosteroid with a long-acting
beta-agonist such as salmeterol. Other classes of inhalable drug
include cromolin and neocromil (preventive), short-acting beta-agonists
like albuterol (rescue/intervention), and anticholinergics such as
ipratropium (inbetween preventive and interventional).

I don't understand this, Karen.  Aminophylline is a
bronchodilator.  It can help with symptoms, but does not reduce
the underlying inflammation.  You need some kind of steroid for
that, which is what the prednisone/prednisolone is.  I can't see
*replacing* an anti-inflammatory with a bronchodilator.  Often
both are prescribed.

Do you have any idea why your vet is resistant to inhaled
therapy?  Just lack of familiarity?

Poor Pearl, indeed.  Purrs for a better vet visit next time.

Well, the new medicine they prescribed for Nikki just before she died
was theophylline; I don't know how closely related it is to
aminophylline. Of course, I'll never know if it was the meds or
something else - e.g. a brain tumour - that gave her the fit that she
never recovered from.

Karen,
I've read the entire thread and think you might be right about your vet
just not being knowledgeable about inhaled meds, thus not wanting to go
that route.  It would seem that as the client you and Pearl have the
right to insist on the route of medication. We know that aminophylline
is a bronchodilator which indicates your vet is currently wanting to
treat the symptoms only. Has Pearl recently had a steroid shot that
might be controlling the inflammation? My thoughts are that the vet
knows she's given Pearl a steroid and is now wanting to give her
something to control coughing. She isn't comfortable prescribing inhaled
meds so she's going with the aminophylline.  When I brought Sam home
from the emergency vet he was on Terbutaline which is another oral
bronchodilator.  I was given a prescription for Albuterol but told not
to use it until he had finished taking the oral terbutaline...emphasis
on do not give both at the same time.  Sam had been given a steroid
injection several weeks before and they did not want to give him another
injection but wanted me to go ahead and begin with the Flovent as soon
as I could. Both the emergency vet and my regular vet were well educated
about inhaled meds so no other options were ever discussed.  I was
directed to the fritzthebrave web site for additional information and
fortunately Sam never gave me any trouble about taking inhaled meds.
Now - 10 months later - when he sees me shaking the canister of Flovent
he runs to the cat tree, sits on the platform and waits for me.

I think if I were you, knowing what you know, that I would make an
appointment with the vet and show up without Pearl and just discuss what
you know about inhaled meds and the fact that you want Pearl to receive
the safest medical treatment possible.  Maybe ease her mind by having
her give you a prescription for the terbutaline in the event you can't
get Pearl to adapt to the mask right away. That would give you a way to
treat an attack. Print out the protocol and pictures found on the
fritzthebrave web site so that she can read it for herself.  Order an
aerokat device which takes several days to arrive and hopefully by the
time you have that she will have read the material you gave her and
you'll be ready to treat Pearl.

Sam started with 2 puffs of 220 mg Flovent, twice a day.  He has finally
reached a point where he can have 2 puffs once a day.  I suspect when
the weather changes and I have to turn on the heat again he may have to
go back to twice a day, although I have eliminated a lot of the triggers
(most importantly, I don't smoke in the house any more).

I don't know if any of this information helps, but Sam is sending extra
special purrs for Pearl, which I know will help ;)

If you'd like, I'll be happy to send an email to your vet telling her
about Sam's case.  He was in acute respiratory distress when we landed
at the emergency vet. He was cyanotic and had a collapsed lung.  He was
in an oxygen cage for 48 hours and within a month of using the inhaled
meds his condition was manageable.  During that month he required fairly
regular doses of Albuterol but now I haven't given him Albuterol in 3
months!

Sending purrs and gentle headbutts to you and Pearl,
Julie, Hobbes, Selena, Lacey, Sam and Barnabus