Karen,

Can you see the rods and donuts on her lung xrays? Is it possible she
might have an infection of some type? I realized we had a problem with
Sam after he had been sleeping all day in the bed. I walked past the
hallway and Sam was laying in the middle of the hall. I teased him
about "sleeping beauty" waking up.  I put some dishes in the kitchen
and walked back across the hall and Sam had moved about 2 feet and was
laying flat out. I decided to check closer and he was gasping for
breath and his abdomen was heaving in and out as if he was breathing
from his abdomen.  His breath was very fast and his tongue was
sticking out.  He wouldn't stand up for any reason.  I gathered him up
and took him to the ER vet.

I just pulled Sam's initial ER vet report which read:

Attitude: Depressed, weak, Shocky
General Appearance: skin turgor ok
Eyes: Mydraiasis (A mydriatic pupil will remain excessively large,
even in a bright environment.)
Oral: Tacky cyanotic
Circulatory:  Normal rate, muffled, pulses weak
Respiratory; Dyspnea, orthopnea, wheezes, crackles, harsh sounds,
acute respiratory distress

Radiograph results:  collapsed right middle lung lobe, something
bronchial pattern, early inlusional avelolar

Reading through his chart it appears through the night Saturday and
all day Sunday he was moved in and out of oxygen.  At 12:15 pm Sunday
a new x-ray was taken that showed improved right middle lobe aerotion
and improved bronchial pattern.

That doesn't all make sense, but I have trouble reading a lot of this
third copy. I wish they wouldn't use NCR paper but rather copy the
originals for the patient's file.

Sam was immediately put in an oxygen cage and kept there for three
days. They gave him Terbuteline which is a broncodilator.  He'd
recently had a long term steroids so they avoided giving him more
steriods but recommended I get started on inhaled Flovent as soon as
possible.  I took him in on a Saturday evening and picked him up on
Monday morning.  He was on oxygen the entire time.  I went straight to
my regular vet who gave me an inhaler and rx for flovent and
albuterol.  We started with 2 puffs of 220 mg of Flovent twice a day
and I've never gone below that.  When Sam has attacks I usually add
Albuterol about 15 minutes prior to the Flovent to make sure his lungs
are opened and receiving the Flovent.

Definitions:  Dyspnea: Difficult or labored breathing; shortness of
breath.
Dyspnea is a sign of serious disease of the airway, lungs, or heart.
The onset of dyspnea should not be ignored but is reason to seek
medical attention.

Orthopnea (Greek from ortho, straight + pnoia, breath) is dyspnea
which occurs when lying flat, causing the person to have to sleep
propped up in bed or sitting in a chair. Orthopnoea is a symptom of
heart failure. It can also occur in those with asthma and chronic
bronchitis, as well as those with sleep apnea or panic disorder. The
condition is often due to left ventricular failure and/or pulmonary
edema. It is also associated with Polycystic Liver Disease.

Patients with orthopnoea often complain of waking up suddenly during
the night 'unable to breathe' if they have slipped down from their
pillows into the supine position. They may run to the window to 'get
some air'.

It is commonly measured according to the number of pillows needed to
prop the patient up to enable breathing (Example: "3 pillow
orthopnea").

Karen, if you want to call me tomorrow, send me an emai at the above
email.  I'll call you as soon as I can.

Julie
purrs from Sam, Hobbes, Lacey and Barnabus