DOI
https://doi.org/10.18849/ve.v7i4.560Abstract
PICO question
In cats with chronic bronchospasm and airway hypersensitivity (asthma) do oral glucocorticoids or inhaled glucocorticoids more effectively control the clinical signs?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Three prospective randomised clinical trials were appraised. Two of the studies followed a crossover design and had a control group, whilst the third study described an interrupted time series
Strength of evidence
Weak
Outcomes reported
The available studies deemed a reduction in eosinophilia on bronchoalveolar lavage fluid analysis, and a reduction in airway resistance as markers of treatment efficacy
Conclusion
There is weak evidence to suggest equal treatment efficacy of oral and inhaled glucocorticoid therapy for management of feline asthma. Higher powered studies would be required before a definitive recommendation can be made
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Leemans, J., Kirschvink, N., Clercx, C., Snaps, F. & Gustin, P. (2012). Effect of short-term oral and inhaled corticosteroids on airway inflammation and responsiveness in a feline acute asthma model. The Veterinary Journal. 192(1), 41–48. DOI: https://doi.org/10.1016/j.tvjl.2011.01.020
Reinero, C. R., Decile, K. C., Byerly, J. R., Berghaus, R. D., Walby, W. F., Berghaus, L. J., Hyde, D. M., Schelegle, E. S. & Gershwin, L. J. (2005). Effects of drug treatment on inflammation and hyperreactivity of airways and on immune variables in cats with experimentally induced asthma. American Journal of Veterinary Research. 66(7), 1121–1127. DOI: https://doi.org/10.2460/ajvr.2005.66.1121
Verschoor-Kirss, M., Rozanski, E. A., Sharp, C. R., Oura, T. J., Egan, A., Bain, P. & Knoll, J. (2021). Treatment of naturally occurring asthma with inhaled fluticasone or oral prednisolone: a randomized pilot trial. The Canadian Journal of Veterinary Research. 85(1), 61–67.
License
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