Allergic pneumonitis is an acute or chronic allergic reaction of the lungs and small airways. The lungs “overreact” to the presence of a parasite or other irritant, causing inflammation and a chronic cough. There is often a higher than normal number of white blood cells, especially those called eosinophils, in the blood. The underlying cause is rarely determined.
Eosinophilic bronchopneumopathy, previously known as pulmonary infiltration with eosinophilia or PIE syndrome is a group of diseases associated with increased numbers of eosinophils in the blood and in the lungs. This group of diseases is one type of allergic pneumonitis. Causes of eosinophilic bronchopneumopathy include parasites, chronic bacterial or fungal infections, viruses, external antigens, and unknown factors.
Heartworm pneumonitis can occur when cats with heartworm infections become sensitized to immature heartworms. Migrating intestinal parasites and primary lung parasites may cause mild signs of allergic pneumonitis.
A chronic cough is the most common sign of allergic pneumonitis. The cough may be mild or severe, and it may be dry (nonproductive) or contain secretions (productive). Weight loss, rapid or labored breathing, wheezing, intolerance to exercise, and occasionally coughing up of blood may be seen. Severely affected animals may have bluish mucous membranes at rest. The degree of labored breathing and coughing is related to the severity of inflammation within the airways and alveoli.
The diagnosis is based on the animal’s history and signs, chest x‑rays, and laboratory tests. Evidence of heartworm disease or parasitic lung disease on x‑rays may suggest these as an underlying cause of the allergic reaction. Blood tests show an increase in several types of white blood cells, indicating inflammation or infection. Fecal analysis and a heartworm test are performed when lung parasites or heartworms are suspected. A specialized procedure called a bronchoalveolar lavage may be recommended to collect samples (such as white blood cells, parasites, or bacteria) from the lungs.
When an underlying cause can be found, elimination of the offending agent and a short-term course of a corticosteroid usually resolve the problem. When heartworm disease or lung parasites appear to be the cause, corticosteroid treatment before or during treatment for the parasite controls the respiratory signs. If an underlying cause cannot be determined, prolonged corticosteroid therapy is often required. If the affected cat has severe airway constriction, bronchodilators or beta2-agonist medications may be helpful. Animals with severe shortness of breath may require oxygen therapy.
Also see professional content regarding allergic pneumonitis.