Coughing vs. Hairball Expulsion: How to Tell the Difference
Many cat owners struggle to distinguish between coughing and hairball vomiting, as the two actions look remarkably similar. According to Cornell Feline Health Center, correctly differentiating between them is crucial for seeking timely veterinary care:
| Characteristic | Coughing | Hairball Expulsion |
|---|---|---|
| Posture | Neck extended, head lowered, crouching close to the ground | Neck thrust forward, abdominal contractions |
| Sound | Dry cough or wheezing | Retching sounds before vomiting |
| Output | Usually nothing, occasionally a small amount of foam | Hairball or mucus-coated hair mass |
| Duration | May recur over several minutes | Typically stops after expulsion |
According to a review in Veterinary Clinics of North America: Small Animal Practice(Trzil, 2020), the true cough reflex in cats involves rapid opening and closing of the glottis, producing the characteristic cough sound. If a cat repeatedly makes coughing motions without expelling a hairball, a respiratory problem should be suspected rather than a simple hairball issue. Recording video for the veterinarian is extremely helpful.
Common Causes of Coughing in Cats
Upper Respiratory Infections
Feline upper respiratory infection (URI) is a common cause of coughing. The primary pathogens include feline herpesvirus-1 (FHV-1) and feline calicivirus (FCV). According to ABCD (Advisory Board on Cat Diseases) guidelines, URIs typically present with sneezing, nasal discharge, conjunctivitis, and fever. While coughing is not the predominant symptom in URI, it may occur when the infection extends to the lower respiratory tract.
Feline Asthma
Asthma is one of the most common lower respiratory diseases in cats and is discussed in detail in the following section.
Bronchitis
Chronic bronchitis and asthma overlap considerably in clinical presentation. According to Veterinary Clinics of North America: Small Animal Practice (Reinero, 2011), the key distinction is that asthma features reversible airway narrowing with eosinophilic infiltration, while chronic bronchitis may involve irreversible airway changes.
Pulmonary Parasites
Lungworm (Aelurostrongylus abstrusus) and heartworm (Dirofilaria immitis) infections can cause chronic coughing. Lungworm is more common in cats with outdoor access. While heartworm infection is less common in cats than dogs, even a small worm burden can cause severe respiratory symptoms.
Pulmonary Neoplasia
Primary or metastatic lung tumors can cause chronic, progressive coughing. This possibility should be considered in senior cats with unexplained persistent cough.
Pleural Effusion
Pleural effusion typically causes dyspnea rather than coughing, but small volumes or early-stage effusion may be accompanied by occasional coughing. Common causes include heart disease, feline infectious peritonitis (FIP), chylothorax, and neoplasia.
Feline Asthma: An In-Depth Look
According to the Journal of Veterinary Internal Medicine (Reinero, 2011), feline asthma has a prevalence of approximately 1-5%, making it the most common chronic lower airway disease in cats.
Pathophysiology
Feline asthma is a chronic airway inflammatory response triggered by allergens, resulting in bronchial smooth muscle contraction (bronchospasm), airway mucosal edema, and increased mucus production, which collectively cause airway narrowing and breathing difficulty. Common allergens include:
- Dust mites and household dust
- Pollen and mold spores
- Cigarette smoke and fragrance products
- Cat litter dust (especially scented clay litters)
- Household cleaners and aerosol sprays
Typical Symptoms
- Intermittent coughing (may show seasonal variation)
- Wheezing
- Rapid or labored breathing
- Open-mouth breathing (an emergency sign during severe episodes)
- Exercise intolerance
Diagnosis and Treatment
Diagnosis typically combines thoracic radiography (classic findings of bronchial wall thickening and hyperinflated lung fields), bronchoalveolar lavage (BAL) analysis, and exclusion of other diseases. According to the ACVIM consensus statement, treatment is centered on inhaled corticosteroids (such as fluticasone, administered via a feline-specific inhaler) and bronchodilators (such as albuterol). Oral corticosteroids may be used for acute control or in cases where inhalers cannot be used.
Heart Disease-Related Coughing
Unlike dogs, heart disease in cats rarely causes coughing directly. According to research in the Journal of Feline Medicine and Surgery(Ferasin, 2009), respiratory signs in feline heart disease primarily manifest as dyspnea (caused by pulmonary edema or pleural effusion) rather than typical coughing. However, the following points are worth noting:
- Early pulmonary edema may produce occasional mild coughing or wheezing
- Left atrial enlargement compressing the left main bronchus (extremely rare in cats)
- If a cat has both heart disease and asthma, careful attention to drug interactions is needed
Hypertrophic cardiomyopathy (HCM) is the most common feline cardiac disease, with a prevalence of approximately 15%. According to ACVIM guidelines, early-stage HCM is typically asymptomatic. When signs such as tachypnea, open-mouth breathing, or hind limb paralysis (aortic thromboembolism) appear, the condition has progressed to a severe stage requiring emergency management.
When to See the Vet and How to Prepare
According to ISFM clinical guidelines, the following situations warrant prompt veterinary attention:
- Emergency: Open-mouth breathing, tachypnea (over 40 breaths per minute at rest), cyanotic tongue or gums (blue-purple discoloration), sudden collapse or weakness
- See a vet soon (within 1-2 days): Coughing persisting beyond 3 days, increasing frequency or severity, accompanied by appetite loss or lethargy
- Schedule a checkup: Occasional coughing with otherwise normal behavior and appetite
Pre-Visit Preparation
- Record video of coughing episodes (extremely valuable for veterinary diagnosis)
- Note the frequency, timing (daytime or nighttime), and duration of coughing
- Identify any specific triggers (entering a particular room, exposure to certain substances)
- Record accompanying symptoms (sneezing, nasal discharge, breathing difficulty, appetite changes)
- List all current medications and supplements
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References
- Trzil, J.E. (2020). Feline asthma: Diagnostic and treatment update. Veterinary Clinics of North America: Small Animal Practice, 50(2), 375-391.
- Reinero, C.R. (2011). Advances in the understanding of pathogenesis, and diagnostics and therapeutics for feline allergic asthma. The Veterinary Journal, 190(1), 28-33.
- Ferasin, L. (2009). Feline myocardial disease 1: Classification, pathophysiology and clinical presentation. Journal of Feline Medicine and Surgery, 11(1), 3-13.
- Cornell University Feline Health Center. Feline asthma: A respiratory condition. Cornell College of Veterinary Medicine.
- ACVIM Consensus Statement. (2020). Guidelines for the diagnosis and treatment of feline hypertrophic cardiomyopathy.