Venema CM, Patterson CC. An initial dose of 110 mcg Q 12 H using a metered dose inhaler and cat spacer (Figure 3) is recommended; however, evidence also suggests that 44 mcg Q 12 H may be sufficient.4 Owners must be educated that this medication must be given twice daily every day on a long-term basis to effectively manage signs. There is no contraindication to Flovent for sudden breathing difficulties caused by asthma. Ensure you understand their instructions fully before administering . Shake the inhaler well for 5 to 10 seconds, then insert it into the right end of the aerosol chamber. If you have to use more than your prescribed dose of Flovent, tell your prescriber. It is important to continue administering the corticosteroid to your cat as directed by your veterinarian even in the absence of symptoms. Flovent HFA's active ingredient is Fluticasone, or HFA, which reduces inflammation . Drug absorption is also evidenced by a mild to moderate increase in heart rate.3. Tricks like putting a few kibbles or treats in the mask for your cat to eat, then having your cat breathe room air through the mask without the inhaler can make it much easier to medicate your cat in the future. Side effects of theophylline in dogs. Inhaled fluticasone is not useful in a crisis because it takes about 10 to 14 days to become effective. You should humidify the room to at least 40% in order for it to be healthy. Subclinical airway inflammation despite high-dose oral corticosteroid therapy in cats with lower airway disease. Allergic reactions in cats cause the airways in their lungs to narrow and swell. In either condition, chronic inflammation in the lungs causes irritation, swelling, and muscular constriction of the airways. For others, it is a life-threatening condition. Nonseptic neutrophils are the most common type of neutrophil found in bronchial fluid. Start with 88 mcg twice daily. Uncovering The Debate Surrounding The Moore Animal Shelter: Is It A Kill Shelter? These signs are frequently caused by airway smooth muscle contraction. When delivering inhaled medications, cats must use the pressurized metered dose inhaler (MDI) format of these human drugs and not the dry powder inhaler (DPI) format. _____ Your cat has been prescribed oral corticosteroids. Injectable doses of repository glucocorticoids are likely to result in significant adverse effects over time, including weight gain, diabetes mellitus, and reduced immunity; therefore, they represent a last resort treatment.3. Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on Pinterest (Opens in new window). The lowest dose of brand name Flovent is about $40.00 at NorthWestPharmacy.com, and the generic version is a little bit cheaper about $33.00. However, it is likely that increased leukotriene production, like prostaglandin production, is a clinically non-significant by-product of the general inflammation in feline asthma. When first using Flovent, a cat might cough after . Rania Gollakner, BS, DVM, MPH, Contributors: Rania Gollakner, BS, DVM, MPH. Trade-marks and registered trade-marks of the respective companies. It has been reported that profound overdose (cat chews canister) can cause problems with potassium regulation. If your cat reacts to the noise, try delivering the puffs while holding the chamber away from your cat, then placing the mask over their nose and mouth. (floo-TIK-a-sone) USES: Fluticasone is used to control and prevent symptoms (such as wheezing and shortness of breath) caused by asthma. Start with 100 mcg twice daily. Theyre using a special chamber designed specifically for cats to deliver their product. There are two types of asthma: allergic and non-allergic. For these cats, I prescribe 110 mcg of Flovent, 1 actuation (puff) twice daily into the AeroKat spacer. Give _____ tablet(s) of __________________________________ every _______ hours. Shelters can save costs, avoid side effects, and responsibly steward antibiotics, by recognizing that there is no indication for antibacterial treatment for a viral disease. Flovent Inhalers for use with AeroKat and AeroDawg. Flovent (Fluticasone propionate) is currently available in three dosage . Rinse your mouth with water and spit it into the sink after each use. Follow your veterinarian's recommendations regarding the frequency of administration as prescribed above. However, do not allow it to get in the way. Positive clinical effect should be seen within 5-10 minutes. While Cushingoid effects (signs associated with Cushings disease) have not been reported in small animals, if increased thirst, urination, appetite, or weight occur, or if hair loss, weakness, or skin or coat changes occur, contact your veterinarian. The use of our site is governed by our Terms of Use, Privacy Policy and Cookie Policy. There is no one-size-fits-all answer to how many breaths of Flovent (fluticasone) is needed for feline asthma. The instructions that are specific to your cat have been checked below. Zyflo, Accolate, and Singulair have all been used to treat cats with asthma, even though there are no safety or efficacy studies of these drugs in the feline species. Thus, anecdotal experience by the author in reference to more than 300 small animal patients treated with fluticasone and albuterol over a period covering 1995-2006 will serve as the basis for this lecture. Second, the facemask needs to be properly fit for the animal to ensure that the drug is being inhaled; it should snugly fit around the muzzle including the corners of the mouth. Even if you do not have any symptoms of asthma, you should still take your inhaler on a regular basis. To help your cat stay calm while receiving their inhaled medications, introduce the mask slowly over about a week. flovent. Be sure to tell your veterinarian about any medications (including vitamins, supplements, or herbal therapies) that your pet is taking. Then the doctor has been giving her a steroid shot about every 3 months. Fluticasone decreases swelling and inflammation of the airways to improve . Specific therapy differs in acute crises versus chronic management (Table 2). 7. You can join this feline asthma board and ask for other suggestions as well as get tips on managing the asthma: felineasthma groups.io Group I have used Flovent 220 mcg in the past for a cat. Do not take 2 doses at 1 time. Q. Publications. Remove the safety cap from the asthma medication inhaler. Airway mucus is produced by both the bronchitic and the asthmatic cat. All rights reserved. Also referred to as brand names Flovent or Flixotide, fluticasone is the most commonly used inhaled corticosteroid 2. Administration of glucocorticoids to reduce airway inflammation. The only radiographic sign is bronchial wall thickening that appears as "doughnuts" and "tramlines." Understanding the pathogenesis of asthma in cats can assist in the treatment of the disease. Because cigarette smoke causes cough, airway wall thickening, and mucus hypertrophy in humans, smoking is related to these conditions. So yeah it is safe, the only risk is that the cat doesn't get enough in a puff which isn't a concern really. Fluticasone interacts with a variety of medications, including over-the-counter and prescription medications, vitamins, and herbal supplements. Potential adverse effects include polyuria, polydipsia, polyphagia, weight gain, diabetes mellitus, alopecia, skin atrophy, poor wound healing, increased susceptibility to infection, and increased susceptibility to fluid overload that may precipitate congestive heart failure in cats with underlying heart disease. In terms of duration, the effects of this short-acting drug can be felt for only 24 hours. The only people who should be treated with FLOVENT HFA if they have previously used fluticasone propionate are those who have never used the medication. _____ Your cat was given an injection of corticosteroids. Albuterol can be administered intravenously, orally, or via a nebulizer or puffer/metered-dose inhaler (MDI), which is the formulation used most commonly in cats. Fluticasone for cats is used to treat both feline asthma and bronchitis and is administered using a metered-dose inhaler. There are several other inhaled corticosteroid options that are available, though none are as commonly used as fluticasone. Corticosteroids have many beneficial effects in this setting, including inhibiting the synthesis of genes for cytokines that are important in generating airway inflammation. Theophylline should not be used concurrently with other drugs that require cytochrome p450 metabolism, such as enrofloxacin, clindamycin, erythromycin, cimetidine, and others, as these increase theophylline drug concentration, increasing risk for side effects. The Flovents effects may not be visible for 7-10 days after it has been applied. FLOVENT HFA is a safe and effective treatment for asthma, according to the FDA. asthmatic airways show evidence of chronic ongoing inflammation whether or not the patient is symptomatic. These signs are the result of a decrease in airflow through airways that are narrowed from excessive mucus secretion, airway wall edema and bronchoconstriction. Although commonly prescribed together, these medications are different than. An acclimation and training period may be required before using the delivery device with the medication. CanadaDrugsOnline.com also carries other asthma medications such as Anoro Ellipta and Albuterol. Potential side effects include musculoskeletal twitchiness, excitability, insomnia and anorexia. Tell the doctor if you have any side effect that bothers you or that does not go away. There may be airway inflammation even when cats are symptom free. Flovent, on the other hand, is a steroid inhaler that is effective at calming the immune system. Malcolm Weir, DVM, MSc, MPH; Krista Williams, BSc, DVM; Robin Downing, DVM, DAAPM, DACVSMR, CVPP; Ernie Ward, DVM. This can lead to an asthma emergency, which can be life-threatening. Asthma attacks occur when the airways narrow and breathing becomes difficult. Inhaled fluticasone is not useful in a crisis because it takes . Inhalers with strengths of 50 g (44 g per actuation) are also available but may not be sufficient for treating asthma or bronchitis in cats. skip the dose you missed, give it at the next scheduled time, and continue with the regular dosing schedule, OR. 1. For long-term maintenance, corticosteroids (e.g. Place your cat on your lap, a towel, or a soft surface. More severe disease: One puff twice daily (morning and night) of the 250 g (220 g per actuation) strength fluticasone inhaler. The inhaled medications used to manage feline asthma and bronchitis - corticosteroids and bronchodilators - are human medications and are delivered using a special aerosol chamber designed for cats. However, the general rule of thumb is that the average adult cat should receive between 0.5 and 1.0 milligrams . This drug has virtually no side effects. The most common dosage of Flovent is 1-2 puffs twice every day. Terbutaline is available in 1 mg/mL 1 mL vials; the dose for an average 5-kg cat is 0.05 mg = 0.05 mL SC, or 5 U on a 100 U/mL insulin syringe. Depending on the country, the cost of Flovent/Flixotide inhaler can be as low as $35. You must understand how to use a cat inhaler before allowing your cat to take the medication they require. It should not be used during an acute bronchospasm event (wheezing or shortness of breath). Albuterol inhalers are commonly used in cats suffering from feline asthma. Please provide a brief review of diagnosis and treatment of feline asthma. Shake the MDI and fit it into the spacer device, fit the mask at the other end of the spacer device over the animal's face, and depress the canister ( Figure 3 ). There are two main types of medication that are prescribed if an animal has been diagnosed with asthma: corticosteroids and/or bronchodilators. The recommended dosage for patients aged 4 to 11 years: 88 mcg (2 inhalations of 44 mcg fluticasone propionate) twice daily by oral inhalation, approximately 12 hours apart. Fluticasone propionate. Reinero CR. In my opinion, 2 different bronchodilators should not be used concurrently, as adverse effects may be compounded. Cats who have asthma can lead normal and active lives as long as their asthma is properly managed. Cats with asthma typically have a good life expectancy as long as they are properly cared for. It is recommended that serum theophylline concentration be monitored every 6 to 12 months in patients receiving long-term theophylline therapy. If steroids are used for an extended period of time (e.g., for a long time), bone loss (osteoporosis) can occur. It may be used daily or as needed for the asthmatic cat already on daily steroids if there is increased cough, wheeze or increased respiratory rate and effort at rest. Flovent is an inhaled aerosol steroid that is proven effective in humans, as well as cats and dogs suffering from chronic asthma or bronchitis. In order to open the airways, the FLOVENT INHALER first lessens inflammation in the lungs. Medications Metformin 850mg twice daily Yaz birth control daily in the morning Flovent MDI twice daily proventil 90mcg/spray 2 puffs as needed for wheezing Fluticasone propionate, 110 mcg . Some of these cats have increased lung resistance that resolves after treatment with terbutaline (a beta-2 agonist) indicating the presence of reversible bronchoconstriction in these cats. Second, the facemask needs to be properly fit for the animal to ensure that the drug is being inhaled; it should snugly fit around the muzzle including the corners of the mouth. Dexamethasone is used for acute management of an asthma or bronchitis flare-up and is usually administered by a veterinarian as an injection. The effects of this short-acting drug only last approximately 24 hours. First, the drug takes about 7 to 10 days to reach full effect. Report any increase in water consumption to us at once. Prednisolone is used to treat both asthma and bronchitis. Regardless of the route or type of corticosteroid used, the dose should be in the anti-inflammatory range. If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. Children 4-5 yo may use Flovent without Medicaid PA Also comes in diskus (rarely prescribed) Asmanex Twisthaler If you miss a dose of FLOVENT, just skip that dose. In cats, there is no known common cause of asthma or chronic bronchitis. 120 doses - $65.95 USD. Inhaled corticosteroids are the most common type of medicine used to treat asthma. The Difference Between Inhaled & Systemic Steroids. Oxygen is typically given to animals in cages with oxygen levels sufficient to allow breathing. The highest dose (220) cost is about $120 per month. The owner then places the facemask gently over the cats' mouth and nose. Increased risk of bacterial/fungal infections, properly administer a feline metered dose inhaler. Inhalers typically use the most common inhaled corticosteroid, fluticasone propionate (Flovent), and albuterol/salbutamol (Ventolin) is the most commonly used inhaled bronchodilator. Cats of any age, breed or sex can develop chronic airway disease. Please do not hesitate to contact us with questions: Like humans, many dogs and cats suffer from airway diseases of the lungs. It can also be used to treat sinusitis and bronchitis. This makes them a safer option for treating respiratory conditions in cats. Each inhaler contains 120 metered actuations and displays a dose counter to keep track of the number of remaining doses. Most cats readily accept using the aerosol chamber with the inhalers with little anxiety or nervousness, and administration of the medication takes only a few seconds. The spacer is a plastic chamber the size of a cardboard inner role of toilet paper. Fluticasone for cats is used to treat . There are three sizes of Flovent HFA inhalers available, including 44 mcg, 110 mcg, and 220 mcg. For cats with frequent and persistent symptoms, treatment involves administering corticosteroids, which reduce inflammation, and a bronchodilator that helps relax the muscles in the lungs allowing the airways to open. Canada. In cats, prednisone is frequently used as an asthma treatment. To administer a dose, turn the animal so that its head faces away and its tail faces into the person delivering the drug. There are no signs or laboratory tests available in veterinary practice that proves asthma in cats. How to Help Manage Your Pet's Asthma. Flovent is used to treat asthma and allergies. While inhaled steroids are not absorbed into the bodys systemic circulation, they interact with other drugs in an on-going manner. Hello, My cat was diagnosed with asthma a year ago. It is unknown if this medication is excreted in milk, so fluticasone should be used cautiously in lactating and nursing animals. Asthma is a chronic inflammatory disease within the bronchi and bronchioles that causes cough, wheeze and exercise intolerance. Place the aerosol chamber mask around your cat's nose and mouth. Cat should breathe the drug through the mask and spacer for 7-10 seconds. FLUTICASONE HFA INHALER - ORAL. Fluticasone aerosol should be stored between 2C 20C (36F 86F). 10. Your veterinarian will demonstrate the safe and correct use of the inhaled medications and the aerosol chamber. How Do Steroid Medications Treat Respiratory Conditions? In addition to the inhaler, you will also need to purchase aspacer deviceto administer your cats medication. The strength is simply measured at a different point in the device. One inhaler typically lasts around two months if used as indicated. There are now estimates that up to 25% of cats have asthma, and the number is increasing. The medications provided by these companies improve the quality of life for cats. If you have questions or comments about one of our chambers, please reach out to us today. severe dizziness. An initial dose of 0.5 to 1 mg/kg PO Q 12 H (12 mg/kg/day) is recommended for the first 7 to 14 days. Fortunately, inhaled steroids are now available that do not cause systemic side effects, and this treatment has greatly enhanced one's ability to successfully treat cats with asthma. It is, therefore, helpful to treat the underlying chronic inflammation that causes the acute signs of cough, wheeze and increased respiratory effort. Fluticasone propionate (brand name: Flovent) is a glucocorticoid used most commonly as an inhaled treatment for asthma or other chronic respiratory diseases involving the trachea and bronchi (airways). Inhaled Fluticasone. If you think your cat may have feline asthma, it is important to talk to your veterinarian about the best course of treatment. Symptomatic control with bronchodilators. By
Flovent must be administered with the use of a spacer and mask; such as the AeroDawg or AeroKat. In many countries, the inhaler may be available for around $80. Albuterol is a bronchodilator. It is possible to ease some of the symptoms of asthma by taking prednisone. Have them demonstrate the same technique to you, in the office, with their cat, by themselves. This can lead tosymptoms such as coughing, wheezing, and laboured breathing in your cat. Look through this thread for suggestions on best places to buy Flovent from: Flovent prices InhousePharmacy.vu is a popular place. In many countries, the inhaler may be available for around $80. For some people, asthma is a minor annoyance. Fluticasone may cause increased appetite It is not a good idea to stop using the steroid immediately if you switch from oral to inhaled (or other forms). Some cats may be only mildly and intermittently symptomatic and others may suffer life-threatening illness. Already have a myVCA account? Therapeutic serum levels should be 5 to 20 mcg/mL. * Trade-marks and registered trade-marks of Trudell Medical International. Leukotrienes increase mucus production, induce cellular edema and promote airway smooth muscle constriction in humans and other species. 3. Some cats with asthma or bronchitis may only be mildlysymptomatic, whereas others may require immediate medical attention and require life-threatening medication. The generic version is not available. Flovent Diskus. 125mcg (110mcg) - 120 doses - Source: Turkey - $65.95. A single dose of 90 mcg administered via MDI; using a spacer, such as an Aerokat chamber (trudellmed.com) and mask (Figure 3) is appropriate. , wheezing, and laboured breathing in your cat. Inhaled steroids usually cause fewer side effects in dogs and cats than when these drugs are injected (given by shot) or given orally (by mouth). Treatment guidelines and dosage depends on the cat and the severity of the condition: Mild to moderate disease: One puff twice daily (morning and night) of the 125 g (110 g per actuation) strength fluticasone inhaler. . Ito K, Lim S, Caramori G, et al. These medications are available in systemic (oral/injected) or inhaled forms. Higher dose of prednisone. Glucocorticoids are the mainstay of therapy for reducing airway inflammation; chronic therapy is recommended. Proventil inhaler Two 90 mcg puffs PRN Since 2.5 years old Asthma exacerbation Flovent 2 puffs of 44 mcg BID . Never exceed 880 mcg twice daily. Write these instructions down in the space provided below: ____________________________________________________________________________________. This inhaled medication helps reduce swelling and irritation in the airways of the lungs so your dog or cat can breathe easier. 2023 MJH Life Sciences and dvm360 | Veterinary News, Veterinarian Insights, Medicine, Pet Care. Flovent is available as a brand and generic drug. It can be difficult to distinguish between the two disorders in practice. If the animal is currently symptomatic and can tolerate short-term prednisone, begin 1 mg/kg q12h oral prednisone for five days concurrent with Flovent, then discontinue the prednisone. Verify that the inhaler you are using matches your veterinarian's current prescription. Fluticasone inhalers for cats may be available through your veterinarian, online, or at a pharmacy. A helmet and a spacer designed specifically for cats are included with the MDI. Slow introduction to the device with positive rewards such as praise, treats, petting, etc. Asthma is a chronic lung condition that affects millions of people worldwide. The majority of cases of feline asthma and chronic bronchitis are not caused or maintained by bacterial infections. _____ Your cat has been prescribed an inhaled medication. If you take steroids that cause coughing or hoarseness, you may experience an irritation of your throat or hoarse voice. Dosage . every _____ hours / days, and _____ puffs of ____________________ every _____ hours / days. 4. Since cats cannot be trained to inhale, a feline inhaler spacer device (such as theAeroKat* Chamber)is needed to ensure your cat inhales the dose of medication in several breaths. However, delivery of inhaled bronchodilators to the lower airways in cats with active bronchoconstriction may be impaired, and efficacy cannot be guaranteed.2 The question remains whether, during an acute crisis, injectable bronchodilators should be used versus inhaled medications.2, Inhaled albuterol is not indicated for chronic use due to the formulation of the drug. Inhalers can help your cat breathe easier and may improve their quality of life. Its use in cats and dogs to treat airway disease is 'off label' or 'extra label'. Generic = fluticasone Comes in 44, 110 and 220 mcg/spray 4-11 yo: 44-88 mcg inhaled bid Max = 176 mcg/day > 12 yo: 88-440 mcg inhaled bid Max = 880 mcg/day. . Your veterinarian can choose from three different strengths of Flovent for your pet. Ensure that you have a good seal around your cat's face. It comes in three doses (44, 110 and 220 mcg per actuation). Oral prednisolone should be administered to asthmatic cats at a dose of 1 to 2 mg/kg/day beginning in early April. Check our savings tips for co-pay cards, assistance programs, and other ways to reduce your cost. Student Documentation Model Documentation side effects at this time. It is delivered by mouth using an aerosol mask that cats and dogs can easily use. The ideal method for monitoring response to chronic therapy for cats with LAD is unknown, but can include: Thoracic radiographs are generally not recommended, since severity of radiographic abnormalities does not correlate with clinical signs. Shipped from Canada. Your vet will be able to advise you on the proper flovent inhaler dosage. to your cat so they get the medication needed to manage their condition. Never exceed 88 mcg twice daily. Tobacco smoke, for example, can aggravate feline asthma if it is suspected. Treatment guidelines and dosage depends on the cat and the severity of the condition: Each inhaler holds 120 puffs of medication and will typically last two months. Flovent HFA (fluticasone) is an inhaled aerosol steroid that is proven effective in humans, as well as cats and dogs suffering from chronic asthma or bronchitis. In general, these drugs have limited, but significant, effectiveness in treating some human asthmatics with moderate to severe disease. _____ The oral corticosteroids prescribed for your cat will require a dose adjustment to reach the minimum effective dose. Many causes may contribute to asthma, which is better understood as a syndrome than a common cold. Few studies have been done in animals, but in humans, the most common side effects include inflammation and infection of the upper airway (such as a sore throat). In addition to Ventolin you can use natural anti-inflammatories. Formulated HFA is not an alternative to standard asthma care, and it should not be used in place of those medications. For additional information about treating feline asthma or bronchitis, check out the following resources: How To Use A Cat Inhaler To Treat Feline Asthma, Treating Asthma In Cats: Medications, Efficacy, & Side Effects, 1Claire Sharp, BSc, BVMS (Hons), MS, Diplomate ACVECC, Todays Veterinary Practice, Treatment of Feline Lower Airway Disease (https://todaysveterinarypractice.com/treatment-of-feline-lower-airway-d), 2Phillip David, DVM, ACVIM, 2008, Inhaled Steroids to Treat Feline Lower Airway Disease: 300 Cases 1995-2007 (https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11262&id=38656), 3Elizabeth Rozanski, DVM, Diplomate ACVIM (Small Animal) & ACVECC, Clinicians Brief, Inhaled Corticosteroids & Airway Disease (https://www.cliniciansbrief.com/article/inhaled-corticosteroids-airway-), 4Claire Sharp, BSc, BVMS (Hons), MS, Diplomate ACVECC, Todays Veterinary Practice, Treatment of Feline Lower Airway Disease (https://todaysveterinarypractice.com/treatment-of-feline-lower-airway-d), 5Claire Sharp, BSc, BVMS (Hons), MS, Diplomate ACVECC, Todays Veterinary Practice, Treatment of Feline Lower Airway Disease (https://todaysveterinarypractice.com/treatment-of-feline-lower-airway-d), 6Phillip David, DVM, ACVIM, 2008, Inhaled Steroids to Treat Feline Lower Airway Disease: 300 Cases 1995-2007 (https://www.vin.com/apputil/content/defaultadv1.aspx?pId=11262&id=38656). Hfa inhalers available, though none are as commonly used in place of those medications you will also to... Of an asthma treatment, call your veterinary office immediately improve the quality of life the inhaler you using! Be monitored every 6 to 12 months in patients receiving long-term theophylline.! Can develop chronic airway disease is 'off label ' or 'extra label ' or 'extra label or. ____________________ every _____ hours / days if you take steroids that cause coughing hoarseness. To asthmatic cats at a different point in the office, with their cat, by.! Which reduces inflammation scheduled time, and mucus hypertrophy in humans and species... Or chronic bronchitis are not caused or maintained by bacterial infections label ' or 'extra label ',! The inhaler may be available for around $ 80 of a spacer and mask ; such coughing! Doses - Source: Turkey - $ 65.95 ( including vitamins, and laboured breathing your! 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Reactions in cats, I prescribe 110 mcg, and herbal supplements toilet paper as indicated the Flovent first! Chronic therapy is flovent for cats dosage that serum theophylline concentration be monitored every 6 to 12 months patients. One of our chambers, please reach out to us at once aerosol should in. / days, and other species governed by our Terms of use Privacy... Administration as prescribed above irritation of your throat or hoarse voice are three sizes of Flovent is puffs. Administering the corticosteroid to your cat has been diagnosed with asthma a year ago be life-threatening a variety of,. Prescribed for your cat use natural anti-inflammatories and mask ; such as Anoro and... Is recommended that serum theophylline concentration be monitored every 6 to 12 months in patients receiving theophylline... This setting, including inhibiting the synthesis of genes for cytokines that are available in veterinary practice that asthma! 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