Do the Kittens Have to Go?

Q: My two daughters were born and initially raised around our cat. After three years the cat died. The kids were doing fine until our recent addition of two kittens. Since their arrival, my 5-year old daughter has been having breathing difficulties due to asthma, and my 8-year old has a problem with nosebleeds and a runny nose. Could my daughters' symptoms be related to the kittens? If so, we really want to keep them and need to know what can be done to minimize our daughters' symptoms.

A: The answer to your question, especially in regard to your 5-year-old with asthma, may indeed be yes. That's because more than half of all people with asthma have a direct link to allergies, with 29 percent of those specifically related to cat allergies. And since a person must have two exposures to become allergic to something, the time interval between your daughters' first cat (primary exposure with sensitization) and second cats (re-exposure) may be contributing to her body's allergy and asthma reaction.

However, don't send the kittens packing yet, especially since almost half of the other asthma sufferers have non-allergy triggers such as the weather (cold or dry air, windy conditions), irritants (cigarette smoke, wood fires, strong odors from household cleaners, perfumes, soaps, others), respiratory infections, emotional upset, and even exercise (exercise-induced asthma).

In regard to your 8-year-old's continual problem with nosebleeds, it may be best to directly visualize the area using a technique called fiberoptic nasal endoscopy. That's because her bleeding may be from a cold, allergies (and needing to constantly blow her nose), dry air, or—rarely—from an anatomical problem in the back of her nose.

Sorry to be vague, but further testing by a family physician, pediatrician, ear, nose and throat specialist (otolaryngologist) or allergist is needed for your girls—as well as the kittens—before a determination can be made. That's because allergy symptoms may include sneezing, a stuffy and/or runny nose, and itchy and watery eyes. And, if your child already has asthma, the symptoms of wheezing, coughing and shortness of breath may be intensified if she is truly allergic to the cats' dander (small and invisible flakes of animal skin), fur, saliva, or even the cats' urine.

In helping to determine if your daughters' have cat allergies, their physician would need answers to the following concerns:

• What are their symptoms?
• When do they occur?
• Do they go away in other surroundings (outdoors, at school, friend's house, etc.)?
• Do they only happen at night or when in close proximity to cats or to areas where cats live?
• Are the symptoms more common during certain seasons of the year?
• Did your daughter with asthma have that problem before the arrival of the kittens?

If there are still questions as to cat allergies or other health issues, their physician may want to include blood tests and/or allergy testing in order to firm up the diagnosis.

While cat allergies may never completely go away, there are measures you can take to reduce the scope of the allergic reaction to them. These include but aren't limited to:

• Having the air vents in your home professionally cleaned
• Keeping the cats out of the bedroom
• Washing the bedding, including mattress cover, sheets, blankets, and pillow cases in hot water (140 degrees) once per week (or more frequently if the cat found its way into the bed) to eliminate or suppress the cat-allergen concentrations
• Using room-size high-efficiency particulate (HEPA) air filters
• Vacuuming the house on most days of the week using a HEPA-equipped cleaner
• Vapor steam-cleaning your carpets, upholstery and curtains at least once per week. This chemical-free method helps eliminate dust mites and cat allergens
• Replacing fabric-covered furniture with vinyl or leather products
• Grooming the cat in an area that is off-limits to those who may be allergic
• While not ideal, confining the cats to areas of your home without carpets may be necessary
• Allowing only non-asthmatic and non-pet-dander-allergic members of your home to clean the litter box
• Vacuuming all hard floors using a device with a HEPA filter
• Frequently changing air conditioner and heating vent filters

If the above measures aren't successful, other options include medications to treat both allergies as well as asthma; allergy shots; and as a last but not pleasant choice, relocating the cats to a new home where they will also be loved and kept happy and safe.

For further information, please visit the National Institutes of Health at www.nih.gov as well as the National Jewish Medical and Research Center at www.njc.org. 

Find all articles by Dr. Rob

Do you have a health question you'd like to ask Dr. Rob? Send e-mail to experts@microsoft.com. Please include Ask Dr. Rob in the subject line.

Each of our experts responds to one question each week and the responses are posted on Mondays on MSN Health. We regret that we cannot provide a personalized response to every submission.

Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)