“Do I really have to get rid of our cat?” my patient asked with a glimpse of a tear in her eyes. Her little boy, Samuel, had recently been diagnosed with asthma and she had been told that she should find another home for her cat. “Sammy’s cat is his best friend and he would be devastated to lose him.”

Cats are known to be a common allergen for many asthmatics and allergy-prone individuals. Cat allergen is secreted by glands in the cat’s skin and is found on the skin and the fur. Allergic reactions can also be caused by exposure to an animal’s urine, feces and saliva. Common advice in the past has always been to remove cats from the household. However, certain studies recently have shown that this may be of limited value in decreasing an asthmatic’s symptoms. Other studies have suggested that exposure to cat dander may also have a protective desensitization effect in some individuals might prevent the development of cat allergies later on.

Many studies are finding that although cat allergen is of course higher in homes of individuals who keep cats, significant levels are also found in cat-free homes as well as in public buildings including schools and offices. It is almost impossible to get away from cat dander, particularly in communities that have a high level of cat ownership, as the allergen can travel in the air and on the clothing of others.

So what is an asthmatic to do? The solution is not always clear. The immediate benefit of removing the cat from the home may not be apparent for up to six to twelve months. Often the cat is a beloved family member is would be emotionally traumatic to lose it. Most studies seem to indicate that if there are no cats in the household, it would be best not to get one. If there is already a cat in the home, unless it is a clearly obvious trigger, it might be possible to keep it, particularly if precautions are taken to limit exposure as much as possible.

Steps that may be somewhat helpful include making the asthmatic’s bedroom a “safe place” where pets are prohibited. Removing carpeting and having laminate or other types of flooring may be helpful. Asthmatics should consider wearing a mask when vacuuming and cleaning their homes. Giving the cat a bath every week may be helpful in limiting the amount of dander on its fur and skin, although this may be quite challenging! High efficiency particulate air (HEPA) filters may be helpful, although the evidence is controversial depending on the brand of filter. Certain types of air cleaners actually emit ozone, which makes the air smell slightly sweet, but actually can be a trigger for many asthmatics.

Subcutaneous immunotherapy, often commonly referred to as “allergy shots,” can be helpful in reducing symptoms, but also can cause dangerous reactions particularly in asthmatics and should be administered only in a physician’s office. High-dose sublingual immunotherapy (under-the-tongue drops) has also been found to be effective in many cases without as much danger of a severe reaction and may be beneficial for up to four to five years after completion of the series. Immunotherapy may also be quite costly and time consuming as it generally involves twice-a-week administration for up to three to five years.

Individuals with asthma should ask their physician for a referral to an allergist for further testing and advice. It might be possible to keep Fluffy!