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Although dog is considered to be man's best friend, man is truly the
domestic cat's best friend. Allergic and asthmatic cat-lovers tenaciously
bond to their cats, forever loyal to these feline friends, in many
instances disregarding the advice given by concerned physicians to "Get
rid of the cat." Their decision, not to comply with the good doctor's
advice, comes from the heart and not from the brain. For, after all, we
all know that our pets, especially cats, give us, as one patient stated,
"unconditional love." Not one of us would part willingly with this
important dividend of life. Nevertheless, in order to put cat allergy in its
proper perspective and to be able to make informed choices, allergic
cat-lovers and those family members who share in health care decisions
should consider the facts. It is time to break the silence, to speak out, to
"let the cat facts out of the bag".
LET THE CAT FACTS OUT OF THE BAG!
Here are some cat facts.
· Approximately six million Americans (2.3% of the population) are
allergic to cats.
· One-third of households in the United States contain one or more cats.
· One-third of all allergic patients are allergic to cats.
· Between one-third and two-thirds of asthmatic patients are allergic to
cats.
· One third of the persons in the United States who are allergic to cats
live with at least one cat in the house.
· Two-thirds of adult cat-allergic asthmatics still have pet cats in their
homes despite the fact that they know they are allergic to cats.
If you think about it, this last fact does not make sense, since the first
step in managing asthma is to eliminate exposure to the underlying
allergens that trigger a patient's asthma,. It does highlight the difficulty
that allergic asthmatic cat-lovers have in parting with these pets by
removing them from their homes.
WHEEZE NOW AND PAY FOR IT LATER!
You do not have to be a rocket scientist to realize that you are
significantly allergic to cats if soon after walking into a friend's house
where there are cats you suddenly begin to sneeze, cough, and
wheeze, and your eyes become red, watery, and itch. This acute onset
reaction, due to release of histamine-like substances, is startling; its
memory is long lasting and instructive. In contrast to the acute reaction,
a later phase reaction also occurs in allergic people continuously
exposed to cat allergen in their own homes. In this more common
instance, the relationship to the cat allergen stimulus is not always
evident. In allergic people who live with cats, an insidious inflammatory
reaction develops in the cells and tissues that cover the inside surfaces
of the nose, sinuses, and breathing (bronchial) tubes of the lungs.
Inflammation is responsible for nasal congestion, watery secretions,
sneezing, and for bronchial congestion and airway hyperirritability
leading to cough chest tightness and wheezing. Because the late phase
reaction is insidious, the cat-allergic asthmatic is less apt to recognize its
importance. Late phase inflammation is long-lasting and the most
important reason for chronic asthma and irreversible lung damage. Its
continuing presence is the reason that many children do not outgrow
asthma. Inflammation is the underlying reason for airways
hyperirritability, "twitchy lungs", and hyperresponsiveness to a variety
of stimuli. It is the reason asthmatics wheeze when they run, laugh, cry,
or when outside in the cold air characteristic of BINGHAMTON winters.
EXPOSURE TO CATS IS A RISKY BUSINESS!
There are two studies that indicate exposure to high levels of allergens,
especially early in life, is associated with an increased risk of developing
sensitization to that allergen. Two additional studies indicate that
individuals who have become sensitized to house dust mites and cat
have an increased risk of developing asthma, whereas those sensitized
to the seasonal allergen grass pollen do not. Other studies have
demonstrated that allergic patients who live with animals at home
require higher doses of steroids to maintain control of their asthma.
Thus, it follows that reducing children's exposure to mites and cats will
reduce their chance of becoming allergic (sensitized) to mites and cats,
help prevent them from developing asthma, and if they get asthma,
reduce their need for steroid medications. Because genetic factors are
also crucial in the development of asthma, these risks are especially
important in families with a strong history of asthma and other inherited
allergic conditions such as hayfever and eczema.
THESE ARE IMPORTANT FACTS TO THINK ABOUT!
The important facts are:
· Allergy to cats can predispose a child to develop asthma in the first
place.
· Cat allergy can cause asthma attacks and other asthma symptoms such
as cough and chest tightness in children and adults.
· Cat allergy is the reason some children do not outgrow their asthma.
· Asthma is the most frequent cause of admission to childrens hospitals.
· Asthma is a leading cause of absenteeism from school and work.
· Asthma impairs the quality of life of cat-allergic children and adults.
IT'S NOT THE CAT, IT'S THE CAT ALLERGEN?
The major cat allergen responsible for human allergy is a protein (Fel d
1) produced by the sebaceous glands of all cats. These glands are
distributed on all areas of the cat's fur with increased numbers around
the neck. The sebaceous glands of male cats make more Fel d 1 than
female cats. Castration (neutering) of male cats reduces Fel d 1
production but does not eliminate it. Fel d 1 is deposited on the cat's hair
as the hair grows and as the cat grooms itself by licking (preening). It
then flakes off the hairs and becomes airborne. Because Fel d 1 is small
(60% less than 2.5 micrometers in diameter) and buoyant, it remains in
the air for a long time even if the air is not disturbed. This is in contrast
to dust mite allergen (Der f) which is most concentrated in settled dust.
PASSIVE EXPOSURE TO CAT ALLERGEN IS LIKE PASSIVE SMOKING!
Fel d 1 not only floats in the air but it also sticks to walls and is present in
carpets, mattresses and upholstered furniture. It is carried on clothing
and can be transferred to places where cats are not usually found.
Significant amounts of cat allergen have been measured in schoolrooms,
hospitals, shopping malls, and even in doctors' offices including the
allergist's office. Unsuspected inhalation of cat allergen is similar to
passive inhalation exposure to tobacco smoke. Both are capable of
contributing to disease. The fact is:
· Studies have shown that over 50% of patients with cat allergy have
never owned a cat.
BUT, I LOVE MY CAT! HE'S A MEMBER OF OUR FAMILY!
So what do you do if you suspect that you and/or your child are allergic
to cats? After the diagnosis of cat sensitivity is made by allergy skin
testing, consider the following sequential choices and discuss them with
those family members and physicians who share in your health care
decisions.
1. Don't get a cat in the first place. This is the best method of prevention
for families who have histories of allergic conditions such as hayfever,
asthma, and eczema.
2. Remove the cat from the house. This is the best method of
management. However, cat allergen may remain in the house for years.
It takes six months for airborne levels to fall.
3. Keep the cat out of the bedroom. This just does not work. Cat
allergen circulates in the air throughout the house.
4. Wash the cat frequently. This is difficult to do. There is no sustained
effect of cat washing on airborne Fel d 1 levels. Cat allergen returns
quickly within one week.
5. Allerpet-C (Allerpet Inc., New York, N.Y.) applied to a cloth used to
wipe down the cat has nothing more to offer than plain water.
6. Use an air filter in the bedroom. When used alone, this has not
significantly reduced airborne cat allergen.
RESULTS OF CAT STUDY
Effects of environmental modifications on airborne Fel d 1 in bedrooms
of 13 cat-allergic asthmatic patients with cats were evaluated. They
were randomly assigned to Group A, B, or C. Group A used an Invisible
Fence that trains cats not to enter bedrooms, and 4 other measures -
barriers for mattress and pillows (Allergy Control Products, Inc.),
weekly vacuuming with HEPA Vacuum Cleaners (Nilfisk), running HEPA
Air Purifiers (Cloud 9) 24 hrs/day, and treating carpets with 3% tannic
acid (Allersearch) at the beginning of the study. Group B used the
allergen controls but no Invisible Fence. Group C used only the Invisible
Fence. Undisturbed paired air samples were obtained simultaneously
from a modified bedroom and an unmodified (control) room of similar
size and furnishing in each home every 6 - 8 wks for 6 mos. Blinded
samples were assayed for Fel d 1 (ng/m3).
In Group A, average airborne Fel d 1 levels (ng/m3) were significantly
lower in the modified bedrooms vs unmodified rooms (2.49 vs 5.24,
p=0.04, two-tailed t-test using the average of observations per subject
within the group). In Group B, average Fel d 1 levels were not
significantly lower in the modified vs unmodified rooms (3.26 vs 3.98,
p=0.57). Group C had higher Fel d 1 levels in the modified bedrooms
(5.42 vs 3.74, p=0.58). The difference was not significant.
Therefore, training cats not to enter bedrooms using an Invisible Fence
(Group C) was not sufficient to lower airborne Fel d 1 levels. Allowing
cats to enter bedrooms but using aggressive environmental controls
(Group B) was not sufficient either. By using the Invisible Fence,
barriers, HEPA air filters and vacuum cleaners (Group A), Fel d 1
airborne levels could be reduced by 50%. Further studies are now
needed to determine if these aggressive environmental modifications
reduce asthmatic symptoms.
Until effective means of modifying the allergic response or modifying the
environment are found and these measures are proven to be clinically
useful, expert clinical scientists in this field agree that physicians must
continue to take a firm stand on the issue of cat removal when it would
clearly be in the patient's best interest.
