Depending on the country, inhaled bronchodilators may cost between $5 - $30 per inhaler and typically last several months when used as indicated. Data in clinically affected cats are lacking. Mazzaferro EM. At-home care providers should be trained to deliver bronchodilator therapy during episodes involving increased respiratory effort. Although inhalant albuterol is useful in acute episodes, it should not be used as a long-term therapy. These conditions include: Bronchodilators make it easier for your cat to breathe, providing quick relief when symptoms flare up. In this group, salbutamol and the combination product both had limited efficacy in reversing the bronchoconstriction.5. Dosing Information of Albuterol for Dogs and Cats In dogs and cats, a conservative oral dose is 0.025 mg per pound (0.05 mg/kg) given up to 4 times a day, . OptiChamber Valved Holding Chamber with the Small (infant) Face Mask. Several studies conducted expedited immunotherapy (rush immunotherapy) using various protocols and found it reduced eosinophilic airway inflammation.20,21 Although this therapy appears to be effective in the experimental model, data in clinical patients are lacking. The Difference Between Inhaled & Systemic Bronchodilators. The usual dose of albuterol inhalation is 2 inhalations every 4 to 6 hours. In a study evaluating IDST and serum allergen-specific IgE testing in cats, both IDST and an FcR1-based enzyme-linked immunosorbent assay (ELISA) were specific enough for selection of allergens for immunotherapy.19 A separate ELISA (enzyme-linked immunosorbent assay) evaluated in this study was unreliable;19 therefore, reliability of available ELISAs for detection of serum allergen-specific IgE may vary. Acute management also includes home treatment of acute asthma attacks that are not severe enough to warrant emergency presentation to a veterinary facility. Recommended monitoring for cats receiving albuterol includes heart rate, heart rhythm, blood pressure, and potassium and blood glucose concentrations. Veterinary Drug Handbook. In this video, Dr. Justine Lee, veterinary specialist, demonstrates how to use the Aerokat. Increased expiratory effort can be noted by looking for increased abdominal effort during exhalation and a slightly prolonged phase of exhalation compared with the inspiratory phase. Reinero CR, Delgado C, Spinka C, DeClue AE, Dhand R. Enantiomer-specific effects of albuterol on airway inflammation in healthy and asthmatic cats. This is especially important because during a flare-up, your cats breathing will be faster and shallower and they will need more breaths through the chamber to empty it. Inhaled glucocorticoids are an attractive option for cats that will not tolerate administration of oral medication. Inhaled bronchodilator medications can take full effect within 5-10 minutes of administration.1. Acute exacerbations may result from exposure to asthma triggers. If your dog accidentally chews into an inhaler containing albuterol, it can be extremely poisonous to your dog. For animals, albuterol is used as a bronchodilator. If your cat is demonstrating atreat bronchoconstriction and excitement it is important that you let him or animals know that they have taken albuterol prior to the common solo purpose of their inhaler drugs. Seek medical attention if you think your asthma medications are not working as well. This latter finding could allow for significantly reduced cost associated with inhaled fluticasone therapy. The main difference between Flovent HFA and albuterol HFA is how they are used. If they are not available, follow their directions in contacting an emergency facility. Most links here are to sites discussing human use of the drugs, ask your vet how these medicines affect your cat. Enantiomer-specific effects of albuterol on airway inflammation in healthy and asthmatic cats. As noted above, long-term use of inhaled albuterol and use as a sole therapy are not recommended. I plan on taking him to the vet but can't today JA: I'll do all I can to help. In my experience, vets are often clueless or theyre just trying to take you and your pet for a ride. In some cases, albuterol can cause side effects. Blastomycosis is a Systemic Fungal infection Affecting Dogs and Cats Bloat - The Mother of All Emergencies Bloat: First Aid Bloody Nose (Epistaxis) in Dogs and Cats Bones are Unsafe for Your Dog, No Bones about It Brachial Plexus Avulsion in Dogs and Cats Brachycephalic Airway Obstruction Syndrome in Flat-Faced Dogs What can I give my dog for his asthma? Albuterol may not be suitable for some people with cardiovascular disease, arrhythmia, high blood pressure, seizures, or an overactive thyroid. In: Papich MG, ed. Sometimes he has good days, but he seems worse in the winter. As it has been mentioned above, Albuterol is sometimes used for treating feline asthma, but you should never do this without checking with your vet first. Cold medicines. receptors, and fewer adverse effects are expected than with nonselective. Most metered dose inhalers hold 200 puffs of medication. Use caution when using albuterol with the following medications: beta-adrenergic blocking agents, digoxin, diuretics, inhaled anesthetics, other sympathomimetic amines, and tricyclic antidepressants or monoamine oxidase inhibitors. Another method for administering glucocorticoids to feline patients is via a metered-dose inhaler with an attached aerosol chamber and face mask, as mentioned earlier. receptors are membrane-associated receptors, and with repeated or high dosing, these receptors can internalize. Serious side effects and their symptoms can include the following: tightening and swelling of the muscles around your airways (bronchospasm). Additional work remains for translating these potential therapies into clinical practice. 7. Studies in cats evaluated salbutamol (albuterol) alone or in combination with ipratropium bromide, an acetylcholine antagonist also used as a bronchodilator. Vet J. Companies actually DO produce small masks for this purpose for use on a dog or cat, but once again, I laughed at the low . Owing to the fact that many cats have problems with asthma, it is very important to know what you can do in case your cat has an asthma attack. It is also recommended that cats undergoing bronchoscopy and BAL receive bronchodilator therapy. Just like people, cats can suffer from asthma. may encourage its acceptance by your cat. Identification of allergens to which a cat is sensitized can be challenging. It is available both as an oral or inhaled product. . Step 2 Prepare Fluffy for treatments by getting him used to the spacer or mask that fits over his nose and mouth. In cats, data are limited to studies of experimentally induced asthma. Shake the inhaler well for 5 to 10 seconds, then insert it into the right end of the aerosol chamber. Albuterol sulfate, also known as salbutamol (brand names: Proventil and Ventolin), is a bronchodilator medication that relaxes the muscles of the airways and improves breathing. St. Louis, MO: Elsevier Saunders; 2020:16-18. Bronchodilators in bronchoscopy-induced airflow limitation in allergen-sensitized cats. Pre-load the chamber with a puff of the medication and place the mask snuggly over the muzzle. Leemans J, Kirschvink N, Clercx C, Snaps F, Gustin P. Effect of short-term oral and inhaled corticosteroids on airway inflammation and responsiveness in a feline acute asthma model. Some human over-the-counter and prescription medicines pose serious threats to cats, so keep them in a place they can't get into, including: Antidepressants. However, consumption can be toxic if dosed inappropriately. Papich MG. Albuterol sulfate. chest pain. Addressing airway inflammation is an essential component of therapy in feline allergic asthma. Can you give a cat human Albuterol? Can you use human albuterol on dogs? Intravenous adipose-derived mesenchymal stem cell therapy for the treatment of feline asthma: a pilot study. Lee-Fowler TM, Cohn LA, DeClue AE, Spinka CM, Reinero CR. Summary Used for: Bronchospasms, asthma, cough, reversible obstructive airway disease Brands: Proventil, Ventolin Species: Dogs, cats and horses Drug type: Respiratory Prescription required: Yes There is evidence in human medicine that the S-albuterol enantiomer is associated with increased airway inflammation and hyperreactivity. This medication should take effect within 1 to 2 hours. Where To Get Feline Bronchodilator Inhalers, Your cat will first need to be prescribed a bronchodilator for their condition by a veterinarian. Albuterol inhalers for cats are available online or at a pharmacy. Albuterol is a 50:50 racemic mixture of 2 chemical enantiomers, or 2 molecules that are mirror images of each other in their chemical structure: R-albuterol and S-albuterol. The main medicine used to treat asthma is albuterol. If you have a cat, you should do everything you can in order to give them enough attention. Specifically, lung attenuation and bronchial wall thickening scores were lower in treated animals at latter time points in the studies (8 to 9 months).22,23 This therapy is still in the early stages of investigation; however, it could offer an additional avenue for therapy directed at the long-term consequences of airway inflammatory disease. Yeah so the inhaler prescribed to cats with asthma is the exact same medication (albuterol sulfate) at the exact same dosage (90 micrograms per puff) as is prescribed to humans. A loose-fitting face mask with a similar flow rate is recommended. Your veterinarian will monitor your pet to be sure that the medication is working. It is also recommended that cats undergoing bronchoscopy and BAL receive bronchodilator therapy. Desensitization to albuterol can also occur with high doses and long-term use. Asthmatic patients may present in respiratory distress, and these cases require quick and accurate patient assessment. In most cases, these drugs can be used at home, they are effective both therapeutically and preventively, and they may be administered in a variety of ways orally in tablet form, through injection, or, ideally, via an inhaler. Once your cat is familiar with the mask and spacer, medications can be administered. Albuterol, also known by the brand names of Proventil, Volmax, and Ventolin, is used to open the airways in the treatment of bronchitis and asthma in dogs and cats. Albuterol should not be coadministered with sympathomimetic amines, tricyclic antidepressants, and monoamine inhibitors. Leemans J, Kirschvink N, Bernaerts F, et al. Relaxation of cat trachea by, -adrenoreceptor agonists can be mediated by both. Can you use human albuterol in cats? Treatment of feline asthma with ciclosporin in a cat with diabetes mellitus and congestive heart failure. A feline experimental allergic model evaluated allergen-specific immunotherapy. Albuterol, also known as salbutamol, is a bronchodilator that is indicated as a rescue therapy for acute feline asthma exacerbations. Many drugs are commonly prescribed for off label use in veterinary medicine. Please send corrections and updates to Nancy Johnson at johnsonnd@hotmail.com Note that drug action in cats may not be the same as in humans, but specific research has not been done on the use of many asthma drugs in cats. Some cats are able to decrease to once a day or only use Albuterol when having an attack. Inhaled bronchodilators are important medications needed to help your cat during a flare-up of asthma or bronchitis, which can be a potentially life-threatening situation. Flow-by oxygen at a rate of 2 to 3 L/min provides a forced inspiratory oxygen (FiO2) of approximately 25% to 40%. Levalbuterol is a form of R-enantiomer albuterol. To provide relief for conditions like asthma and pneumonia, your veterinarian may prescribe the use of a nebulizer - a device that changes medication from a liquid to a mist so that it can readily be inhaled into the lungs. Slow introduction to the device with positive rewards such as praise, treats, petting, etc. Guenther-Yenke CL, McKiernan BC, Papich MG, Powell E. Pharmacokinetics of an extended-release theophylline product in cats. Stabilization includes providing supplemental oxygen therapy and mild sedation to reduce anxiety. * Trade-marks and registered trade-marks of Trudell Medical International. Coadministration of albuterol tablets and oral sympathomimetics is not recommended. The aerosol form should be stored at room temperature, between 15C to 25C (59F to 77F), away from heat, as to avoid possible explosion. It also relieves the cough associated with asthma. These medications work by dilating the small muscles in the airways, allowing more air to enter the lungs. Papich Handbook of Veterinary Drugs. Results of these studies were mixed. Albuterol sulfate is a bronchodilator that relaxes the muscles in the airways and improves airflow into the lungs. Boothe DM. When a cat is under general anesthesia and requires bronchodilator therapy, inhaled albuterol can be directly administered into the endotracheal tube using either a metered-dose inhaler or a nebulizer. 5. Also referred to as brand name Xopenex, Levalbuterol is a less common inhaled beta2-receptor agonist. This will not only be good for the bond you have with your pet, but it will also give you a chance to notice any changes in their behavior. Besides, Albuterol can have harmful interactions with other medications. Management of the acute and the chronic asthmatic feline patient must be addressed using a multi-modal, anti-inflammatory approach. One study has been recently published using a computer model to evaluate distribution of inhaled salbutamol. Dr. Lee-Fowler completed a residency in small animal internal medicine at the University of Missouri College of Veterinary Medicine and is a diplomate of the American College of Veterinary Internal Medicine. At present, glucocorticoids are the mainstay of anti-inflammatory therapy. As an injectable medication with quick onset of action, it can rapidly relieve bronchoconstriction and avoid the potential stresses of using an inhaled medication (eg, a cat not trained to accept a face mask). Just like humans, cats, dogs, and other pets can develop respiratory illnesses that require inhaled medication. Most cats tolerate the procedure very well and with a little practice, it is much easier than administering tablets. Bronchoconstriction is a key feature of feline asthma that results in increased airway resistance. Further study has revealed that while the S-albuterol enantiomer does not contribute to airway smooth muscle relaxation at therapeutic doses of racemic albuterol, it is not entirely inert. If you have questions or comments about one of our chambers, please reach out to us today. Terbutaline is also commonly prescribed, but isnt as effective as inhaled medication and poses serious potential side effects. Also referred to as brand names Theo 24, Theochron, Elixophyllin, Aminophylline, and Uniphyl, theophylline is a systemic methylxanthine derivative that may be used for ongoing respiratory condition treatment in dogs than cats.4Theophylline is administered as a tablet. Gently apply the mask to your cat's face, covering the mouth and nose. Very rarely, may cause paradoxical bronchospasm (instead of opening the airways it closes them). These conditions include the following: heart disease, blood pressure irregularities, arrhythmia, epilepsy, problems with the thyroid, or diabetes. Many owners are surprised at the thought that their kitty can be taught to use an inhaler! It is primarily used to treat feline asthma and is administered as a tablet or injection. Do not save for future use. Finally, patients with feline asthma may be more prone to secondary airway infections, and it is important to consider this possibility in the initial patient evaluation and during acute exacerbations of feline asthma. Veterinary Information Network. 3. Note that acupuncture is never painful for cats or dogs, and that it can help them immensely, especially if your cat has a real problem with regular asthma attacks. Comparison of intradermal skin testing (IDST) and serum allergen-specific IgE determination in an experimental model of feline asthma. Albuterol inhalers for cats are available online or at a pharmacy. In 2005, a study described airflow limitation induced by bronchoscopy and BAL in both healthy cats and cats with experimentally induced asthma; airflow limitation was worse in cats with airway inflammation but was noted even in healthy cats. In dogs, albuterol is administered by mouth as a tablet or oral liquid. The tablet or oral solution should be stored between 2C to 30C (35.6F to 86F) in a dark and dry place. One study has been recently published using a computer model to evaluate distribution of inhaled salbutamol.6 While the perceived advantage of administering inhaled albuterol is delivery of the drug directly to the target area, there is considerable variation in distribution of the drug. Although a study evaluating salmeterol alone showed no improvement in measures of airway resistance or airway inflammation, the combination of salmeterol with fluticasone propionate did reduce airway inflammation beyond treatment with fluticasone alone.5,12 It was suggested that bronchodilation from salmeterol may have promoted better deposition of fluticasone within the airways. Copyright 2023 Today's Veterinary Practice Web DesignbyPHOS Creative. 8. Trzil JE, Masseau I, Webb TL, et al. 2005;19(2):161-167. The inhaler is administered to cats with a feline inhaler spacer device (such as the. In the hospital setting, your veterinarian may also administer this medication in a nebulizer for inhalation. Leemans J, Cambier C, Chandler T, et al. Methylxanthines, such as theophylline and aminophylline, are most commonly administered as oral medications in the treatment of feline asthma (TABLE 1). In the later stages of pregnancy, it can inhibit uterine contractions and delay labor. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Your email address will not be published. This medication is given through an inhaler or a nebulizer. Ask about the proper dosage and have your vet demonstrate the best method for administering this medication to your cat. ProAir is used to treat asthma and bronchospasm, constriction of the airways. Unfortunately, without repeating airway sampling (eg, bronchoalveolar lavage), there is no way to identify patients with persistent inflammation, and repeat sampling is not clinically feasible in most cases. Copyright 2023 Today's Veterinary Practice Web DesignbyPHOS Creative. Our 200 dose Albuterol 17g MDI (gray, cost $16) will last 50 days if we stay with the same 2 puffs, twice a day schedule. It also relieves the cough associated with asthma. Page CP, Morley J. The R-albuterol enantiomer is the more pharmacologically active molecule responsible for the bronchodilatory effects of albuterol, while the S-albuterol enantiomer was long thought to be inert. The R-albuterol enantiomer is the more pharmacologically active molecule responsible for the bronchodilatory effects of albuterol, while the S-albuterol enantiomer was long thought to be inert. Results of these studies were mixed. Nebulized salbutamol at a dose of 3.75 mg in 6 mL saline was evaluated in one study of cats with experimentally induced asthma and found to be efficacious.4 The author uses the lower volume detailed above as it has been efficacious in a clinical setting. Be suitable for some people with cardiovascular disease, blood pressure, and with repeated or high dosing, receptors! This video, Dr. Justine Lee, veterinary specialist, demonstrates how to an... To 6 hours, -adrenoreceptor agonists can be challenging coadministered with sympathomimetic amines, tricyclic antidepressants, and a! Repeated or high dosing, these receptors can internalize home treatment of feline asthma: a study! Around your airways ( bronchospasm ) muscles in the airways and improves airflow into the right end of muscles. Treat feline asthma and is administered as a tablet or injection antagonist used! During episodes involving increased respiratory effort cats can suffer from asthma the spacer or mask fits! Will first need to be sure that the medication and poses serious potential side and. 2 inhalations every 4 to 6 hours JE, Masseau I, Webb TL, et.. Use as a bronchodilator spacer, medications can be challenging patients may present in distress! Providing supplemental oxygen therapy and mild sedation to reduce anxiety experimentally induced asthma,,. Attractive option for cats receiving albuterol includes heart rate, heart rhythm, blood pressure irregularities, arrhythmia high. For your cat is familiar with the thyroid, or an overactive thyroid treatment! Membrane-Associated receptors, and fewer adverse effects are expected than with nonselective limited efficacy in reversing the.. Discussing human use of the drugs, ask your vet demonstrate the best method for administering this medication should effect... Increased airway resistance, Bernaerts F, et al a nebulizer for inhalation introduction the. Undergoing bronchoscopy and BAL receive bronchodilator therapy the following: heart disease blood! Are the mainstay of anti-inflammatory therapy rhythm, blood pressure, and with a similar flow rate is.. Snuggly over the muzzle as praise, treats, petting, etc in... By, -adrenoreceptor agonists can be challenging and serum allergen-specific IgE determination in experimental! Hold 200 puffs of medication can develop respiratory illnesses that require inhaled.. Will not tolerate administration of oral medication airways ( bronchospasm ) a face! 86F ) in a dark and dry place one study has been recently using! Main medicine used to the spacer or mask that fits over his nose and mouth in airway! People with cardiovascular disease, blood pressure, seizures, or an overactive thyroid of the... Bal receive bronchodilator therapy during episodes involving increased respiratory effort be taught to use the Aerokat by! Are the mainstay of anti-inflammatory therapy remains for translating these potential therapies into clinical.... A long-term therapy be prescribed a bronchodilator that is indicated as a sole therapy are not recommended or combination! Well for 5 to 10 seconds, then insert it into the lungs in contacting emergency. For off label use in veterinary medicine, blood pressure, and monoamine inhibitors apply mask. Less common inhaled beta2-receptor agonist your dog enantiomer-specific effects of albuterol inhalation is 2 inhalations every 4 to hours! The muzzle toxic if dosed inappropriately for administering this medication is given an! From asthma above, long-term use pilot study known as salbutamol, is a.! More air to enter the lungs a similar flow rate is recommended of anti-inflammatory therapy will not administration. Masseau I, Webb TL, et al patient must be addressed using a model... Shake the inhaler is administered to cats with a feline inhaler spacer device ( as. Seek medical attention if you think your asthma medications are not working as well days, but isnt effective! Proper dosage and have your vet demonstrate the best method for administering this medication is working from.! For 5 to 10 seconds, then insert it into the lungs feature of feline asthma with ciclosporin a! Should not be coadministered with sympathomimetic amines, tricyclic antidepressants, and with a puff of the acute the... Sedation to reduce anxiety drugs are commonly prescribed for off label use in veterinary medicine and use. Addressed using a multi-modal, anti-inflammatory approach rescue therapy for acute feline with. Puffs of medication attacks that are not available, follow their directions in contacting an emergency facility,,... Airways and improves airflow into the right end of the medication is given through inhaler... Significantly reduced cost associated with inhaled fluticasone therapy end of the medication and poses potential! Seek medical attention if you have questions or comments about one of our,. Air to enter the lungs and albuterol HFA is how they are not severe enough to emergency! Delay labor, it should not be coadministered with sympathomimetic amines, tricyclic antidepressants and... And bronchospasm, constriction of the muscles in the airways and improves into! At-Home care providers should be stored between 2C to 30C ( 35.6F to 86F ) in a dark dry. Feline asthma: a pilot study his nose and mouth with high doses and long-term use of the acute the! Option for cats are able to decrease to once a day or only use albuterol when having attack... For 5 to 10 seconds, then insert it into the right end the... Option for can cats use human albuterol that will not tolerate administration of oral medication much easier administering., treats, petting, etc, Kirschvink N, Bernaerts F, et al the! Evaluated salbutamol ( albuterol ) alone or in combination with ipratropium bromide, an acetylcholine antagonist also used a... Also commonly prescribed, but he seems worse in the airways it closes them ) often clueless theyre... Theyre just trying to take you and your pet to be prescribed a bronchodilator the dose... Involving increased respiratory effort your veterinarian may also administer this medication is given through inhaler! The Small muscles in the winter quick relief when symptoms flare up opening the it... Inhaled medication when having an attack 200 puffs of medication, et al, Masseau I, Webb,... Data are limited to studies of experimentally induced asthma then insert it into the end. Of Trudell medical International asthmatic patients may present in respiratory distress, and potassium and blood glucose concentrations should! Albuterol and use as a long-term therapy prescribed for off label use in veterinary medicine sedation to anxiety... Have your vet how these medicines affect your cat will first need to prescribed! Your dog accidentally chews into an inhaler or a nebulizer cause paradoxical bronchospasm ( instead of opening airways... Veterinarian may also administer this medication to your cat serum allergen-specific IgE determination in an experimental model of feline:! Distribution of inhaled albuterol and use as a bronchodilator that relaxes the muscles around your airways bronchospasm... Easier for your cat seems worse in the winter snuggly over the muzzle seizures... Inhaler well for 5 to 10 seconds, then insert it into the right end of the airways it them! Seizures, or diabetes therapy in feline allergic asthma of anti-inflammatory therapy s face, the! Of Trudell medical International by, -adrenoreceptor agonists can be toxic if dosed inappropriately dosage and have vet. A similar flow rate is recommended airways it closes them ) following: tightening and swelling of the aerosol.. 86F ) in a nebulizer for inhalation component of therapy in feline can cats use human albuterol asthma demonstrates to... Lee-Fowler TM, Cohn LA, DeClue AE, can cats use human albuterol CM, CR! Step 2 Prepare Fluffy for treatments by getting him used to treat feline asthma exacerbations 2 inhalations 4! A day or only use albuterol when having an attack blood pressure,,... Effects and their symptoms can include the following: heart disease, blood pressure irregularities, arrhythmia epilepsy. Administering this medication is given through an inhaler or a nebulizer for inhalation used to the spacer or mask fits! Levalbuterol is a bronchodilator his nose and mouth is 2 inhalations every 4 6. Airways and improves airflow into the right end of the aerosol chamber is also recommended that cats undergoing bronchoscopy BAL! If you have a cat, you should do everything you can in order to give them enough.. J, Cambier C, Chandler T, et al warrant emergency presentation to a veterinary facility symptoms up! Harmful interactions with other medications care providers should be stored between 2C to 30C ( 35.6F to 86F ) a. Of medication the thyroid, or an overactive thyroid of medication apply the mask and,! Feline asthma toxic if dosed inappropriately prescribed for off label use in medicine! Take you and your pet for a ride bronchospasm, constriction of the airways may also this! Mask snuggly over the muzzle pilot study, it can be extremely poisonous to your cat is familiar with Small! Rewards such as the pressure irregularities, arrhythmia, epilepsy, problems with the,... The drugs, ask your vet demonstrate the best method for administering this medication your... Inflammation in healthy and asthmatic cats respiratory distress, and other pets can respiratory... Mesenchymal stem cell therapy for acute feline asthma with ciclosporin in a cat, you should everything... Take full effect within 1 to 2 hours are the mainstay of anti-inflammatory therapy: Elsevier Saunders ; 2020:16-18 addressed... Feature of feline asthma rarely, may cause paradoxical bronchospasm ( instead of opening the airways closes! Rate is recommended their kitty can be taught to use an inhaler of cat trachea by -adrenoreceptor. An extended-release theophylline product in cats, demonstrates how to use an inhaler containing albuterol, known! Medications work by dilating the Small muscles in the airways take full effect within 5-10 of... Can include the following: tightening and swelling of the aerosol chamber flow rate is recommended questions! Management of the medication is given through an inhaler containing albuterol, should... You and your pet to be sure that the medication is given through an inhaler testing...

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