I have asthma and love my cats. Can peop

Call your prescriber this week to put the controller inhaler back on your existing plan and to get a written asthma action plan — and keep doing the two things you are already doing, cats out of the bedroom and the HEPA running. Most families can keep a cat and keep asthma controlled; the daily preventer, not the filter, is what holds the control together.

Where you stand right now

The filter is not the treatment. In a controlled trial in cat- and dog-allergic children with asthma, HEPA cleaners did trap airborne pet allergen, but there was no change in disease activity (Sulser et al., *International Archives of Allergy and Immunology*, indexed in the US EPA HERO database). The daily preventer is the treatment; the filter is housekeeping.

Do not

• Do not skip, halve, double, or swap the controller inhaler on your own, and never use someone else's inhaler — including another adult's or a school spare.
• Do not count puffs or work out "how much is left" from this answer. Your action plan and your pharmacist own that.
• Do not buy prescription inhalers online, and no mystery powders, herbal shortcuts, or "air-purifying" supplements.
• Do not add an ionizer/ozone air cleaner. ACAAI notes these can irritate allergies rather than help: particles stay put and the ozone is an irritant.
• Do not add a humidifier. ACAAI: keep indoor humidity below 50%, do not use vaporizers or humidifiers.
• Do not "test" by letting the cat into the bedroom to see what happens. That triggers flares; it does not teach you anything.
• Do not let scented sprays, incense, candles, or cooking smoke fill the house on a twitchy day — ventilate the kitchen when someone is frying, and let the asthmatic person step out while it is smoky.
• Do not rehome the cat in a panic tonight. Whether cats can stay is a question for a clinician who knows this person.

Red flags

Call 911 now (your local emergency number) if any of these are happening:

• Cannot speak in full sentences.
• Lips or fingertips blue or grey.
• The chest has gone quiet — the wheeze stopped while they still look unwell. A silent chest in an unwell person is deterioration, not improvement.
• Exhausted, drowsy, confused, or unable to walk to the door.
• Wheeze with rash, tongue or throat swelling, or collapse after a sting, food, or a medicine — treat that as anaphylaxis.
• Rapidly worsening over minutes to hours.

Same-day call to the prescriber or an urgent appointment if they can still speak in sentences but: the reliever is being needed more than usual, night cough or night wheeze has returned, chest tightness appears on exercise, or a child is missing school for breathing.

Never: use someone else's inhaler, start leftover antibiotics or steroid tablets from an old flare, wait on a home oxygen or peak-flow number before seeking help, or judge severity by how loud the wheezing sounds. Loud wheeze is not severity.

Tonight / today — decision tree

```
Is anyone in the house breathing badly right now?
├─ YES → Any red flag above?
│ ├─ YES → Call 911 now. Sit them up. Use only their own
│ │ prescribed reliever with their own spacer, exactly as
│ │ they were trained. Bring every inhaler and spacer.
│ │ Do not wait for a home number.
│ └─ NO (can still speak in sentences) → same-day call to the
│ prescriber. Tonight: sit up, own reliever only, cats
│ out of the bedroom, HEPA on, no smoke or scented
│ sprays, and log it.
└─ NO → Tonight's checklist (25 minutes, no cooking needed):
1. Bedrooms: cat out, door shut, HEPA running, window cracked
or fan if the air feels stuffy.
2. Damp-dust bedroom surfaces (damp cloth, not feather dust).
Vacuum with a HEPA vacuum if you have one — vacuuming stirs
dust up, so do it when the room is empty and let it settle.
3. Cat bedding: into the wash today, warm water, dry fully.
Groom the cat outdoors or in a room the asthmatic person
is not in.
4. Meds: put the controller inhaler and its spacer by the
toothbrush, so tomorrow's dose is a given, not a decision.
5. Write the call note below and send it.
```

The call to the prescriber or pharmacist is the only item on that list that changes asthma control. Everything else lowers the load on the lungs.

What the call should say

"I have asthma and I have been skipping my daily controller inhaler because [feeling fine / side effects / cost / running out] — I want to go back to it on the plan you gave me, and I need to know what to do on the days when I've missed it. Second: we have two cats at home. They stay out of the bedroom and we run a HEPA filter. Is that enough for me, should I be tested for cat allergy, and can I get a written action plan with names, doses and timing filled in — and can the nurse check my inhaler technique with a spacer?"

Bring every inhaler and spacer, the counter reading, how many times the reliever was used in the last day and week, night waking, and what set it off. Ask to be shown the technique — it is often wrong, especially in children, and it is free to fix.

If the school nurse is already on your list, fold this into that call instead of making a second one: ask for a copy of the written asthma action plan for each child, ask who holds the school copy of the plan and of the spare inhaler, and ask them to confirm the school's own technique check. One of your outstanding items is the inhaler not accounted for since the start of the month — make that the first question on that call, and ask for the written action plan in the same conversation.

24-hour success looks like this

Not "no symptoms ever" and not "the cats are proven safe." In the next 24 hours:

• Breathing at the same activities as yesterday, no new reliever use beyond what your own plan allows, no night waking.
• Controller inhaler back on the plan, in the same place each day, spacer with it.
• Bedroom: cat out, door shut, HEPA running, cat bedding in the wash or washed.
• One message or call sent to the prescriber or pharmacist, written action plan requested.
• Tonight's row of the log filled in.

The honest limit: HEPA filtration and a cat-free bedroom lower the airborne allergen load, but trials show filtration alone does not change asthma disease activity, and whether cat dander is a trigger *for this person* is decided by a clinician, often with skin-prick or blood testing. This plan is about doing everything you control at home while that question gets answered. It is not a promise that keeping the cat is safe, and it is not a cure.

The log (one line a day, on the fridge)

Three scripts to hand over

To the school or after-school caregiver
"[Child] has asthma. Their inhaler and spacer stay in [exact place] and travel in the outside pocket of their bag — if it is not in the bag, they do not go. If they start coughing, wheezing, or cannot finish a sentence: sit them up, help them use their own inhaler and spacer the way the school nurse showed them, and call me. If they cannot speak in full sentences, their lips go blue, or the wheezing stops while they still look unwell, call 911 right away. The cats never go in the bedroom — that is our rule at home too."

To the elder or sibling who is nearby
"Quick version: [name] has asthma and keeps a daily inhaler by the toothbrush. If they are coughing or wheezing, sit them up and help them use their own inhaler — do not use anyone else's inhaler, and do not stop their daily inhaler even if they say they feel fine. If they cannot speak a full sentence, their lips go blue, they look very tired, or the wheezing suddenly stops while they still look unwell, call 911 straight away. Cats stay out of the bedroom; if the cat is in the room and they are struggling, move the cat out first."

To anyone offering a shortcut
"I already have a plan from my doctor, so I'm not changing my inhaler without them. What would help is: the cat stays out of the bedroom, the HEPA runs, and I'm getting a written action plan and a technique check. Thank you."

What I cannot do here

I cannot diagnose this, prescribe, change or restart your medication, set doses, or decide whether your asthma is well controlled. Asthma diagnosis and asthma medication management sit outside this library's allergy evidence, so every medicine decision above is written as a question for your prescriber, and the emergency number printed here (911) was looked up for your area this round, not recalled from memory. If someone has an airway reaction right now, this guide is the wrong document: follow the red flags and call 911.

Sources checked this round: ACAAI "Air Filters" page — HEPA for pet dander, CADR matched to room size, humidity below 50%, no humidifiers, no ozone/ionizer cleaners, HEPA vacuum, groom the pet outside the home, wash pet bedding. Sulser et al. (EPA HERO index) — HEPA retained airborne pet allergens, no effect on disease activity. Allergyfacts-Australia, via our allergy archive — ongoing dander exposure can also cause allergic conjunctivitis in dander-allergic people. WHO asthma fact sheet, Merck Manual and RCH clinical guide, as used in our asthma safety card — the red flags and never-do list above.

One question, because it changes what I write next: the controller inhaler that got skipped — is that yours, or one of the two children's? If it is a child's, the school handoff and the action-plan wording need to be the child's, and I'd want the school nurse's copy rather than the pharmacy alone. If it is yours, the school scripts still matter for the two children, but the visit-and-technique-check part is yours.

*One note on numbers: the only figures here are the 50% humidity ceiling and the 25-minute checklist, both from the ACAAI guidance and my own step-counting rather than any clinical threshold. The 25 minutes is an estimate I made from the household steps, not a measured figure.*