Cats with asthma or other respiratory conditions may need to use inhaled medications administered with a spacer and mask. This method delivers the medication directly into the lungs and may have fewer side effects than oral steroids. Most cats do not tolerate things placed over their faces, so training them through cooperative care to voluntarily place their nose and mouth into an inhaler mask will reduce their stress.

Items needed:

• Treatment station
• Clicker or marker word such as “yes”
• High-value treats (lickable treats preferred)
• Inhalant medication, spacer, and mask
• Pretzel stick

Phase 1: Set Up and Use a Treatment Station

Set up and train your cat to use a treatment station. This may be a cat bed, a chair, a countertop, or the floor if climbing is difficult. 

Phase 2: Introducing the Mask and Spacer

• Place the mask, inhaler, and spacer separately on the treatment station.
• Sprinkle high-value treats around them to create a positive association. You may also pet your cat if they enjoy it while exploring the parts.
• As your cat touches each part, mark and treat for the interaction.

Phase 3: Place a Lickable Treat Near the Mask Opening

• Once your cat is comfortable exploring the equipment, hold the mask in your hand and let them sniff it. Mark and reward your cat for interacting with the mask in your hand.
• Smear a small amount of a lickable treat onto a pretzel stick. Hold the mask at a comfortable height and angle for your cat.
• Carefully extend the stick past the opening of the mask. This will allow your cat to enjoy the treat while it is near the mask opening.
• Hold the mask still to avoid scaring your cat or hitting their face with it.
• Let them approach the mask and lick the treat off the stick.
• After they lick the treat, remove the mask and the pretzel stick. This minimizes the contact time, making it a positive experience. Repeat this 10 times throughout the day.

Phase 4: Face Into Mask

• Offer the lickable treat through the mask opening again, this time extending the pretzel stick midway into the mask space. This will encourage your cat to place their face into the mask.
• Allow your cat to lick the pretzel stick.
• After a lick, remove the mask and pretzel stick. Repeat this 10 times throughout the day.
• Gradually hold the stick farther back inside the mask over multiple repetitions, encouraging your cat to lick the treat at each approximation. Monitor your cat for discomfort by observing their body language closely with each step and return to the previous step if needed.

Phase 5: Face Into Mask Duration

• When your cat reliably puts their face deeply into the mask to lick treats off the pretzel stick, smear a small amount of the treat in the mask hole where the spacer is attached.
• Let your cat insert their face into the mask to lick the treat.
• When they take a couple of licks, remove the mask. Pause for a second, then offer a few more licks. Over several repetitions, gradually increase the time between licks of the treat. Your cat’s face should remain in the mask between licks. If they withdraw, go back a step and increase the duration more slowly.

Phase 6: Practice with the Spacer

• Apply a thin smear of the treat to the opening where the spacer attaches.
• Attach the spacer to the mask and let your cat put their face into it to lick.
• Repeat the steps in Phase 5 and work up to holding the mask in place for 5–10 seconds while praising and giving treats. The inhaled medication will stay in the chamber for up to 15 seconds.

Phase 7: Add the Sound (Desensitize to Puff Noise)

• The sound of the inhaler puff can be startling for most cats. The inhaler can be depressed into the chamber just before your cat puts their face into the mask; however, they should be desensitized to the proximity of the sound.
• Some inhalers are quieter than others. Ask your veterinarian about noise-reduction strategies.
• First, “puff” the inhaler away from your cat so they can hear it without associating it with the inhaler. You can also try prerecorded sounds of the puff or use a pressurized air can wrapped in a towel.
• Pair the sound with a treat.
• Slowly incorporate the sound while the mask is near your cat without delivering a dose.

Phase 8: Combine and Deliver

• Once your cat is comfortable with the above phases, offer the mask with the spacer and inhaler attached.
• Administer a puff and count at least 5–10 slow breaths. Watch the flow-through indicator to count your cat’s breaths.
• Wipe your cat’s face with a damp cloth after removing the mask.
• Reward immediately with a high-value treat.

Tips:

• Keep sessions short and positive. 
• Train daily or as often as your cat tolerates.
• Never force the mask or medication. This can cause fear.
• Play with your cat afterward if they have games they enjoy.

Allow your cat to set the pace when teaching them to use an inhaler. This may take a few days to weeks, but being patient will help build trust with your cat. Through a combination of Low Stress Handling® and positive reinforcement, these methods will enable you to support your cat’s physical health while also strengthening your bond. For additional help, talk to your veterinarian or seek advice from a board-certified veterinary behaviorist..