Viral Wheeze vs Asthma

[Benjt]

Does anybody have any experience of Viral induced Wheeze? we had suspected my 4 year old Son may have asthma as he was getting a cough after running around, he was given an inhaler to try then shortly after he developed a bad cough and wheeze, he ended up in hospital with it and was discharged with regular inhalers, we went for a follow up appointment with the GP, he was still no better and she prescribed a weeks worth of antibiotics along with continuing the inhaler, the following week he was prescribed more antibiotics and oral steroids. We thought he had recovered but as soon as he finished the steroids the wheeze/cough returned. He was then prescribed a brown preventer inhaler a couple of days ago which so far has made no difference so we have been back today and been prescribed 5 more days of oral steroids alongside the preventer inhaler with the hope that the preventer inhaler will have taken effect by the time the course of oral steroids has been completed. We are in the 4th week now with no sign of it improving. They can’t tell me what is causing it, all they will say is it could be viral wheeze and it could be asthma. Does anybody have any experience of anything similar? Can Viral wheeze even last this long? I have 2 older older children and never experienced anything like this before. Any advice is appreciated, I am worried about him being on the steroids but neither of us can cope with the sleepless nights we get when he’s not on them!

Have you tried an antihistamine? If an allergen, eg pollen, dust mites, animal fur, is the trigger then the antihistamine mighr help?

I have started to wonder if he may be allergic to our dog, we’ve had her for a year now though, he has had a slight cough for a lot of that time but nothing this severe so I thought if it was that this probably would have happened sooner? I haven’t tried an antihistamine but guess I would need to wait until he has finished the current course of steroids?

You can call into your pharmacy and ask if you can try antihistamines alongside his course of steroids. They will be able to advise if that's the case.

My dd had viral induced wheeze last year. She was only 2 but she ended up in hospital on a nebulizer. Funnily enough she came out in chicken pox 2 days after she was discharged from hospital so I think the 2 were linked as she had the pox extremely bad.

Seen as this has gone on for a period of time I would say possibly an allergy so defientley ask pharmacist if you could try or wait till the course has finished then try them

Almost certainly antihistamines can be taken with steroids as GPs prescribe them together all the time. However talking to a pharmacist is probably more sensible than my non-medic knowledge!

Thank you, I’m just not sure there’s much point taking antihistamines while he’s on the steroids as the steroids do work and he’s loads better on them but if he goes back to how he was after this course then I will definitely try the antihistamines. Would the steroids work if it was an allergy?

A viral induced wheeze would generally be a short lived episode caused by being unwell with a virus. Generally the kid gets better when they get over the bug. They can get it repeatedly but generally there's no symptoms in between and they grow out of it as they get older. The treatment for that and asthma are the same. As he has symptoms for such a long time it sounds more like asthma. He's had a lot of oral steroids so I think it would be reasonable for the gp to refer to paediatrics. Make sure he's on the highest dose of the brown inhaler twice a day (ask the gp). If it's not working there are other preventer inhalers and medicines that can be tried, but they do generally take a few weeks to work. Is he taking it with a spacer?

It's definitely worth starting a daily antihistamine such as loratidine or cetirizine. The steroids would be helping if it was an allergy but if you start taking the antihistamine now it will be working by the time he comes off the steriods. It might be worth giving his room a deep clean and hoover to get rid of any dog hairs and saliva and keeping the dog out of his room in case he is allergic. Also this time of year consider pollen allergies, so keep his bedroom window closed, don't hang his clothes outside etc.

If he starts getting bad again after the steroids though I'd say he definitely needs a referal to paediatrics.

Wow, thank you IwillrunIwillfly, this is really helpful!

We do use a spacer with the inhaler but the GP did say that she has put him on the lowest dose of the brown inhaler, 1 puff morning and night so maybe I should go back and ask for that to be increased, they seem very reluctant to prescribe anything but the minimum and yet we have been to the dr so many times over the last few weeks and every time he has been wheezy and the last time his sats were down to 91%. A couple of times a paediatric referral has been mentioned so I think I need to push for that now.

Are the antihistamines that you mention available over the counter or prescription only? As much as I don’t want him to suffer any more I worry that if we start antihistamines now and the wheeze doesn’t come back we won’t know if it’s just gone or if the brown inhaler is working or if it’s the antihistamines.

Thank you so much for your reply, I have no experience of asthma or allergies so feel totally clueless!

Normally I'd agree that you don't want to change more than one thing at a time but if his breathing has been getting so bad so quickly I'd say do everything you can to prevent it, then if it seems better maybe in 4 week you could stop the anti histamine and see if symptoms return. But definitely discuss it with the gp if you're worried! You can but both of those antihistamines over the counter.

If you're ever worried about his breathing acutely, and feel he is working hard to breathe, don't feel bad getting him seen again, whether gp or a and e. If he's really working hard and 2 puffs of the blue inhaler don't relieve it, go to to giving him 10 puffs again through the spacer and get him seen again. Keep a note of how often you need to use the blue inhaler and if anything triggered it eg after running about, after playing on the grass etc. If things are under control you shouldn't need to use it very often at all.

It can be hard to get the right balance of things but theres still lots of medicines to try! Hopefully over the next few years he might still grow out of it as many children do, but the important thing to to get on top of the symptoms for now. Hope the gp is helpful!