Brandy Pitman suffers from a lifelong allergy to cats, enduring regular bouts of congestion, sneezing, and watery eyes.
Even so, it hasn't stopped her from working as an office manager for a feline veterinary hospital in Louisiana, or from inviting four strays into her home.
"They showed up and never left so I took them in," Pitman said of her domestic shorthair clan Marbles, Miss Kitty, Teachy and Callie. "There wasn't really a choice."
For many allergic cat lovers, like Pitman, living without a feline companion isn't an option. According to the American Academy of Allergy, Asthma & Immunology (AAAAI), nearly 10 million people choose to live with pets even though they're allergic to them.
"Most people who are real cat lovers elect to suffer some, or take medicines, rather than give up their pet," said Dr. Robert Wood, division chief of pediatric allergy and immunology at Johns Hopkins Children's Center in Baltimore.
For people with mild to moderate allergies, controlling flare-ups involves managing their home environment, taking medication and having their pets groomed regularly.
Cat-induced allergies affect about 20 percent of the U.S. population, according to studies, and is caused by a protein found in the animals' saliva and dander (dead skin cells.) Because felines lick their fur to keep clean, the troublesome protein, called "fel d 1," is also deposited on their coats.
What's more, the super-lightweight allergen floats through the air, sticking to walls, rugs, clothing and other surfaces.
"Most people who are real cat-allergic know pretty quickly after they've walked into a house whether there's a cat there or not -- they'll sense the beginning of a reaction happening just from what's in the air," Wood said.
Reactions run the usual gamut of allergy symptoms such as a stuffy nose and red, itchy eyes. Asthmatics are at risk for experiencing more severe reactions, including difficulty breathing.
"We feel most strongly about not living with a cat if you have asthma that's hard to control because that can lead to life-threatening situations," said Wood.
For individuals who are not highly sensitive, living with a feline requires taking some simple steps to reduce allergens in the home and on the cat.
Veterinarian Vicki Thayer, president-elect of the Winn Feline Foundation, a nonprofit that supports studies to improve cat health, recommends owners regularly bathe their pets with a mild shampoo or wipe them down with a damp wash cloth.
Weekly brushings done outside by a non-allergic person are a good idea, too. A spray-on formula available through veterinarians and pet retailers may also help to reduce the amount of dander found on coats.
Another option, with reportedly mixed results, Thayer said, is adding tiny amounts of acepromazine, a prescribed tranquilizer, to a pet's food or water. The diluted mixture is thought by some veterinarians to reduce or remove the protein that causes cat allergies.
Owners, depending on their symptoms, may also get relief from prescription nasal sprays, eye drops or pills. Wood said shots given for cat allergies provide a little bit more comfort but several studies have shown they're not hugely effective.
Inside the home, keep cats out of the bedroom and put allergy-proof covers on the mattress and pillows. Wash bedding materials in hot water, wash your hands after contact, and limit the amount of wall-to-wall carpeting, especially in the bedroom. "Even if you keep the cat out of the bedroom, eventually the carpet gets loaded with the allergen just from what's carried around on your feet," said Wood.
Frequent steam cleaning helps remove allergens hiding in carpets.
Allergy experts also recommend running a good quality HEPA (high efficiency particulate air) air cleaner; changing forced air heating filters monthly and using a vacuum with a HEPA filter.
"With those things, most people are able to co-exist with a cat," he said.