In times of anxiety, people usually seek help and advice online first and foremost. When you post a request for help in an online community, you might receive the following types of responses:
Out of 10 responses, 6 might give similar answers like these:
“It might have heart disease; take it to the vet for an echocardiogram immediately.”
“It’s probably heart disease; my Chihuahua had similar symptoms before. Hurry and take it to a cardiologist for a check-up.”
Then, three of them might give different answers:
“Tracheal collapse, an X-ray examination is needed.”
“Our Pomeranian has been coughing a lot, and the doctor said it’s due to congenital tracheal collapse.”
The above content is correct; heart disease and tracheal collapse are indeed two of the most common diseases causing coughing in dogs, especially more prevalent in small breeds.
There is a saying: “Doctors fear treating coughs.” This applies not only to humans but also to veterinarians who face particularly challenging tasks when dealing with cough issues. Casually flipping through any medical literature, there are more than 40 differential diagnoses (possible causes of coughing) for canine coughs.
Many cough issues, if the cause cannot be accurately identified, are difficult to treat effectively. In fact, there are quite a few diseases where even with a clear cause, the treatment goal is often only to alleviate symptoms, not to cure. The entire medical diagnosis and treatment process follows this principle: strive to find and identify the exact problem, then proceed with corresponding treatment. The purpose of treatment may be to cure, to control the condition, or sometimes merely to slow the progression of the disease.
Failure to identify the cause can lead to poor treatment outcomes. Some diseases, even with a clear cause, can only aim to alleviate symptoms and cannot achieve a cure.
Besides heart disease and tracheal collapse, what are some other common causes of coughing in dogs?
Bronchomalacia
The proportion of small dog breeding is relatively high. Almost all parents who raise small dogs (such as Pomeranians, Chihuahuas, Maltese) know that heart disease and tracheal collapse are issues their furry friends may face as they age. However, in addition to these, bronchomalacia is also one of the common diseases among these little ones. It is worth noting that bronchomalacia often coexists with other heart and respiratory diseases, and the proportion of mutual influence is quite high.
In newer veterinary medical literature, the term “tracheobronchomalacia” is gradually being used. The reason is that the trachea and bronchi are anatomically similar, both mainly composed of cartilage rings. In addition, many medical studies and clinical experiences have shown that the vast majority of patients diagnosed with tracheal collapse almost simultaneously have bronchomalacia.
Most patients diagnosed with tracheal collapse almost simultaneously have bronchomalacia.
Canine Infectious Respiratory Disease, commonly known as Kennel Cough
The name of this condition, Kennel Cough, evokes images of kennels or other places where dogs gather (such as shelters) for the occurrence of the disease.
In fact, this is not the case. As the name suggests, it is a contagious respiratory disease (Canine Infectious Respiratory Disease, CIRD). As long as a dog goes out for a walk or has the possibility of going to a veterinary hospital, or has the opportunity to come into contact with other dogs and greet each other, it can be infected. Therefore, the reason for the common name “Kennel Cough” is precisely because in places like dog kennels where dogs gather, the risk of transmission is higher.
Then, without maintaining social distancing and wearing masks,
This disease can spread easily, leading to mass infections.
However, this condition does not refer to a single disease but is a collective term for a variety of common respiratory infections, including viruses and bacteria (such as adenovirus, Bordetella, or Mycoplasma infections, etc.). In some cases, dogs can recover from this disease without medication. However, if a dog has other respiratory issues, it can easily worsen into pneumonia.
Chronic Bronchitis
Chronic bronchitis is one of the main causes of chronic coughing in dogs. Many pathogenic factors can lead to this issue, such as pets living in an environment with secondhand smoke, or long-term exposure to air pollution (such as a habit of burning incense at home), as well as long-standing structural respiratory issues (such as bronchomalacia) and chronic gastroesophageal reflux, all of which can trigger chronic bronchitis.
The diagnosis of chronic bronchitis is indeed quite challenging. This disease usually occurs deep in the respiratory tract, so a patient needs to be anesthetized for confirmation, and a bronchoscope must be inserted deep into the airway to collect sputum for analysis. This is considered a medium to high-risk diagnostic procedure. However, the diagnosis of such diseases is extremely important because once diagnosed, dogs need long-term use of corticosteroids for control. If medication is used indiscriminately without a clear condition, it will inevitably cause difficulties in controlling the condition.
If a furry friend is in an environment with secondhand smoke, or long-term exposure to air pollution (such as a habit of burning incense at home), coupled with long-standing respiratory structural issues (such as chronic bronchomalacia) and chronic gastroesophageal reflux, it can lead to the occurrence of chronic bronchitis.
Laryngeal Paralysis
Owners of large dogs need to pay special attention to this condition. Although this disease is not common, it is occasionally encountered in clinical outpatient settings.
Laryngeal paralysis mainly occurs in large dogs in their senior years, such as Golden Retrievers, Labradors, etc. In daily life, owners may suddenly notice that their dogs cough easily when eating or drinking. At this time, it is necessary to be vigilant, as this symptom may be a differential diagnosis of laryngeal paralysis. These situations increase the disease’s recognizability, so dog parents must understand this disease.
Finally, regarding coughing, there is a cause that is currently less focused on in veterinary clinics but continues to receive research attention.
Gastroesophageal Reflux / Aerodigestive Disorders
“Hey, wait a minute, aren’t we discussing the causes of coughing? Why have we suddenly switched to a gastroenterology health education article?”
When reading this article, I wonder if anyone has ever experienced gastroesophageal reflux? Or imagine, when we eat too much, we burp, and unexpectedly, the food and beverages we just consumed, mixed with gastric acid, surge upward through the chest and towards the throat. Do you feel a sour, hot sensation? The throat may also feel sore, prickly, or even itchy.
And then? Next, you may feel the urge to cough.
In humans, some patients who visit thoracic medicine, cardiology, or otolaryngology for chronic cough are eventually referred to gastroenterology and discover that it is caused by gastroesophageal reflux (Gastroesophageal Reflux Disease, GERD). The principle is that the entrance to the respiratory tract and the opening of the digestive tract are closely connected, forming an important structure. These types of problems are collectively referred to as aerodigestive disorders.
Therefore, the refluxed gastric contents or stomach acid may irritate the laryngeal area, thereby causing coughing. Acute and severe conditions may lead to so-called aspiration pneumonia. In addition, long-term and chronic conditions may continuously inhale these substances, medically referred to as microaspiration. Over time, this may be a risk factor for causing chronic bronchitis.
“Some patients who visit thoracic medicine, cardiology, or otolaryngology for chronic cough eventually discover, after gastroenterology examination, that it is caused by gastroesophageal reflux.”
Other Causes
Of course, the causes of coughing are diverse, and other possible reasons include pneumonia (aspiration, viral, bacterial, fungal, parasitic), thoracic tumors, lung tumors, chronic bronchitis, eosinophilic pneumonia, pulmonary embolism, primary pulmonary fibrosis, etc., too many to list one by one. (Note: Currently, in veterinary medicine, there is no such disease as “asthma”. If a dog is found to be easily out of breath or coughing severely, it is imperative to take it to the doctor to rule out any cardiopulmonary-related or other diseases causing the problem.)
Dogs in clinical practice are currently not diagnosed with asthma.
How to find the cause of dogs’ persistent coughing?
The enemy is often more than one
The challenge faced by doctors is that the causes of diseases are not simple and usually cannot be explained by just one reason for all situations. The various causes of coughing mentioned earlier may be found in the same patient with 3 to 5 different reasons. However, doctors, like detectives, piece together the whole picture of the disease through every possible detail.
The process of piecing together the disease is like solving a puzzle, but unfortunately, the puzzles that doctors hold are always missing some pieces.
For example: When a Chihuahua seeks medical treatment for coughing and is diagnosed with pneumonia, what we need to think about is not just how to treat pneumonia, but also the underlying considerations include: Is this pneumonia aspiration? Is it contagious? So, why does pneumonia occur? Is it due to low immunity? Or is it due to bronchomalacia leading to poor ciliary movement in the airways? Does the patient’s bronchomalacia have concurrent pulmonary hypertension? Has the patient recently had gastrointestinal symptoms? Is there a possibility of aspiration pneumonia?
In an instant, countless “whys” often flash through the doctor’s mind to piece together various possibilities and consider how to deal with the changes in these diseases in the future.
What methods can be used to find the cause?
Through detailed medical history and various examinations (such as blood tests, X-rays, ultrasounds, and physical examinations), we can usually grasp the general direction. However, sometimes further tests, such as computed tomography or respiratory endoscopy, are needed to determine the exact cause. Since dogs cannot express themselves in language, “medical history” is particularly important. For example, when we feel stomach discomfort or acid reflux, we can usually inform the doctor through simple questioning or our own feelings, but dogs may not show symptoms of vomiting when they have stomach discomfort or acid reflux. So, how can we speculate and judge whether dogs have these issues?
At this time, we will ask: “Has it burped recently after eating?” “Has the frequency of licking its mouth increased recently?” “Does it easily choke or cough when drinking water or eating?” and so on, through these questions to speculate whether dogs have potential gastroesophageal reflux issues. We will continue to delve into asking dog owners about various detailed onset conditions, which requires careful observation from all dog parents.
Because dogs cannot speak, so-called medical history is particularly important.
Is there a cure for coughing?
No!
Therefore, all diseases are similar, and there is no such thing as a cure. The most important role of a doctor is to assist patients in self-repair and healing. The use of medication can accelerate recovery or aim to stabilize the condition and slow down deterioration. Identifying the correct cause and providing corresponding treatment is crucial. For example, different diseases causing coughing have almost completely different treatment directions and methods.
- Chronic bronchitis requires long-term use of corticosteroids for intervention to control the condition and reduce the occurrence of complications.
Canine infectious respiratory disease – whether it requires antibiotic treatment or can heal on its own?
- Laryngeal paralysis – requires surgical intervention
- Tracheal collapse and bronchomalacia – currently incurable, the main goal is to stabilize the patient’s condition, maintain the quality of life, and reduce complications.
Emphasis: Pet owners with tracheal collapse at home must not rush to demand the installation of a tracheal stent! The tracheal stent is not a bad choice, but it must be decided at the right time. Be sure to discuss and communicate fully with your doctor before making a decision.
Although there is no cure, there are some treatment principles to follow
“Cough suppression and expectoration” is a phrase I believe everyone has heard. This concept is basically correct, but (there is always a but) it is only half right.
Let’s talk about the issue of expectoration first. The principle of expectoration is not too controversial, and the choice of medication is relatively safe. Commonly used expectorants include lysozyme, acetylcysteine, and bromhexine, etc. These medications usually do not easily produce side effects even when taken continuously for a long time.
When the respiratory system is problematic, a large amount of mucus (phlegm) is often produced. Coupled with inflammation or congenital structural abnormalities (such as bronchomalacia), these factors may lead to a decrease in the ciliary movement and expectoration ability of the airways. In this case, using some expectorants can break down the phlegm deeply adhering to the airway walls, making it thinner and more conducive to expectoration. Excessive phlegm accumulation in the respiratory tract may exacerbate inflammation and even lead to secondary infections. Therefore, assisting in expectoration is particularly important. In addition to oral expectorants, nebulization therapy is also a very effective option.
So, assisting in expectoration is very important.
What about cough suppression? Didn’t I just say that “assisting in expectoration is very important”?
Yes, the timing of cough suppression does need to be carefully chosen! The main purpose of coughing is to expel substances from the respiratory tract. Therefore, in the case of disease, forcibly using potent antitussive drugs to suppress coughing may lead to a decrease in expectoration ability. Therefore, cough suppression may not actually be an ideal treatment method.
Of course not.
All medical choices have their pros and cons, and we need to adjust in a timely manner according to the specific situation. For example, when the patient’s cough affects the quality of life (for example, unable to rest well, or coughing so much that the pet owner at home cannot sleep), it is particularly important to intervene in time and give some antitussive drugs.
Furthermore, when the cough condition suddenly worsens, intense coughing may cause laryngeal or tracheal mucosa to become more edematous, inflamed, and even congested. These conditions can make coughing more severe, forming a vicious cycle. In this case, appropriate cough suppression intervention is particularly important. Therefore, it is essential to discuss the most suitable treatment plan and options with the doctor. Of course, in addition to cough suppression and expectoration, accurately understanding the cause and using antibiotics, corticosteroids, and other drugs according to different conditions is also very important.
Nowadays, many patients with coughing severely affect their quality of life (for example, unable to rest well, or coughing so much that the pet owner cannot sleep soundly). At this time, intervening and giving appropriate antitussive treatment is particularly important.
Besides medication, how else can I help my coughing furry child?
Some parents of furry children have asked us if we can help with cough suppression through massage. In response, our answer is no solution, because this part is closer to the category of traditional Chinese medicine. In addition, even if massage is performed, we suggest being careful to avoid pressing on the trachea to prevent excessive stimulation of the trachea, which may trigger more severe coughing, forming a vicious cycle and making the symptoms difficult to relieve.
However, there are two things we will definitely advise pet parents with coughing symptoms to pay attention to: one is weight control, and the other is to pay attention to weather changes.
Weight Control
Weight control! This is one of the most important things we keep reminding parents in every outpatient department! A number of clinical studies and experiences have shown that obesity can exacerbate cough symptoms. Weight loss and maintaining a stable weight can significantly improve cough conditions!
Pay Attention to Weather Changes
Be careful of weather changes. In addition to the common intuition that we need to pay attention to the cold, it is more important to prevent overheating! Never let dogs feel too hot. The respiratory system is an important way for dogs to dissipate heat. Dogs with respiratory diseases have poor heat dissipation ability. Once overheated, they will regulate their body temperature by “panting.” However, the process of panting leads to intense exercise of the chest and abdominal muscles, and the body thus produces more heat, further exacerbating panting, forming a vicious cycle. (Obesity also exacerbates this vicious cycle.) Excessive panting can also lead to respiratory edema and congestion, thereby exacerbating cough symptoms.
Obesity can exacerbate cough symptoms. Weight loss and maintaining a stable weight can significantly improve cough conditions!
Never let them feel hot!
So, when should I seek medical attention?
If today you notice your dog’s tongue color has changed from the original pink to dark purple, this usually means they are severely oxygen-deprived. In this case, be sure to take your furry child to the vet as soon as possible. In addition, if the cough has severely affected the quality of life for both the dog and the owner (for example, the dog coughs in the middle of the night, causing the owner to be unable to sleep), it is also appropriate to seek medical attention in a timely manner to discuss the treatment plan with the doctor. Other situations to watch out for include when the frequency and severity of coughing have increased significantly, and it is also necessary to take the dog to the vet as soon as possible to check for any changes in the disease.
Original article by KPTer, if reproduced, please cite the source: https://www.kaipet.com/en/dog-coughing-diagnosis-therapeutic-measures