The coughing dog (part 2)

Back to the topic after the slight digression earlier.

2 articles ago, I covered the subject of a young coughing dog and the most likely causes it is associated with.
Today I will aim to discuss the likely causes behind a geriatric/ mature dog that is coughing.

More often than not, these animals present to us with a chronic cough (cough that has been ongoing for a period of time). As an emergency veterinarian, I see a sizeable amount of cases presenting as a respiratory emergency.

Questions that we typically ask clients in such a situation includes- an increase in water intake? exercise intolerance? frequency? time of the day the episode is observed, access to toxins, etc. Videos of the coughing episodes are extremely useful so I like to get my clients to whip out their phones when they witness any.

The 2 most common causes of a chronic cough in a mature animal I will be discussing today is that of congestive heart disease/failure and a collapsing tracheal.

Collapsing tracheal (collapsing windpipe)
This is most commonly seen in a small breed dog (ie. Silky Terriers, Jack Russells, Malteses, Shih tzus,  Poodles, Cavaliers, Chihuahuas, Yorkshire terriers, etc.. (and the list goes on)). A goose honk cough is how I describe it. See this video for how it may present. Some animals may gag/ cough when they eat and drink

This is an irreversible, chronic and progressive condition that can either be congenital or an acquired disease. Cartilage is present on the tracheal to help keep a healthy animal’s airway patent when they breath. In the acquired condition,  the cartilage weakens with age and flattens out when the animal breathes, essentially occluding the airway.
This results in respiratory compromise and animals may collapse and become cyanotic (turning blue) when this occurs.

Being a dynamic disease, plain radiographs (X-rays) may not be able to capture the image of a collapsed tracheal (as it is a static image). Gold standard diagnosis include fluoroscopy, where the trachea can be visualized as the dog inhales and exhales. (Some small clinics may not have the equipment for this and referral may be required

Medical treatment, or rather.. management may include bronchodilators, cough suppressants, sedatives to reduce the coughing spasms and associate anxiety. However it is IMPORTANT to know that treatment is NOT curative. But aims to control the animal’s symptoms.
Supplements may be beneficial in strengthening the cartilage (I recommend this to be done TOGETHER with medical management)
Ensuring that the animal is not obese or overweight is essential to the success of medical management. In addition, I recommend that clients use a body harness instead of a neck collar as tugging on a neck collar may precipitate a coughing response.

In severe cases, surgical management may be required. This is an extremely specialized surgical procedure and only a trained veterinary surgeon should attempt this procedure. The truth is that majority of my clients have not opted for this to be done due to associated cost and age of the patient 😦

 

Heart disease/ failure
There are many forms of heart disease, and this is just one of the cardiac condition that afflicts dogs. Acquired Congestive heart disease is an extremely common condition that I see regularly. There was a time (when I was still working in SG) where I had approximately 35-45 geriatric patients that I was concurrently managing on medical treatment.

A large proportion of patients I see with CHF are small to medium breed dogs, however any breed could be affected by this condition. Breeds such as Cavailers, Minature Poodles, Maltese, Shihtzu and Chihuahuas are over-represented. Photo 13-3-17, 3 57 18 PM.jpg

This is a progressive and often chronic condition. As the heart starts to  fail in it’s ability to pump blood to the body, fluid back up and results in congestion. Coughing occurs due to an accumulation of fluid into the lung. (though fluid can also build up in other areas in the body).

Physical examination often reveals an underlying heart murmur. Your veterinarian will likely perform other diagnostics test such as radiographs, blood test, echocardiogram to assess your animal’s condition.

As with collapsing tracheal, treatment is aimed at managing the animal’s clinical signs. Clients will need to be made aware that LIFE LONG treatment is required. I have had several clients presenting as an emergency as they were previously not informed that the animal will need to continue on the medications for the rest of their lives and stop treatment the moment they finish their initial course. Owners also have to be aware that ultimately, end-stage CHF may develop, and  humane euthanasia will need to be considered.
Heart disease is not a death sentence. Some dogs can live with cardiac disease for years if their conditions/ symptoms are managed by appropriate medications.

Covered in the 2 articles are collectively the most common causes of cough I’ve seen in dogs. There are other less common causes of coughing such heart worm, rodenticide toxicity, cancer and even obscure conditions that results in cough. However as we’ve said, Common things do occur commonly!

Hope the above information helps!

 

If you have any questions or concerns, you should always visit or call your local veterinarian.

 

 

 

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