Coughing is a response stimulated by mechanical or chemical irritation of the trachea (windpipe), large and small airways. It can easily be confused with sneezing, gagging, retching, and can accompany or be misinterpreted as vomiting, especially as a terminal retch or cough. If at possible, a video should be obtained to show to your pet’s primary care veterinarian for appropriate diagnosis, especially as sometimes the episode is not witnessed in the hospital or clinic.
A good description of the cough consistency (dry or moist), productive or nonproductive, characteristic sound (“goose-honking”), frequency (less than 10 times per day, more than 10 times per day), whether coughs are in singles and at random times, or if the coughing is in paroxysms or ‘fits,’ if the cough is worse at night, is the cough worse with exercise/excitement, more coughing indoors or outdoors, and response to any previous therapy administered. Keeping a journal of coughing descriptions and frequency will be very helpful in both the diagnostic phase and therapeutic monitoring phase.
Please make sure to mention vaccine history, any travel to different parts of the country, as well as any changes in the environment (new carpet cleaner, air freshener, burning of incense, or exposure to cigarette smoke).
A physical examination by a veterinarian will likely focus primarily on the cardiac and respiratory systems. Thoracic radiographs (chest x-rays) in addition to baseline bloodwork (complete bloodwork and serum chemistry) may be recommended as first-line diagnostics. Additional bloodwork, including heartworm testing and other infectious disease screening can be considered. A ‘wash’ procedure under a brief anesthesia may be considered prior to initiation of antibiotics if pneumonia is suspected.
Advanced diagnostics, including consultation with a veterinary cardiologist to further evaluate the heart with an echocardiogram (ultrasound of the heart) may be recommended if a heart problem is suspected. An endoscope procedure to visually evaluate the large and small airways for evidence of collapse and obtain small biopsy samples or focal wash samples may be recommended if a primary lung problem is suspected. A fine needle aspirate or biopsy can be obtained for evaluation of cells under a microscope if a mass is identified on thoracic radiographs.
As a general rule, anti-tussive or anti-cough medications are withheld until a definitive cause is identified, as promoting and encouraging cough may be part of the treatment protocol (ie nebulization and coupage for pneumonia).
Please contact your pet’s primary care veterinarian to discuss heartworm disease and heartworm prevention. Please seek veterinary care immediately with your pet’s primary care veterinarian or an emergency veterinarian if your pet develops difficulty breathing, if the gums or tongue turn a pale color or bluish/purplish, if your pet collapses as a result of a coughing fit.
Dr. Jessica Diaz