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Hello this is Dr. Holloway but you can call me Dr. H for short.
I am so very sorry that Harley is not doing so well. I will do my best to advise you on my thoughts of what could be contributing to his illness and the next best steps for his care.
I see you have had some diagnostics done for him. The coughing and labored breathing is a concern of lung involvement here. Has he had chest x-rays to look at his lungs for any potential infection or masses (due to his age)?
Also has he had a heartworm test done to check for heartworm disease (suspected because of the cough)?
- Dr. H