it is not that the urine itself causes harm directly but the odor can cause a bronchospasm (lung spasm)
this would be similar to an allergic cough from dust/mold and would be difficult to pick up unless in the envirnoment that trigger it
they have done pulmonary function testing/spirometry and a chest xray right?
if those are normal then a trial of an inhaler is best to see if she responds, this would be done in the environment (using prescription provental or proair) and is she notices an improvement in the cough she can use a long term inhaler or oral singulair to help prevent it
other causes can be cardiac or stomach
has she had a stress test and echo to be sure the fatigue is not a sign of heart disease
other causes of chronic cough can be reflux... if above have been normal and no change with an inhaler then next indicated would be ruling out reflux
if you can go with her to next visit and discuss possibility of trial inhaler would be best
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they gave her a stress test but they had to stop for some reason.As far as pulmonary tests, I have no idea.I know she has an inhaler and uses it when I am there. I live in Colorado and she lives in Kansas so going to the doctor would be very hard for me. Do you think she should bring up the horrible urine odor to her doctor?
she should have had spirometry (pulmonary function testing) if the inhaler is not making a difference it is less likely but possible that changing it may-if a low dose that can be increased or the type depending on the brand it is
best thing would be to call her dr and bring up the odor question or be sure that she does since they will more likely encourage her to take care of the problem to lessen inflammation/bronchospasm