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Peter Bennett, DVM
Peter Bennett, DVM, Veterinarian
Category: Dog
Satisfied Customers: 1306
Experience:  20 years experience as a Small Animal veterinarian
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I have a 8 pound 11 year old pomeranian.He coughs when he wakes

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I have a 8 pound 11 year old pomeranian.He coughs when he wakes and after sleeping for a period of time.It is assumed he has a collapsing trachea.I gave him Tussigon and that helped.He only needed first thing in morning and some evening.Recently Tussigon was ineffective and he was wheezing too.Weather got colder in San Diego.We tried Prednisone 2.5mg daily with Terbutaline 1.25mg once a day.   We slowly weaned him off the Terbutaline and the Prednisone to every other day.It brought him back to the place before the worsening.It did not prevent him from coughing so back to Tussigon.I would like to try fatty acid but how much?Other suggestions to control reason he coughs? I am trying to keep the tissue in the trachea healthy.
Submitted: 5 years ago.
Category: Dog
Expert:  Peter Bennett, DVM replied 5 years ago.
HiCustomer

The symptoms you are describing are not what is generally expected with a collapsed trachea. We expect there to be a cough whenever the dog exhibits excitement, such as when you return home after work. Also, the great majority of CT's are congenital, and thus have been noticeable since the dog's youth. For this to be a CT just appearing is suggestive of something pressing on the trachea, such as a tumor of some sort.

The good news after all that is that it probably isn't a collapsing trachea. But there is some problem, none the less.

You are seeing a soft cough after a rest period which is exaggerated by cool weather. Antibiotics, steroids, and cough suppressants have been ineffective. A chest x-ray suggests a normal sized heart, and from this it is taken that there is no heart problem.

In my opinion you are seeing early signs of congestive heart failure, quite commonly seen in 11 year old dogs, especially in the small breeds. This quite often is from a condition that enlarges the heart, but not always. I suggest that you have at least an electrocardiogram before concluding that the heart is not at the root of the problem, OK?

I hope this is helpful. If you have questions, feel free to reply with them. Otherwise, best wishes.
Customer: replied 5 years ago.

About 5 years ago was his first coughing incident and my vet then gave him a shot in the throat and for at least 3 years he didn't cough. If he runs a lot now he does cough and gasp for breath. He coughs and can sound like a goose or coughs and then sounds like he is choking or clearing his throat. he can just do a little cough. He also makes a lot of high pitched noses at times. He snores when he sleeps some of the time.

Is it possible we did not keep him on the prednisone long enough? We started the process on Dec 23.

The vet thought he heard fluid in his lungs and that is why he had the chest xray now. He had another vet look at it because of some shading but they concluded it was nothing.

Here are my questions: So if it is not collapsing trachea it doesn't hurt for him to cough?

I will check on the electrocardiagram. I know I want him to enjoy his life and not feel worse on medicine to exist.

You can tell when he feels good and when he doesn't.

How do I know if my vet is good. Should he be able to see the collapsing trachea on the x-ray. He never tried to palpitate the throat to check the cough. I think it was an assumption.

 

 

 

 

Expert:  Peter Bennett, DVM replied 5 years ago.
Hi again, and thanks for the additional questions. Let's take them one at a time, or try.

About 5 years ago was his first coughing incident and my vet then gave him a shot in the throat and for at least 3 years he didn't cough.

There should be no relationship to that problem after this amount of time.

If he runs a lot now he does cough and gasp for breath.

If he has beginning CHF, or some other sort of pulmonary problem, this is what would be expected.

He coughs and can sound like a goose or coughs and then sounds like he is choking or clearing his throat. he can just do a little cough. He also makes a lot of high pitched noses at times. He snores when he sleeps some of the time.

These sounds come from a congested or restricted airways. Choking and clearing the throat suggests that the cough is bringing up some phlegm or other fluids... which is found in CHF. Wheezing and squeaks also suggest airway congestion.

Is it possible we did not keep him on the prednisone long enough? We started the process on Dec 23.

Steroids are not a cure for any of the problems we are considering here, even though they may rapidly clear the symptoms. If rapid relief isn't achieved, then a different approach to treatment, or diagnosis, should be taken.

The vet thought he heard fluid in his lungs and that is why he had the chest xray now. He had another vet look at it because of some shading but they concluded it was nothing.

I would think that the possibility of fluid in the lungs had not been either proved or disproved at that point. Pneumonia or CHF are suspects and more tests would be beneficial to make a decision.

So if it is not collapsing trachea it doesn't hurt for him to cough?

Persistent coughing puts more strain on the heart than on the trachea. A CT isn't harmful, it is just a continual irritant to that part of the trachea involved (which may be anywhere between the lungs and the mouth.)

How do I know if my vet is good

It usually takes a flagrant error in judgment or procedure, neither of which are present here. We all make errors in our evaluations from time to time. We are also pressured by our previous experiences with the patient, which hinders having a completely open mind to any diagnosis. Probably the most reliable test is your personal comfort with the service you receive... inexact to be sure, but so are most of the other 'tests'.

Should he be able to see the collapsing trachea on the x-ray. He never tried to palpitate the throat to check the cough. I think it was an assumption

I think that most of the time a CT is diagnosed by the customer's description of the event, unless it can be demonstrated in the office. Catching the collapse on X-ray is tricky... it happens only on a taking of a breath. The collapse causes a turbulence in the airway, which is interpreted as congestion and hence elicits the cough.

And you cannot feel it. Most of the collapses occur within the chest cavity, and even then the collapse occurs on that part of the trachea that is against the spine... out of touch. Palpation of the throat is commonly done as a diagnostic aid to Kennel Cough, as the affected trachea is so sensitive that this will induce a coughing spell.

Again thanks, XXXXX XXXXX this also helped demonstrate the need for more testing, and hopefully cleared up some of the questions resulting from your understanding of her condition and previous treatments.

Any more come to mind?
Customer: replied 5 years ago.

I so appreciate your patience with me. I just want to make sure I am doing the best for my best friend. I will call the vet tomorrow and discuss the congestive heart failure with him.

I can only imagine the challenges of diagnosing animals especially when there is the cost factor.

Do you have a preference of medications to treat congestive heart failure?

Does this disease progress slowly?

It sounds like i would have to restrict his playing-chasing a ball if he is coughing.

 

I just took dog for a slow walk but it was chilly. He came and home and coughed. He looked at me for help. So I gave him the cough medicine and he is resting.

 

He has to be able to enjoy his life.

 

 

 

Expert:  Peter Bennett, DVM replied 5 years ago.
Hi,

You are doing the best you can for him, which is taking him to his vet for answers rather than trying to do it on your own. The cost factor is significant, even before the additional strains on our resources since last summer.

And technology today... CAT scans, MRIs, ultrasounds, chemo and radiation therapies, echocardiograms, digital x-rays, and other less dramatic procedures. With such expensive equipment being necessary to provide such informative techniques, it tugs at our hearts when they are kept separated from our pets by a fence of dollar signs.

As for meds? Many of the drugs are the same as used in human practices. Which are used depends on the nature of the heart problem, and the particular preferences of the vets. Generally, there will be diuretics of some type, somewhere in the treatment plan.

Progression of a condition is generally slowed under satisfactory treatment, which lessens the work the failing heart has to do. Think of it as bailing a leaky boat with a bucket having a hole in it. The bigger the hole in the bucket, the more effort required to keep the boat afloat. Treatment isn't aimed at the boat, just the leaky bucket.

If it turns out to be CHF, treatment may get him back to fairly normal activity, including an occasional run. Dogs don't have heart attacks as we are used to seeing in humans. And, they pace themselves better than 'driven' human personalities... when they feel tired, they slow down (unless some thing or body is chasing them). When he tires of chasing a ball, he'll simply not run after it.

Enjoying life is sometimes just sitting and watching the world go by....
Peter Bennett, DVM, Veterinarian
Category: Dog
Satisfied Customers: 1306
Experience: 20 years experience as a Small Animal veterinarian
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