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Dr.Fiona, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 6273
Experience:  Small animal medicine and surgery - 16 years experience in BC, California and Ontario
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How to relief wheezing and coughing for dog with heart mur

Customer Question

My 13 years old Shih Tzu, Baby has been on Fortekor medication for 2 years for her heart murmur. Recently in July, she was admitted to hospital for a week, and the vet diagnosed her with kidney disease. Baby is currently on a holistic herbal program - Canine Kidney Program by Five Leaf Pharmacy. Her BUN level dropped from 130 to 58 and Creatine is now at 1.6. Our vet advised to put her on daily drip of 250ml.

However, last week, Baby started to have breathing difficulity, wheezing, coughing. We didn't dare to hold her down as she gets very agitated when we want to administer the drip on her. Vet did an x-ray for her, found that her heart had enlarged and was pressing against her windpipe and lungs, thus causing her breathing difficulties.

Is there anyway I can help to relief her wheezing and coughing? Please kindly advise.

Submitted: 7 years ago.
Category: Dog Veterinary
Expert:  Dr.Fiona replied 7 years ago.
Hi there,

Welcome to Just Answer! I would like to try to help you but need a bit more information in order to better assist you.

How old is the dog?

What breed is the dog?

When did the wheezing and coughing start?

Customer: replied 7 years ago.

My dog is 13 years old, she has heart murmur and kidney disease.

She started to eat normally now but does not want to drink water on her own.

Expert:  Dr.Fiona replied 7 years ago.
Could you please count for me how many breaths she takes in one minute?

Customer: replied 7 years ago.

When her wheezing attacks starts, she would take in deep hard breaths of about 20 - 23 in 30 seconds. Then the attack stops for about 30 seconds and continuous again.


Last few days, these attacks have been more frequent, about at least 5 times a day.

Expert:  Dr.Fiona replied 7 years ago.

and right at this minute is she having this problem?

or is she resting comfortably right now?

Customer: replied 7 years ago.

yes, she is sleeping comfortably now.


she seems more comfortable when she is lying down sideways.


i tried massaging her lightly when she wheez and breathes very hard. Her chest enlarges alot when she has these attacks.


i just read about giving her aromatheraphy to ease her wheezing problem. not sure if it would really be helpful.

Expert:  Dr.Fiona replied 7 years ago.
Hmmm... aromatherapy might not help, depending on what is triggering the cough.

Did you vet mention any fluid in her lungs?

With her sleeping right now, can you tell me how many breaths she is taking per minute right now?

Customer: replied 7 years ago.

sorry, pls give me a few minutes to check. i'm in the office at the moment.


The vet said her lungs are clear, no fluid.


I noticed Baby started to wheez when we held her down to put her on the drip. She became very agitated and wheezed more. We have stopped giving her the drip on our own, I brought her to the vet yesterday for her drip. I believe that when we held her down, it stressed her heart.

Expert:  Dr.Fiona replied 7 years ago.
Ok - thanks for that information.

I will stand by to hear about her respiratory rate!

Customer: replied 7 years ago.

Hi Dr. Fiona,


She is taking about 53 - 54 breath per minute now.

Expert:  Dr.Fiona replied 7 years ago.
And that is while she is sleeping?

If I understand correctly, she started the fluids given under the skin last week?

Has she had any repeat x-rays taken since then?

Customer: replied 7 years ago.

yes, this is while she is sleeping.


i started giving her the fluid near end of july, she was in a pretty bad shape then. she did not struggle at all, just laid on her side while i administered the fluid drip.


slowly, she got better, gained energy and didn't want to stay still for the drip. i brought to the vet for help with the drip, vet told me to hold her down to give her the drip. my dad helped with the 'holdiing her down'.


initial 2 weeks, she reacted quite obediently. last week, she started to get very agitated and struggled a lot more. which i think my dad used more strength to hold her and i guess it stressed her heart :(


she took the x-ray only yesterday.

Expert:  Dr.Fiona replied 7 years ago.

Ok, that really helps - I understand much better now what may be going on!

With what you are describing, it sounds like Baby's heart is pushing on her main airway, and compressing it a bit. This will lead to gagging and wheezing, especially if she struggles.

This is a very tough situation to handle! It might be really worthwhile to have an ultrasound (echo-cardiogram) done on her heart to determine how much of this coughing is due to heart disease, and how much is due to compression of the trachea and bronchus (the major airways). It is very tricky to determine this just from x-rays and thus hard to know how to treat.

If this is due just to irritation to the airways, it is called bronchitis.
More here about this: chronic bronchitis

So, if we assume that this is just due to compression of her airways (and NOT to fluid in her lungs), then we usually manage this with:

- cough suppressants, and/or
- short "pulse" treatment with steroids.

For cough suppressants in dogs with airway compression, I have used:
1. Dextromethorphan (which is a cough suppressant used in human cough medicines - though you have to be VERY careful that you find one with just this ingredient and no others in it).

More here:

2. Butorphanol
- this is a prescription drug available through your veterininarian

More here:

3. Hycodan
- this is again a prescription drug that your vet would likely send you to a human pharmacy to obtain

More here:

For steroids, I usually reach for dexamethasone tablets, and only use them for a few days to decrease the irritation.

More here:

With your little Baby, I do feel that she needs treatment for this as her resting respiratory rate is definitely high. Most sleeping dogs will have a respiratory rate of under 20 breaths a minute... and her's is double to triple that.

In a perfect world, where we did not have to think about money, I would strongly recommend an echocardiogram to see exactly what is going on with her heart and to be able to determine if part of this problem is due to congestive heart failure. I am worried it might be.

Please talk to your vet about starting Baby on one of the cough suppressants to see if that helps her at all. I do hope that it will so that she feels better soon!

If this has been helpful, please accept my answer and leave feedback.

If you need more information, just click on reply and I will still be here to provide it.

The above is given for information only. Although I am a licensed veterinarian, I cannot legally prescribe medicines or diagnose your pet's condition without performing a physical exam. If you have concerns about your pet I would strongly advise contacting your regular veterinarian.

Best wishes, Fiona

Customer: replied 7 years ago.

My vet just called me, she made an appt with another vet to perform an ultrasound.


Also, my vet prescribed anti histamine to calm her down. will this help?

Expert:  Dr.Fiona replied 7 years ago.
Oh, I am so glad you are going to take Baby for an ultrasound! That will really be helpful!

An anti-histamine might help as it does cause drowsiness.

If she keeps wheezing and coughing the anti-histamine might make her drowy enough for her to stop struggling and thus relax enough to stop coughing. It also might be helpful if your vet suspects that allergies could be part of this.

I hope she feels much better soon! You are doing such a great job of looking after your little companion. She is lucky to have you!


Customer: replied 7 years ago.

apart from medications, would any particular position of lying or massage help to provide some relief?


its awful not being able to help her relief her hard breathing and wheezing.


Expert:  Dr.Fiona replied 7 years ago.
It might help her to lie on her left side, as then her heart would be less likely to push on her trachea.

Certainly, anything you can do to CALM her would be most helpful.

Rubbing her belly or gently rubbing behind her ears - whatever you know she really likes would help to calm her so she is relaxed.

That would help her to stop gasping as when she sucks in a rapid breath she is more likely to irritate her airways further and cause them to collapse. So, if she would do slow, deep breathing, that would help.

A lot of getting HER to relax is going to be about getting YOU to relax as she will know when you are anxious. So, if YOU can try to take slow deep breaths, too, that can help!

Dr.Fiona and 2 other Dog Veterinary Specialists are ready to help you
Customer: replied 7 years ago.
Thank you!
Expert:  Dr.Fiona replied 7 years ago.
You are very welcome!