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Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 10379
Experience:  I have been a practicing veterinarian for over 30 years.
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My 13 year old female Pom has spells of coughing and throwing-up,

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My 13 year old female Pom has spells of coughing and throwing-up, is it a heart murmur? She has no parasites or heartworms, and the coughing spells are getting more frequent.

Hi Beverly, I'm Dr. Deb. I will do my best to assist you today.
I'm sorry for this concern for Sheba.
I do have a few questions to ask about her first, if you don't mind:

1. How long has she been coughing?
2. Does she bring up phlegm or mucous after she coughs?
3. Does she have other signs such as exercise intolerance (she gets tired easily) or weight loss?
4. Can you tell me what pills she's been taking?
5. Has she had a chest x-ray done?

There may be a slight delay after I receive your answers since I have to type up a response to you. Thanks for your patience. Deb

Customer: replied 4 years ago.

She's been coughing for about a year-yes, she brings up phlegm and yellow mucous, and sometimes her stomach contents-don't know the name of pills she took, no chest x-ray

Thanks so much for the answers to my questions.

I know that it's sometimes difficult to tell the difference between mucous produced secondary to coughing and mucous secondary to vomiting. But if her phlegm is actually yellow and she brings up her stomach contents (bile or food, in other words), then I wouldn't be concerned about a heart murmur. I'd be more worried about her gastrointestinal system.

Can you please confirm, if possible, that coughing is the issue. If so, then I can address various possible reasons why a dog this age might cough for a year and why it might be getting worse. I can even provide a few over the counter cough suppressants which you might want to try.

If she's producing bile (which is very yellow and is produced by the stomach), then I can provide possible explanations for this problem and ways to deal with it.

The suggestions I might have will be very different depending on her specific symptoms

Thank you. Deb

Customer: replied 4 years ago.

coughing is the issue-most of the time she throws up clear liquid-I think it may be intestinal, also. Sometimes she throws up yellow, but not often.

That's very helpful.

I probably wouldn't be too concerned about the bile, then, if it's fairly infrequent. A lot of dogs will do this if they haven't eaten for a while which is because excess acid build-ups in the stomach. Acid can be irritating to the stomach lining which causes these dogs to vomit the yellow bile that you see. Sometimes just changing the timing of the meals, or feeding smaller amounts through the day can be helpful.

Antacids can be particularly effective for this problem.
Pepcid AC at a dose of 1/4 mg/lb twice a day or
Prilosec at a dose of 1/2 mg/lb once a day (it can be given twice, if necessary) or
Zantac at a dose of 1 mg/lb twice a day.

To address the coughing she's doing.... there could be several different reasons why a dog this age would cough and the cough is getting worse. Ruling out heartworm disease and lungworms is a good first step. Other causes would include the following:

1. Problems with the heart whereby the heart can enlarge compressing the trachea and/or fluid is building up in the chest.
A heart murmur in and of itself wouldn't cause coughing... this must means that the a value is leaking. But, a heart murmur might indicate that there is underlying heart disease if one is heard in an older dog who then starts to cough.
An x-ray may indicate fluid in the chest or an enlarged heart but usually an ultrasound is needed to identify what kind of heart disease is present. Then an appropriate treatment plan could be devised; we have many excellent drugs to treat heart disease these days.

2. Bronchitis which is similar to asthma in a person. These dogs are reacting to something in their environment that triggers inflammation in their lungs. Changes in the lung pattern is often seen on an x-ray when dogs have this problem.
If this is the case, then control vs cure is what might be expected and the treatment is often different for each dog.

Some of these dogs will respond to anti-cough medications (listed below). Others will respond to bronchodilators such as Aminophylline which would have to be dispensed by your vet. Sometimes antibiotics can improve the situation since secondary bacterial infections can occur while other dogs will improve on steroids such as humans would use for asthma.


3. Collapsing trachea is primarily seen in smaller dogs; this is exactly what it sounds like and tends to worsen as dogs age.

This is also a manageable condition for the most part unless surgical intervention is done to correct the problem. This is sometimes difficult to diagnose on an x-ray but is also managed rather than cured (unless surgical correction is performed).

Many of the above treatments for bronchitis are also used for these dogs.

Carrying extra weight can be a problem for dogs with this condition and can make it worse.
Additional tips:
Use a harness instead of a collar.
Avoid any potentially irritating substances such as cigarette smoke or excessive dust.


4. Unfortunately cancer can also be seen in a dog this age. I am not trying to alarm you but just provide you with all of the information. A chest x-ray can usually identify changes consistent with this condition.


5. Valley fever (coccidioidomysosis) which is a fungal infection can also cause chronic coughing depending on where you live.



I usually recommend and advise that a chest x-ray is done in cases of chronic coughing especially in a dog this age to evaluate the heart and lungs, with additional testing if necessary.

But if you want to try cough suppressants first at least for a few days or a week to see if they help improve the situation, then the following are safe to give her. I'm going to assume she weighs about 10 lbs.


1. Robitussin Pediatric Cough (1.5 mg/ml)--1/2-1 teaspoon 2-3 times a day.

2. Vicks Formula 44 (2.0 mg/ml)--1/2-1 teaspoon 2-3 times a day.

3. Mucinex 600 mg 1/4-1/2 tablet twice a day



I hope this helps. Deb



Dr. Deb and 5 other Dog Veterinary Specialists are ready to help you

I just wanted to thank you for the rating; it's greatly appreciated.

I also wanted to wish you the best with Sheba.

I hope you'll keep me posted about her. . Even though you've rated, we can still continue to communicate at no additional charge to you. I can also send you a follow up email in a few days to which you can respond when you have the time to do so.

Kindly ignore the request for additional information. Regards, Deb

I'm just following up on our conversation about Sheba. How is she doing? Deb