Thank you again,
Now your lad's history, duration of signs, and the character of his respiratory sounds does raise a few suspicions. First, since Max's signs have been present over such an extended period of time, we can rule out transient or temporary issues (ie infectious agents, foreign bodies, etc). As well, if his signs are non-seasonal, then we'd be less concerned about an allergy component. Furthermore, since this started when he was so young, I'd be less suspicious of upper airway polyps or growths
With those aside and considering everything you have told me, I have two main concerns here. One concern is that he has reverse sneezing
(what you saw in the video). This is a condition that we see in small breed dogs that have sensitive upper airways. They can be prone to this if they have longer then normal soft palates or if they are just sensitive to air borne irritants that they breathe in.
Further to this, the other issue that I'd also be suspicious about with Max is a collapsing trachea. This too is very common to our small breed dogs and often are something they are born with but can progress over the course of their lives. It occurs because the cartilage rings in the trachea are softer then ideal. So, when the dog gets excited and tenses their neck muscles
, it pulls the trachea taut and collapses it. This can lead to coughing after excitement and in severe cases they can also faint.
In regards ***** ***** we approach these cases, it depends on the severity of signs and your vet's exam/xray findings. For severe cases, surgery can sometimes be indicated (ie to shorten the palate, to place a stent to increase tracheal rigidity). But in Max's case, if no treatment has been tried, then you may want to discuss treatment options with his vet. For example, if he is sensitive to an airborne irritant, then antihistamines (ie Benadryl) could be helpful in reducing his signs. Otherwise, we'd want to consider a trial on anti-inflammatories (ie steroids or non-steroidal anti-inflammatories). This can reduce inflammation and sensitivity in the palate and thus reduce the reverse sneezing and these episodes. As well, it can reduce the risk of tracheal collapse in dogs that have tracheal sensitivity (though we wouldn't be likely to complete reduce this since the tracheal rings would always be softer then they should be). It will be a case of trial and error to see what works best for him. Still, if we can reduce that irritation then we can hopefully reduce these episodes for him.
So, do check with his vet what tests were done and what their findings are. But if these 2 issues were their findings, then it'd be worth considering a trial on anti-inflammatories to see if we can reduce Max's signs and keep him more comfortable.
Please take care,