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Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 30380
Experience:  University of California at Davis graduate veterinarian with 45 years of experience
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My dog has had a cough for 5 months, my vet hasn't a clue

Customer Question

My dog has had a cough for 5 months , my vet hasn't a clue what's wrong
Submitted: 11 months ago.
Category: Dog Veterinary
Expert:  Dr. Michael Salkin replied 11 months ago.

You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

Expert:  Dr. Michael Salkin replied 11 months ago.

I'm sorry to hear of this with Smudge, Kenny. The initial database for such a patient should include thoracic radiographs (x-rays) and a lateral cervical radiograph, fecal examination for lungworms if lungworms are endemic where you live, heart antigen test if you live in a heartworm endemic area, and a routine medical evaluation including a complete blood count, biochemistry profile, and urinalysis if a patient shows systemic signs. If all of the above have been performed by Smudge's vet and the etiology of his coughing hasn't been clarified, it's time to have another vet attend to Smudge - preferably a specialist veterinary internist as can be found here: rvc.ac.uk/small-animal-referrals/internal medicine

Please respond with further questions or concerns if you wish.

Customer: replied 11 months ago.
Smudge has been back and forward to the vet since June , sometimes twice a month , she had a course of steroids for the first couple of months then the vet included antibiotics , these didn't make any difference so she was taken in to be knocked out and a full internal examination with a camera was carried out , the only thing that was picked up on was an amount of mucous in her throat , her heart lungs etc were all as should be , the vet then prescribed bisolvon powder for the last 3 weeks to help loosen things up , still she coughed but It was more like a wet cough . I had to take her back yesterday where she was given yet more steroids and another doze of advocate spot on , she's been coughing worse today after the advocate treatment . My vet suggested the next step would be to refer her up to the " dick vet" in Edinburgh but says it will cost me a fortune as they tend to start from stage one again regardless as to what's already been tried . I don't know where to turn next , is there any chance that this could be an allergy from something in our house ? Kind regards ***** *****
Customer: replied 11 months ago.
Forgot to mention she had X-rays done at the same time as the camera down her throat
Expert:  Dr. Michael Salkin replied 11 months ago.

Thank you for the additional information, Kenny. To answer your directly, yes, topical irritants such as dust and immune-mediated sterile bronchitis ("asthma") can cause such protracted coughing. I would have expected to see increased bronchovascular markings in Smudge's X-rays if either were the case, however. Was a culture and cytology (microscopic exam of a sample of the retrieved wash) performed as well as scoping?

Considering her extensive steroid therapy, it appears that the working diagnosis has been a sterile bronchitis. Was there any positive response to the steroids?

Customer: replied 11 months ago.
As far as I'm aware there wasn't any microscopic exam done . When she was first put on the steroids they did seem to make a difference but then the coughing becam worse then improved then worse again so pretty hard to say . Smudge seems to go through spells where she only coughs 5 or 6 times to clear her throats after awakening from a snooze then she can cough nearly all the next day then return to the minimal cough for a week then back to coughing all the time . Today when I took her a walk she sounded like a pig snorting as she was sniffing scent left by another walker , there seems to be a build up in her nose . Sometimes we can take her away in my car to the beach and she doesn't cough once , the reason I ask about the allergy is that my partner has a horse and when she took smudge in her car to the vets smudge coughed and coughed like never before , her car is full of horse tack and dust etc . In fact it was the first time the vet had actually witnessed smudges cough . The other thing I seem to remember is I took smudge away for a couple of day to visit family and I never heard her cough once , that was back in august . weve spent nights upon nights trying to work out what she could be allergic to if anything . She's been on 2 steroid tablets per day up until last night where my vet put her up to 1 1/2 tablets twice a day
Expert:  Dr. Michael Salkin replied 11 months ago.

It does sound as if her cough is allergically mediated. A tracheal/bronchial wash would have been handy to see if evidence of allergy were present - an abundance of the white blood cell eosinophil and an absence of infectious agents. How much does Smudge weight and how many milligrams are in each tablet, please?

Customer: replied 11 months ago.
She weighs 27.5 kg and they are 2mg tablets , her weight is down 1.5 kilos from when she was spayed a year ago
Expert:  Dr. Michael Salkin replied 11 months ago.

2 mg of methylprednisolone? Dogs weighing 18-36 kg are usually administered 4-8mg daily; doses should be divided and given 6-10 hours apart. There are a plethora of doses and protocols, however. Has immunotherapy been discussed with you - allergy "shots" or sublingual therapy? Testing isn't necessarily essential. Newer protocols attempt to desensitive against all of the common offending allergens where you live.

Customer: replied 11 months ago.
It says " medrone" on the lable , no allergie advice was mentioned , I asked the vet last night if this could be an allergic and she said that she didn't think so as she would have expected to see signs in smudges lungs
Customer: replied 11 months ago.
I need to go out for 2 or 3 hours so I won't be able to respond to your questions until I return , thank you , Kenny
Expert:  Dr. Michael Salkin replied 11 months ago.

Yes, that's methyprednisolone. It sounds as if Smudge has a post-nasal drip seen with inhalant allergies. Her lungs may remain normal but her naso- and oropharynx is likely to be quite inflamed. I think that she's a good candidate for immunotherapy if only to lessen the dose of methylprednisolone. I'll watch for your next post.