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My dog has had rapid breathing (around 100 breaths per

Customer Question
Hi. My dog has...

Hi. My dog has had rapid breathing (around 100 breaths per minute) for over a week now.

Veterinarian's Assistant: I'm sorry to hear that. What is the dog's name and age?

Jen and 8 years in four months.

Veterinarian's Assistant: Is there anything else important you think the Veterinarian should know about Jen?

She is no longer herself. She has no energy, is always laying down in random areas of the house, her bark and cries seem different and she has 100 breaths per minute however her gums are pink. I have chest X-rays but I don't know where to send it.

Submitted: 8 months ago.Category: Dog Veterinary
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9/25/2017
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 8 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 33,761
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 8 months ago

I'm sorry to hear of this with Jen. Thank you for the X-rays. There's consolidation in the area of her middle lung lobe apparent in the right side of her chest. Fluid appears to have accumulated in the area. This can represent lung lobe collapse due to infection, trauma, or neoplasia. Her liver appears enlarged and is extending past the margin of her ribs. Her stomach lining appears quite thickened. Needle sampling of the chest area under ultrasound guidance should be considered in such a patient. I would need to review all of Jen's history and test results to be more informative for you. Please respond with further questions or concerns if you wish.

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Customer reply replied 7 months ago
Jen's birthday is ***** 15, 2010, making her 7 years old right now and soon to be 8. She is s Pomeranian cross Maltese Shihtzu (allegedly!) is female and not desexed. She is 15kg and overweight for her size and all her life is fed human food (later cooked beef) but never pet food so she always had a diet high in fats. Unfortunately, for her entire life, she has never visited the vet besides one time when she was a few months old for vaccinations so any ongoing health issues before this are not known.Last Tuesday morning (September 19, 2017) I went into my parent's room where she usually sleeps every night and noticed her breathing (note: I differentiate breathing as her breathing with mouth closed and panting as mouth open breathing) was rapid and shallow, roughly 80 breaths per minute. She seemed lethargic, depressed, tired, not herself and was just laying in bed breathing really fast for no reason (she was sleeping the entire night!).So I took her to the vet that afternoon. For whatever reason (and this continues for the next week), the idea of taking out the leash excites her. She seems so normal, active and energetic when she is outdoors, almost as if she is normal. But as soon as she comes back into the house, she is lethargic, not herself, depressed, always wanting to lay or sit down and is just a completely different to her usual self that is energetic. At the vet, because I walked her to the vet, she was tired and thirsty so therefore she was rapidly panting (which is normal for any dog). Because of this, at the consultation with the veterinarian, I don't think he was able to see exactly what I was talking about or see what was of concern. He listened to her heart beat, took her temperature and it was around 40 degrees Celsius/104 degrees Fahrenheit which meant she had a fever. He pointed out that she was overweight and because of the fever, possibly had some sort of illness/infection and was just sick. He took a blood test to be able to get a more detailed look (which I have attached in the files attached) for her and gave her a metacam injection as well for possible infection.That night, I took her home and she was still breathing (mouth closed) very rapidly and shallow (80-100 breaths per minute) no matter what she was doing, whether she was resting, waking up, back from a walk, anything. I knew something was wrong, and did a lot of research, and planned to go back the next day to the vet for the blood test results and for more info (with a video of Jen's breathing this time so he can see what she is like at home).The next day, we got her blood test results and brought Jen in. She still had the fever and high temperature, but still seemed like herself at the vet (she could walk just fine) and behaved when walking her around the vet. The blood test results (which I have attached) revealed quite a few things: low red cell count and a high white cell count which I'm not sure what that indicates - could you enlighten me?Her chloride was slightly higher than reference ranges, bicarb slightly lower and BK was also high.
Amylase was 1861 U/L and lipase was 331 U/L, which are both really high and indicative of possibly an inflammation of the pancreas. Alk phos was also very high at 568 U/L.
I have attached the blood test results if you could view it and tell me what it all means for Jen.With this, the veterinarian said due to her diet and the blood test results, she most likely had inflammation of the pancreas and told me to let her go on a bland diet (chicken and rice) and gave her a shot of Clavulox/Noroclav injection (an antibiotic) and 12 Clavulox pills to give her twice a day as an antibiotic. He said that her rapid breathing was most likely due to the pain from the pancreas, so I came home with her but was left unsure. I know dogs have faster breathing sometimes due to pain, but her rapid breathing was CONSISTENT and happened 24/7, not just for a few hours. Her mouth is always closed as well. It just didn't make much sense to me, though I did believe in the inflammation of the pancreas diagnosis due to her diet but was not convinced it was linked to her strange respiratory rate.Changing her diet proved difficult as she rejected white rice (would actively avoid eating the rice in her food bowl and only ate the chicken) but I found that mashing everything together forced her to eat everything. Strangely, she would go long periods without drinking water, but when she did drink water, she would drink a lot. However, her rapid breathing did not change and her behavior was still very depressed and not herself.
I waited another day for the antibiotics and new diet to work, but still, her rapid breathing and down behavior remained. I did a lot of research on what could affect her breathing and wanted an X-Ray.
Customer reply replied 7 months ago
The next day (Friday - so 3 days after I first noticed her rapid breathing) I went to the vet and spoke to another veterinarian. I wasn't happy that Jen wasn't getting better and wanted more answers as I was extremely worried for my dog's health and wellbeing. She said as my previous vet mentioned that an ultrasound as the next step that it would most likely be best to do one. She took Jen and had an ultrasound done, and came back and said everything seemed OK (though I feel like she didn't look at any other organs properly with an ultrasound) but that her pancreas was definitely inflamed, and it looked very inflamed. She said that she'll give Jen painkillers to help relieve her pain, which should calm her breathing down. She gave Jen a shot of methadone, and a fentanyl patch, a painkiller that'll kick in once the methadone wears off and should last 3 days. She also gave me metrogyl/metronide 200mg tablets as an antibiotic to give to Jen on top of the other antibiotics that I was already given.That night, her rapid breathing remained the same through the methadone and the rest of the weekend despite the fentanyl patch, which confirmed what I had already suspected - that her fast respiratory rate and rapid, shallow breathing was not a result of pain from the pancreas (though this was good to find out in order to fix her diet and help the inflammation). She was restless when sleeping, I mean, who wouldn't be breathing 100+ breaths per minute 24/7. At home, she was still not feeling herself, always going into random rooms and standing or laying there, no energy or motivation to do anything, she was not herself at all most likely due to how uncomfortable she was from her breathing. Fortunately, I would regularly check her gums and they would still be pink. Strangely enough, I noticed that her barks sounded different (deeper?) and her sounds and cries were slightly different too but didn't think too much of it. She also had diarrhea. There was also one night where resting she was rapidly panting too after just laying there, maybe she got too hot? Not sure, it really scared me.Enough was enough and on Monday, I wanted an x-ray done. I had spent almost $1000 that week on consults, an ultrasound, medication, and I was nowhere close to figuring out why Jen was breathing the way she was or her behavior was the way it was. The vet was fully booked out but agreed to give Jen an x-ray when they found time. So I dropped her off at the vet at 9am, and I waited all day and they sadly didn't do the x-ray til 4pm and the veterinarian wasn't free until 6:45pm to talk to me. So that night, I went in to pick her up and take a look at the x-rays (which are attached to my original question) and was hoping if you could give me a detailed analysis on the x-rays and everything that seems abnormal.
The veterinarian told me that she had an enlarged heart, as evidence from the shape of the trachea above. He also pointed out that there was fluids in Jen's lungs, which could be the reason for her breathing issues. He said that the "dots" (?) above her heart in the side x-ray could be indicative of cancer, but was not certain and did not think so. I think he said he tested for a heart murmur but did not think she had it, but possibly pneumonia. He said Jen's situation was a strange one, due to her breathing problems and her having a lot of different health issues, but due to her not coughing, could rule out a lot of other issues like cushing's disease. He had sedated her to perform the x-ray and gave her a shot of some diuretic, and sent me home with frudix tablets 40mg to give 1.5 the amount to her twice a day to hopefully expel the fluids in her lung and see if it changes anything.At home, she felt really off. She of course drank more water due to the medication, but kept standing in random areas of the house (at the doorway, parent's bathroom, etc) and just sitting there for long periods of time (not even sleeping). Sadly, that night her breathing was still rapid and not the same and today, here we are.She is still not herself, is always laying around the house, seems tired, no energy and depressed, rapidly breathing 24/7. I hope that on medication I'll see some improvement, but if the main issue that has resulted in her condition isn't because of the fluid in her lungs, then I'm scared. I know that an enlarged heart is a huge issue that is irreversible. You mentioned her liver being an issue too. I just want to find out what is happening and how to treat it and get the old, fun, energetic Jen back and let her live life normally and was wondering if you could read all this, see all the files attached, and really help me out here. I've spent hours researching and want an expert to give me a detailed analysis on what could be happening to Jen.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

Thank you for the detailed history.Nothing in the blood work tells me the primary problem. There's a mild nonregenerative anemia, mild increase in white blood cell count (both are consistent with a chronic inflammatory disorder), she's acidotic (many systemic disorders cause the blood to be too acid), elevation of both amylase and lipase (but neither identify pancreatitis but apparently the ultrasound did), a significantly elevated alkaline phosphatase but this "liver enzyme" can elevate from both pri***** *****ver disorders and disorders outside the liver such as pancreatitis, a mildly decreased glucose (starvation?), and a low thyroid hormone level likely due to non-thyroidal illness.

I don't appreciate an enlarged heart or, at least, a significantly enlarged one. The "dots" appear to represent focal calcification of no concern. The most significant pathology remains in the middle lung lobe/consolidation of lung in that area. It's not unreasonable to continue antibiotic therapy and a low dose of diuretic. Pancreatitis is treated symptomatically and supportively with fluids, analgesia (a narcotic such as tramadol is preferred over the nonsteroidal inflammatory drug meloxicam/Metacam), antiemetic and antacid (if need be). I still would want to needle aspirate that abnormal lung area. Jen is a complicated enough case to consider referral to a specialist veterinary internist.

Please continue our conversation if you wish.

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Customer reply replied 7 months ago
Hi there, are you able to explain to me what using a "needle to aspirate the abnormal lung area" means? Is that getting vials for testing or is that to clear the fluid?Since being on frudix (furosemide) 1.5 x2 a day, her breathing seems to have... changed. It's not as rapid anymore (no longer 90-120 breaths per minute), now it's 50-60 but it's also now much more.... heavier. She looks like she's breathing in and out a lot more deeply, and at night this becomes pretty vocal when she's sleeping.Also, she's trembling... a lot. I think it might even coincide with when she's taking her meds, could this be from her antibiotics or the furosemide do you think that she's currently on? (she's on two different antibiotics that I write about in my post)Also, do you know how enlarged her heart is? Is there an easy way to tell how bad it is without old x-rays to pull info from?Thank you so much!
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

A needle would "tap" that cloudy area in her lungs. Cells or fluid retrieved is then analyzed which hopefully would clarify why that area looks so abnormal in the X-rays. Furosemide can "dry out" that area somewhat which would make breathing easier but 50-60 is still too high. Trembling is likely to be a pain response. As I mentioned above, I didn't appreciate an enlarged heart, or at least, a significantly enlarged one. It would be nice to compare it to old films.

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Customer reply replied 7 months ago
She sadly has no old x-rays to compare to. Is there a way for us to tell how large her heart is enlarged based off the biology around the heart without comparing to old x-rays?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

There are various way to estimate heart size but if I had ten radiologists look at her heart, it's likely that I would get ten different opinions. On the lateral view it appears slightly enlarged. On the D-V view it looks normal to me.

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Customer reply replied 7 months ago
Also, in the past few days, I've noticed ***** *****ke... licking her lips a lot (?) while she's laying down? She's doing this a lot more than usual.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

That's usually a sign of nausea, gastroesophageal reflux (GERD, acid reflux, heartburn), or nonspecific GI distress and can be addressed with an over the counter antacid such as famotidine (Pepcid) dosed at 0.25 mg per pound of body weight at 12 hour intervals.

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Customer reply replied 7 months ago
Hi, since being on the new med, Jen has been chewing and licking a lot throughout the day on nothing. Is this a side effect of the diuretic, dehydration or could it be something in her mouth? Or even a sign of dental disease?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

Dry mouth (from the diuretic) or those other problems I mentioned will cause that behavior. Oral pain/dental disease is possible.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
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Customer reply replied 7 months ago
Nothing has changed since her furosemide dose.She is still lethargic, sleeping all day, and not herself. She is so different to the dog she used to be, one energetic to now nothing. She doesn't even want to go on walks anymore and the first week she still would walk and eat (and now she's barely eating)Her breathing is 70-80 breaths per minute and she is trembling every now and then and barely eats at all. She also isn't peeing a lot despite being on furosemide.I'm gonna wait to go to the vet later this week to find out more. Do you know what I should do or ask whilst I'm there besides maybe ask to analyse a fluid sample from her lungs and get another x-ray? I also heard about vetmedin that could be good?I just want the old Jen back.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

Yes, repeat X-rays are needed and if there's a pocket of fluid to tap it should be tapped and then the fluid analyzed. I wouldn't wait until later this week. She needs attention before that and if her vet can't determine what's going on with Jen, referral to a specialist veterinary internist should be considered.

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Customer reply replied 7 months ago
Hi, based off the blood work and symptoms, do you think she could have Addison's Disease and what is the best way to treat it?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

There's no evidence of Addison's in the blood work nor would Addison's cause the changes in her lungs.

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Customer reply replied 7 months ago
I've noticed her starting to limp when she goes to drink water. She's sleeping almost 24/7 now, so it's hard to get a good look at what this issue could be and on which leg.Could this just be from her sleeping all day causing her to limp when she walks for water or is this something to be concerned about? Possible indication of arthritis and/or heart worm disease?
Customer reply replied 7 months ago
ACRUALLY, could it even be a bad side effect of the furosemide?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

No, lameness isn't an adverse effect of furosemide and it doesn't indicate heartworm disease. Trauma, arthritis, neoplasia, myelopathy (spinal cord disorder) are all considered.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

Regretfully, these films are too unclear to be properly assessed.

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Customer reply replied 7 months ago
I just came back from the vet and here are her X-Ray's. the good news is that the furosemide has cleared up the fluid in her lungs! The bad news is that this means the fluid in her lungs didn't directly cause her rapid breathing and depression, so now we're putting her on 2.5mg x2 a day on vetmedin to see if that will change things.anything notable on the X-Ray's?
Customer reply replied 7 months ago
Also, in both the original and new x-ray, there's like a gas pocket or something empty at the bottom right near the liver. What is that?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

I don't understand why this would be bad news. Fluid in the lungs is the most likely cause of her tachypnea and depression. I don't see anything exciting in the lateral view but there appears to be bilateral ventricular enlargement in the VD view. The gas pocket is in her stomach.

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Customer reply replied 7 months ago
It's pretty much completely cleared up here, yet her tachypnea and depression has stayed the same?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

Her heart needs to be better understood. That's done by having an echocardiogram (ultrasound of her heart) performed.

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Customer reply replied 7 months ago
She's been on Vetmedin for a few days now and her breathing is still rapid and laboured, though it'll take a bit more time before we'll see if it changes things.I've noticed her gums are pale pink, and it makes me wonder if all her symptoms (lack of appetite, fast breathing, depression, ect) are as a result of anemia.I attached blood results in one of my earlier questions and I was wondering if there was anything there to indicate this or if I should go back to get anemia tested.I'm just worried too about the Vetmedin as I heard it could have a negative affect on dogs who aren't necessarily in CHF yet, or early stages and Jen hasn't been officially diagnosed with any heart problems.
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

I would be reluctant to prescribe pimobendan (Vetmedin) without confirming a heart condition. Hence, the need for an echocardiogram. As mentioned bove, she was minorly anemic. It would be smart to recheck her complete blood count.

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Customer reply replied 7 months ago
Just wondering if it's possible that her rapid breathing is due to some sort of tooth ache?It's been 3-4 weeks now and her breathing is around 60-70 breaths per minute 24/7, however she's still alive today and her gums are still pinkish. She also is constantly doing some sort of chewing motion or licking her teeth, then swallows throughout the day. I don't think it's nausea as she only does it for a few seconds and doesn't continue for a while later? Whilst if it was nausea you'd think it'd be constant for at least a few minutes?Though i've been trying to do research and I haven't seen many reports of dogs having tachypnea 24/7 for weeks from tooth pain
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

Rapid breathing can be due to pain of any kind. Yes, nausea isn't likely for just a few seconds. I agree. Cardioplumonary disorders are most likely to cause such persistent tachypnea.

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Customer reply replied 7 months ago
Also, based off earlier x-rays, would Jen be diagnosed as having pulmonary edema or pleural effusion (lung or chest) or are they the same thing?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

It's unclear if the earlier X-rays revealing consolidation of the middle lung lobe represented a local edema or effusion. Edema is swelling of tissue with fluid. An effusion is free fluid in a cavity.

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Customer reply replied 7 months ago
it's been a month and a half since I first noted the symptoms, but she's back to her normal self now, minus the rapid breathing. None of the meds have done anything. She even fell asleep last night sitting but with her head still up (she seemed so restless and uncomfortable).Also, last night I noticed one of her nipples really red and swollen. Today, that specific nipple doesn't look as swollen, but the other nipples have gone bigger and more red. I was wondering what this could be? There are also red marks (not really rashes) all over her belly that appeared weeks ago and haven't disappeared.I was thinking it was mastitis but I know 100% she isn't pregnant, and even if it was a false pregnancy, she isn't exhibiting any other false pregnancy signs and I don't think mastitis would explain her rapid breathing from one and a half month ago until now.Could it also be an infection (the one that maybe caused the rapid breathing) that has spread to other parts of her body causing mastitis?
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 7 months ago

I see a diffuse erythema (redness) of the abdominal skin as well as the swollen nipples. I can't rule out a false pregancy if it's been 1-3 months since her last heat. A superficial spreading pyoderma (bacterial skin infection) is the most likely cause of the erythema. I don't appreciate mammary gland swelling indicative of mastitis, however.

My moderator won't allow my continuing on in this conversation. It was opened a month ago. You'll need to close it by rating and then open up a new conversation, please.

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Dr. B.
Dr. B.
Veterinary Degree (BVMS)
3,475 satisfied customers
My cat is in the final stages. He has pancreatic cancer but
My cat is in the final stages. He has pancreatic cancer but recently got worse. He was walking earlier today (with difficulty) but now he won't put weight on his back leg. Last year he had back surger… read more
divealot1
divealot1
DVM
8 satisfied customers
Is it possible for a dog to have pancreatitis that does not
Is it possible for a dog to have pancreatitis that does not show on ultrasound? He's been anorexic and depressed for 3.5 days, and hospitalized and on IV and meds for 2 days. He had a SNAP test that w… read more
Dr. Bruce
Dr. Bruce
Veterinarian
Doctor of Veterinary Medicine
9,533 satisfied customers
My dog has been hospitalized for suspected pancreatitis
Hi - my dog has been hospitalized for suspected pancreatitis since Tuesday. An ultrasound came back clear, but he isn't any better at all. Lethargic, constantly sleeping and won't eat or drink. He's o… read more
Kelly Hill
Kelly Hill
Doctor of Veterinary Medicine
600 satisfied customers
My primary question concerns changes in behavior which
My primary question concerns changes in behavior which include pacing and what seems to be frustration at night, including whining.Mikos is a 17-year-old Chihuahua mix and has been in relatively good … read more
Dr. Denise
Dr. Denise
Veterinarian
Doctor of Veterinary Medicine
532 satisfied customers
My chicken had chicken pox. Can you please help me with
My chicken had chicken pox. Can you please help me with that? It started like 2 weeks ago, i didn't notice until now because his chicken pox it not that bad. i mean he had chicken pox, but not too muc… read more
Scott Perry
Scott Perry
Veterinarian
Doctor of Veterinary Medicine
2,468 satisfied customers
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Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

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