E122
Coughing/Gagging


Introduction: Coughing or gagging is a common problem found in dogs. Coughing is sometimes confused with panting, shortness of breath, sneezing, reverse sneezing, wheezing, retching, gagging, choking, and attempted vomiting. Severe coughing fits may often be followed by retching or vomiting which can confuse a pet owner into thinking a cough is actually an upset stomach.

Causative Agents: A cough generally occurs because of an abnormality in the lower respiratory system (trachea, bronchi, lungs). Abnormalities include irritation to the sensitive tissues lining the airways (kennel cough or other viral/bacterial infection), pressure from nearby structures on the airways (heart or lymph node enlargement), or fluid leaking into the airways or air sacs of the lungs (rodenticide poisoning or pneumonia). Coughing can also be caused by heart disease and cancer in the lungs or other structures. These are only a few of the many causes.

Clinical Signs: A cough, just as in people, is a forceful expulsion of air from the lungs. A cough may be dry or moist in its sound, may or may not be productive (meaning that it brings up a substance such as mucus or blood, which may be expelled or swallowed), and may be worse at certain times of the day. All these pieces of information are valuable to the veterinarian.

Diagnosis: History and physical examination comprise the beginning point for making a diagnosis. As part of the physical exam, the lungs are often listened to with a stethoscope (see below, A560, and B890 for additional help). This beginning point alone may be sufficient for diagnosing mild cases of infectious tracheobronchitis (kennel cough) and a few other causes of coughing. Radiographs of the lungs and heart, however, are a very high priority for a dog with a cough. By using radiographs, the lungs and the patterns which occur in the lungs of a coughing dog can be observed. This is extremely helpful in determining the cause of a particular coughing problem. Other tests which may be recommended include bloodwork (CBC, blood chemistry profile, coagulation profile), urine analysis, transtracheal wash (TTW), and ultrasound of the heart (echocardiography). See Section D for detailed information on many of the above tests.

Treatment: Any disease causing a cough has the ability to lower the natural defenses of the lungs, giving an opportunity for tiny organisms (bacteria, viruses, etc.) to cause an infection. Because bacteria and other infectious agents are constantly being inhaled and brought into contact with the delicate lining inside the lungs, antibiotic therapy is recommended in a high percentage of coughing dogs.

Other types of therapy which may be utilized include medication to improve the function of a failing heart, diuretics which may be helpful in pulling fluid from the lungs, antidotes for some types of poison (i.e. rodenticide poisoning), anti-inflammatory agents, airway dilating agents, surgery, chemotherapy, oxygen therapy, and fluid therapy. Because coughing may actually prove beneficial in many coughing conditions (such as pneumonia), anti-tussive therapy (drugs which suppress coughing) is utilized only occasionally. Coughing may also provide a gauge on how the pet is responding to medication.

Prevention: Many of the infectious problems causing a cough can be avoided through routine vaccinations and basic disease prevention techniques. Avoiding exposure to other infected animals will also reduce the occurrence of this problem. Careful monitoring of a petís respirations and lung sounds will greatly enhance the chances of detecting a problem early in its progression. This increases the chance for a rapid and successful recovery. See pages B890 and A560 for additional suggestions on how to monitor the respiratory system of a pet.

In general, any animal with a productive cough (especially if blood or pus is expelled), a lingering cough of more than a week, or with other signs of illness such as listlessness or poor appetite, should be taken to a veterinarian as soon as possible.

With practice, normal and abnormal lung sounds can be identified. See pages A560 and B890 for normal respiratory rates and additional suggestions.

Note: Signs of respiratory problems include nasal discharge, coughing, rapid breathing, and sneezing.