Why is My Dog Coughing

🩺 Why Is My Dog Coughing?

A Step-by-Step Veterinary Diagnostic Flowchart

1. Start With Key Questions

➡️ How old is your dog?

·       If under 8 weeks, consider birth defects (eg heart problem), cleft palate, or aspiration pneumonia

·       If 2-36 months, consider infectious disease (bronchitis, kennel cough) or allergies

·       If over 5 years, consider lung cancer, heart disease, or heart base tumors.

·       If older dog and symptoms occur during/after eating, consider laryngeal paralysis.

 

➡️When did the cough begin?

• Sudden onset → often infection, allergy, or aspiration.
• Gradual or chronic → could be heart, airway, or long-term inflammation.

➡️ What does the cough sound like?

• Dry and honking: May indicate tracheal collapse or airway irritation.
• If lungs are normal but trachea is harsh, likely tracheal collapse or irritation (eg leash)
• If airways are harsh or crackles/ wheezes are heard, consider pneumonia or bronchitis
• Wet or productive (ie, trying to “hack something up”: Could suggest pneumonia, heart problems, or severe bronchitis.   Diagnose with chest x-rays.  Treat pneumonia with antibiotics, typically doxycycline or clavamox.  If pet not eating and drinking, hospitalize for IV fluids and drug administration.   If bronchitis, pet can usually be treated at home with antibiotics if infection suspected, or steroids if allergies suspected.  Recommend bronchodilators like theophylline to improve breathing.

➡️ Has your dog been around other dogs in the last week?

• Yes: Prioritize infectious causes such as:
• Kennel cough (Bordetella, parainfluenza)
• Canine influenza
  🧪 Testing: Respiratory PCR panel, chest X-rays
  💊 Treatment: antibiotics like doxycycline or clavamox, rest, isolation

➡️ Where do you live?

• Central/Southern CA, AZ, NV, or NM: Consider Valley Fever (Coccidioidomycosis).
  🧪 Testing: Coccidioides antibody titers (IgM/IgG)
  💊 Treatment: Long-term antifungal medication (fluconazole or itraconazole)

➡️ Is your dog on heartworm prevention?

• No: Heartworm disease can cause coughing, fatigue, and exercise intolerance.
  🧪 Testing: Heartworm antigen test
  💊 Treatment: Heartworm therapy under veterinary supervision

➡️ Does the cough worsen with excitement, drinking, or pulling on the leash?

• Yes: Suggests tracheal collapse or laryngeal paralysis.
  🧪 Testing: Chest X-rays, fluoroscopy
  💊 Treatment: Cough suppressants, bronchodilators, weight control, use of harness instead of collar

➡️ Does your dog have a heart murmur or irregular heartbeat?  If so, consider cardiac disease as reason for cough. Diagnosis with chest x-rays and EKG, may require echo exam.

 

➡️ Consider urgency:  Recommend IMMEDIATE veterinary exam if…

·       Dog cannot stop coughing

·       Dog has not been eating

·       Dog is depressed

·       Dog’s gums are white or grey

·       Dog is having difficulty breathing

·       Dog has a fever

·       Dog cannot catch breath

·       Dog coughing up blood or frothy foam.

 

3. Recommended Diagnostic Tests and Why They Matter

Test	Why It’s Done	What It Tells Us
Chest X-rays	Check lungs, trachea, and heart size	Pneumonia, collapse, enlarged heart, tumors
Heartworm Test	Detects parasite infection	Confirms or rules out heartworm disease
Bloodwork (CBC/Chemistry)	Looks for infection or organ changes	High white cells → infection; eosinophils → allergy or parasite
Tracheal Wash or Airway Sample	Identifies bacteria, fungi, or inflammation	Guides antibiotic or antifungal choice
Echocardiogram (heart ultrasound)	Evaluates heart function	Detects valve disease or heart failure
Coccidioides Titers	Tests for Valley Fever	Positive = fungal infection from desert soil exposure

4. Common Diagnoses and Treatments

Diagnosis	Urgency	Typical Treatment
Infectious Cough (Kennel Cough, Flu)	🟡 Moderate	Antibiotics if bacterial, rest, isolation, avoid excitement
Pneumonia	🔴 High	Hospital care, IV fluids, oxygen, antibiotics
Heart Disease or Heart Failure	🔴 High	Heart meds (furosemide, pimobendan), oxygen if severe
Tracheal Collapse	🟡 Moderate	Weight control, cough suppressants, harness, bronchodilators
Chronic Bronchitis	🟡 Moderate	Inhaled steroids, bronchodilators, avoid smoke/dust
Valley Fever (Coccidioidomycosis)	🔴 High	Long-term antifungal meds (6–12 months), periodic blood rechecks
Lung Tumor or Metastatic Cancer	🔴 High	Imaging, biopsy, oncology referral
Heartworm Disease	🔴 High	Melarsomine injections, exercise restriction

5. What You Can Do at Home While Awaiting Results

✅ Keep your dog rested and calm
✅ Avoid exposure to other dogs until infection ruled out
✅ Use a harness, not a collar
✅ Do not give over-the-counter cough medicine unless directed
✅ Record when and how often your dog coughs — Video is best.  Helps your vet assess patterns