Coughing occurs commonly in dogs and cats and has many potential causes. Coughing must be differentiated from sneezing, reverse sneezing, gagging and retching, which can be challenging even for an experienced clinician!
Extensive diagnostic testing may be required to differentiate the underlying causes. Some pets may exhibit more than one cause! In mild cases, coughing may be self-limiting, resolving spontaneously. In more severe cases, coughing is persistent, and some animals may present with breathing difficulty. You, as the pet owner, will play a vital role in the clinical workup of your coughing pet! This is because you know your pet better than anyone and can observe them at home when they are most at ease!
How to evaluate your pet’s cough
During the consultation, the clinician will ask questions to better define the cough and to formulate a diagnostic and treatment plan. They will require elaboration on the nature of the cough. It may be helpful to characterise your pet’s cough according to the three C’s:
- Character
- Chronicity
- Concern
1. Character: what is the nature of the cough?
- Continuous vs sporadic/paroxysmal: Does coughing occur non-stop at regular intervals or at random times? Can the cough be characterised as violent, uncontrollable episodes or even as exhausting coughing fits?
- Moist vs dry: A moist cough may suggest lower respiratory involvement. Is your pet also dull and depressed? Conversely, can the cough better be described as dry and “hacking” or as a “goose honking” cough?
- Productive vs non-productive: Does coughing bring up mucus or phlegm? What does the material look like? (eg clear, blood-tinged fluid or frank blood). Does your pet appear to swallow immediately after coughing? Does your pet appear to vomit or regurgitate immediately before or after coughing?
- Timing: Is coughing worse during the day or night, or is it independent of time of day?
- Exacerbation: Can you identify any other features that may exacerbate the coughing? (eg rest/sleep, exercise, excitement, pulling on the leash, exposure to cold air).
2. Chronicity: how long has the cough persisted?
- Acute: Persisting for days to weeks but less than 3 weeks.
- Subacute: Persisting for multiple weeks.
- Chronic: Persisting for months or longer.
- Acute on chronic: Recent exacerbation (in severity or frequency) of a persistent/chronic cough.
3. Concern: what is the impact of the cough on your pet?
- Frequency: Is the coughing becoming more frequent? Is there complete resolution between episodes?
- Severity: Is the coughing becoming more severe?
- Duration: Do coughing episodes persist for longer periods?
- Other signs: Are there any new or concurrent clinical signs? This may include weakness in the limbs, collapsing, vomiting or regurgitation. It’s important to keep an eye out for any other symptoms!
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Reasons why your pet may be coughing
There are many reasons why your pet may be coughing, and dogs and cats may also cough for different reasons. These are some possible causes:
- Allergies: Just like humans, dogs and cats can suffer from allergies that can cause coughing. Dust, pollen, mould, or certain foods could trigger this. Allergies may cause coughing but also sneezing, and watery eyes.
- Asthma: Feline asthma (also known as feline allergic airway disease) is a respiratory condition in cats where the airways become inflamed and constricted, resulting in breathing difficulty, coughing and wheezing. Asthma “attacks” are often triggered by allergens or irritants in the environment.
- Heart disease: Coughing may occur secondary to heart disease (congestive heart failure or less likely, heartworm). This is much more typical in dogs than cats. This type of cough is made worse during physical exertion but can also occur at night when at rest. A typical normal respiratory rate when your pet is at rest is less than 30 breaths per minute.
- Collapsing trachea: Smaller breeds (Pomeranians in particular) may develop a collapsing trachea, which can cause a dry, honking cough.
- Respiratory infections: Dogs and cats can get upper respiratory infections that cause coughing, nasal discharge, or wheezing. These infections can be viral or bacterial. Canine kennel cough and cat flu are the most common respiratory infections in dogs and cats, respectively. These are common and highly contagious, spreading readily in areas with higher animal density, such as boarding facilities, dog parks, or grooming salons.
- Parasites: Heartworms, lungworms, and other parasites in endemic areas can also cause coughing in dogs and cats.
- Irritants: Smoke, strong perfumes, cleaning products and other irritants can trigger coughing.
- Foreign objects/obstruction: Foreign material may include toys, food, hairballs. Obstruction may also be caused by growths in and around the airways.
When should my pet be evaluated for coughing?
It is recommended that your pet is evaluated by a veterinarian as soon as possible if coughing is a persistent feature. Evaluation may be more urgent if clinical signs are more severe, progressive, or your pet appears systemically unwell!
What are the available management options?
There may be available medications to reduce the severity and duration of your pet’s cough. However, more definitive management should be focused on identifying and treating the underlying cause. Sometimes this is an easy fix or may require multiple diagnostic tests and treatment trials. In some cases, coughing may remain as an ongoing problem despite having a diagnosis.
What diagnostic tests will be required?
Diagnostic tests will depend heavily on the clinical history and presenting signs, but may include one or more of the following tests:
- Upper airway evaluation
- Chest X-rays
- Chest CT scan
- Tracheoscopy/bronchoscopy
- Transtracheal wash (TTW)
- Bronchoalveolar lavage (BAL)
- Fluoroscopy (swallowing study)
What are the necessary treatments and over what timeframe?
This also depends heavily on the diagnosis and severity of signs. It is important to remember that only treating the clinical signs may not address the underlying problem. Clinical follow-up and review will be required to monitor a response to treatment and to make decisions regarding ongoing management. Follow-up diagnostic tests may be required or a change in the prescribed medications.
If your pet’s cough persists for more than a few days or is accompanied by other clinical signs (eg, lethargy, loss of appetite, or difficulty breathing), it’s a good idea to get them assessed by a veterinarian as soon as possible. Recommended diagnostic tests and the treatment will depend on clinical evaluation findings.
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