Pet Vet: Find the cause behind the cough to treat ailing Lhasa Apso

March 28, 2016 

This week I am going to address a letter I received from Marty in Santa Barbara. Marty has been caring for Starr a 7-year-old Lhasa Apso dog for all of her life. In the last six months or so, Starr has developed a cough that has gotten a bit worse with time. It seems that when Marty first gets up in the morning, Starr coughs quite a bit and when she gets home from work, Star again will have significant coughing episodes.

During the weekdays, Marty is unaware of any coughing while she’s at work and on the weekends it seems to follow the morning pattern. According to Marty, Starr is fed a high-quality dog food as well as some food from her table. She seems perfectly healthy in every other way. Marty does add that she has taken Starr to her veterinarian who did treat her with antibiotics at one point without resolution of the problem.

First of all I want to commend Marty for a good detailed letter about Starr’s problem, it really helps keep my wheels turning. I also found the timeline description of Starr’s cough quite interesting and potentially quite helpful.

As we’ve touched on in the past, a cough is a symptom occurring as a result of some type of insult to the respiratory tract. It is not a disease nor is it a representative sign of one particular disease. I know it sounds like I am beating a dead you-know-what, but a cough, like any other symptom, needs to be "worked up" with appropriate diagnostics in order to discover and hopefully resolve the underlying disease process.

Starr needs to have a thorough physical examination, which should always include auscultation of the chest, which might provide some audible clues. We can hear abnormal noises in the chest including harsh air sounds and crackles that can represent problems with the airways or the lungs. It is possible to sometimes determine the presence of fluid in the chest as well. I would also carefully palpate Starr’s throat area on exam to see if the cough is easily elicited.

Along with a good physical examination, we have an excellent tool available to help in the diagnosis of a cough, the chest radiograph. These films can demonstrate many types of problems within the chest that can result in a cough. Bronchitis, pneumonia, fluid in the chest, heart disease, indications of heart worm disease, lymph node disease, tumor masses and the list goes on. Another possible cause that may indeed be possible in Starr’s case is a collapsing trachea.

The trachea or windpipe is the tubular cartilage that delivers air to the lungs. It does so by breaking into smaller and smaller branches called bronchioles that eventually terminate into tiny structures within the lungs called alveoli. I realize this may be more than you want to know but sometimes it helps in understanding certain diseases.

If the cartilage rings that support the trachea becomes weakened, it can have a propensity to collapse as a dog inspires. This collapse makes exhaling difficult and the dog will often times cough to open the trachea for expiration. This is manifested more often when these dogs are excited such as when their caretakers arrive home from being out or in the morning when they greet them. It also can occur when the throat and section of trachea in the neck are palpated.

Obesity can greatly exacerbate this condition in these patients as the extra fat around the trachea inside the chest serves to put extra pressure on the already weakened trachea. Marty did not mention if Starr was on the chubby side.

Some breeds of dogs show a much higher incidence for this condition. All those breeds in this category are small dogs and Lhasa Apsos do fall into this group, as do poodles, Pomeranians, Yorkshire terriers and others.

If indeed Starr has collapsing trachea, it can be very difficult to treat depending on the severity of the condition. There is no true cure in most cases although surgery can have some limited success if the collapsing portion of the trachea is outside the chest in the throat. If Starr is obese or even just overweight, weight reduction can have a profound good effect on this condition. We can sometimes use cough medications designed to suppress coughing that can be helpful. Your veterinarian can outline a treatment protocol that will best suit Starr.

On final point: In many cases with collapsing trachea, there can be secondary bronchitis and even pneumonia associated as the propensity for the trachea to collapse can compromise the patient’s ability to clear their respiratory tract.

These patients will need to be treated for these underlying conditions as well.



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