Ron Hines DVM PhD
How Does Your Veterinarian Go About Deciding Why Your Pet Is Coughing?
When veterinarians question owners about their pet’s cough they usually begin the interview with the same set of questions every time: Is your pet a cat or a dog? That brings a certain set of common causes to mind. When it is a cat, the common causes are somewhat different. Is it a small breed of dog – less than 15 pounds or is it larger? How long has the cough been going on? How old is your pet? Is the cough harsh and dry or is it moist and productive? Does your pet cough more when it is up and active or when it is lying down? Is your pet listless or more depressed than usual? Is it having trouble breathing or breathing rapidly? Does the problem occur during a particular season every year or in particular situations? Does your pet sneeze too? Does it have a runny nose? Was the pet been boarded or groomed recently? Has your pet gained or lost weight? Are there any other changes you have noticed in your pet? Those sort of questions give your veterinarian a basis to begin an examination. I usually begin an exam by looking at the pet as it walks around the exam room. It is amazing how much a dog or cat will tell you through its mannerisms – if you just observe them closely. Here are some things you and your veterinarian can can do to narrow things down:
Breed Characteristic:
Dogs and cats with flat faces that snore, often have elongated soft pallets in the rear of their mouths (brachycephalic breeds). This can cause coughing and gasping and in severe cases, collapse or even death. Pekingese, Pugs, Bulldogs, Lhasa Apsos, Shih-Tzu and some exceptionally short-faced Persian and Burmese type cats fall into this category. When its an emergency, providing oxygen, sedating the pet to reduce anxiety, (with drugs like acepromazine or butorphanol, and placing an endotracheal tube usually get it through the crisis. During a crisis, epinephrine spray or gauze and forceps application can be helpful. If nothing is working (the pets gums turning blue) emergency surgery to stitch the abnormally long and floppy soft pallet to the roof of the mouth can be attempted. After or during serious flare-ups I put these pets on a short oral course of corticosteroid and antibiotic treatment. But both of those drugs can take up to a day to produce positive effects. Later, in severe cases where the pet don’t get enough air oxygen. surgical removal a portion of the soft palate and remodeling of the nostrils can be performed. This is very exacting surgery and must be performed cautiously. If too much tissue is removed or scarring occurs, the coughing will become worse, and the pet will breathe food and water into its lungs developing aspiration pneumonia.
Coughs Due To Tonsillitis:
Tonsil infections, one of the many manifestations of Kennel Cough, is primarily passed from dog to dog through close contact, but it can occasionally be contracted from food, water bowls and other objects contaminated by an ill or carrier dog. Tonsillitis is most common in toy breeds of dogs and puppies. Tonsillitis is much rarer in cats. Your dog’s two tonsils normally lie in deep crypts (depressions) or crevices at the far back of its mouth. Many, many organisms (sometimes in combination) can cause tonsillitis. In humans, 19 different virus and bacteria have been blamed. In pets there are probably quite a few as well. (read here). But I know of no cases where your cough and tonsillitis has spread to your pet or vice versa although second hand or primary smoke can irritate and cause respiratory tract irritation in both of you. The shape of your pet’s face and throat are major contributors to kennel cough severity.
With infections such as kennel cough, tonsils enlarge, which partially obstructs your pet’s throat. Usually, both tonsils are affected. When enlarged tonsils become inflamed and ulcerated a dog might spend hours coughing and gagging in an attempt to cough them up. This is a retching, violent cough that usually ends in a gag, usually produces foam. Sometimes they will paw at their mouth. I treat many of these dogs with a two-week course of antibiotics. If the tonsillitis returns frequently, I often suggest that they be removed.. Many toy breeds naturally have large tonsils. But removing them rarely prevents coughing because in these breeds, it is usually a narrow trachea that is the root of the problem.
Coughs Due To Hairballs In Cats:
Long-haired cats that are infrequently groomed will periodically retch, cough and vomit up mats of hair. Brushing your cat frequently, cutting its hair or weekly administration of a flavored petrolatum-based hairball remedy usually solves this problem. Hairball cat food, high in fiber, also solves this problem. Petrolatum (Vaseline™) is a petrolum product. It is not absorbed. But being an oil, it and mineral oil-based products might absorb the fat soluable vitamins (A,D,E &K) in your cat’s diet so that they are not absorbed. So do not overdo the administration of cat laxatives.
Coughs Due To Tooth And Mouth Infections:
Small breeds of dogs, especially Toy poodles, Yorkshire terriers, Maltese and Pomeranians are very subject to gum disease, loose infected teeth and mouth inflammation. This is partly due to their genetics, but also due to feeding them soft table foods. They figure that whatever you eat must taste better than dog food and that if they turn up their nose long enough and walk away from their food bowl you will give in. These oral infections sometimes inflame the rear of the throat causing coughing. Often the problem is magnified by a flabby, narrow trachea or windpipe as well as tonsillitis due to the mouth infection. This is a quite serious problem because the bacteria in mouth infections can migrate to the valves of the dog’s heart (its mitral valve) damaging its heart as well.
So all these pets need to have diseased teeth removed by your local veterinarian. This is not major surgery in these pets because the teeth are already loose and no longer used in eating. Many vets place these pets on two or three weeks of antibiotics, and try to get the owners to feed them balanced dog foods. Changing a pet’s eating habits is not easy. Veterinarians who specialize in dentistry can perform any procedure to salvage a tooth that your dentist can. But dogs don’t look in the miror to admire their smile as we do, and, other than their four front canine teeth, they do just fine without them.
Kennel Cough
Kennel cough in dogs, is also called infectious tracheobronchitis. It is just a descriptive term as many different disease organisms with a predilection (strong liking) for the respiratory tract can be involved – singley or in combination. , Bordetella bronchiseptica bacteria as well as many respiratory tract virus are high on the list. The signs of bordetella, parainfluenza virus and Canine Adeno-2 virus and respiratory coronavirus can be identical and often the two or three organisms are working in tandem along with mycoplasma to cause your pet’s cough. To get these problems, your dog must have had recent contact with a sick or recovering pet. None of them persist long in the environment. Soft dry coughs and sneezing are the two most common signs dog owners see. They generally begin 2-7 days after your dog was exposed. Some dogs with this problem only cough when they are excited. Kennel cough organisms are highly contagious and passes directly from dog to dog at kennels, grooming parlors, pet stores, doggy parks and humane societies, dog shows, etc. Dogs with this disease rarely act ill or depressed, although they may vomit food and foam due to enlarged tonsils and tracheal irritation. In otherwise healthy dogs, the cough can last seven days to three weeks. But it can persist much longer in flat-faced breeds, dogs with narrow tracheas (their windpipe) or other lung and respiratory tract issues.
I have never seen a case of kennel cough that endangered an otherwise healthy pet’s life. But if a dog is seriously ill in other ways, kennel cough could push it over the edge. As I mentioned, it can also be life-threatening or linger in flat-faced breeds that already have trouble breathing. It is not clear that antibiotics will always make your pet get well any faster since virus are immune to antibiotics. But most vets place these dogs on antibiotics for a week or two. If the cough is not too severe, many vets dispense a guaifenesin-based cough syrup. If guaifenesin is not sufficient to control the cough, there are stronger narcotic cough suppressants such as butorphanol (Torbutrol®) for dogs. Mechanical humidifiers can be helpful in clear mucous from the throat allowing the dog to breathe easier. With either, do not exceed the amount your veterinarian suggests.
What About A Periodic Kennel Cough Vaccination?
Pets that are frequently exposed to other pets and that have a tendency to cough might benefit from a yeabrly kennel cough vaccination although I doubt that vaccine protection lasts more than about 6 months – although the manufacturers claim otherwise. (read here) Show dogs might need boosters more frequently. The intranasal vaccine is thought by most to be more effective than injectable products. However, vaccinating your dog in the days before it goes to the kennel or groomer is valueless because it takes a good week to ten days for vaccines to protect in people and pets. Kennel Cough vaccines come in two forms: One that is given by injection and one that is given as drops placed in your pet’s nose (Intra-Trac 3®, Bronchi-Shield III® etc.). In my opinion, the injectable vaccines are of little or no value. (read here) If the intranasal vaccine is accidentally given to your pet by injection, the result can be a very severe reaction. Some vets still use the injectable product because it frees them from this concern. Read more about kennel cough here.
Rhinotracheitis (Herpes-1 virus) In Cats:
The cat in the first photo above looks fine. But it still could be carrying the Herpes-1 virus. The kitten in the second photo showes a typical first-time exposure to this herpes virus. On later relapses, its symptoms of conjunctivitis should be considerably milder. Much like the cat in this exaggerated photo
You will find a more extensive description of this problem and how I have treated it under the articles entitled “Why Is My Cat or Dog Sneezing” and Upper Respiratory Infections In Your Dog or Cat. When cats with this infection cough, I believe it is usually due to secondary bacterial infections that accompany this virus. The same bordetella bacteria that causes kennel cough in dogs will cause this condition in virus-weakened cats. So I treat these cats with antibiotics, multivitamin drops, non-narcotic cough suppressants and, most importantly, good nursing care.
The amino acid, lysine, is thought by many to help cases of rhinotracheitis resolve back to an inactive state. This amino acid is thought by some to reduces the amount of another amino acid, arginine, that is present in your cat’s body. Arginine is thought to be necessary for the herpesvirus to reproduce. The suggested lysine dose for cats is 250-500 mg per day sprinkled on canned cat food until the acute flare-up has resolved. But many cat owners continue the supplement indefinitely. Lysine can be purchased at health food stores. Pick a brand that is propylene glycol-free. Read more about rhinotracheitis/herpes1/cat flu here. Concerning this problem, you can also read articles here, here, here, here and here.
Coughs Due To Collapsing Trachea:
Toy breeds of dogs are sometimes prone to a genetic abnormality called tracheal collapse. I believe I have seen it most frequently in Pomeranians, but others say Yorkies or toy poodles top the list. The trachea is made up of cartilaginous rings in the shape of a sideways “C” with the open space to the top. In collapsing trachea the inner soft portion of the windpipe is sucked into the airway during inspiration – partially blocking it. We do not know why the cartilaginous rings that form these dog’s trachias are overly flexable. With time, the lining becomes inflamed, causing a chronic dry, hacking cough. You can diagnose this condition by massaging the trachea near the dog’s chest for a minute or two. Dogs with this problem go into a coughing spell as soon as you finish the massage. But your veterinarian should check to be sure other serious problems are not also involved. Read more about the problem here.
When the problem flares up, many vets place these dogs on a cough suppressant and an anti-inflammatory drug such as prednisone until the problem resolves. It is never wise to give pets prednisone or other steroids for long periods of time if it can be avoided. Air humidifiers are also helpful. These dogs do better wearing harnesses rather than collars with their exercise limited until their cough is better. Various surgical techniques are used to attempt to cure this condition. They all meet with mixed success.
Coughs Due To Migrating Hook And Roundworm Larva:
Dog and cat hookworms and roundworms can also cause a cough. Veterinary and medical doctors call this a verminous cough. This problem is primarily a concern in young dogs, kittens and puppies coming from unsanitary conditions. When a dog or cat accidentally eats a hookworm or roundworm larva or egg, the larva burrows through the pet’s stomach or intestine into its blood stream. When it reaches the lungs it is coughed up, re-swallowed and then matures in the pet’s intestine. If the pet becomes infested with large numbers of larva due to an environment contaminated with feces, the owners will notice the cough. Children in that type of environment are also at risk of serious eye infections.
Preventing verminous coughs is a mater of sanitation. Dog feces need to be collected and disposed of properly and your children (and you) separated from contaminated soil. Hookworm larva thrive in damp shaded soil. One of the best ways to prevent this problem is to keep all your pets on a monthly heartworm medication that is formulated to kill these parasites as well. The new monthly isoxazoline+ products (eg Bravecto 1 Month Triple®) are quite effective in doing that. Read their labels to be sure they destroy hookworms. So is a twice-yearly treatment with fenbendazole (eg SafeGuard®) Again FOLLOW THE PRODUCT LABLE NOT WHAT YOU READ ONLINE!
Coughs Due To Allergies And Irritants:
Some dogs and cats, like people, experience throat and nasal irritation due to the chemicals in perfumes, cigarette smoke, new bedding, carpeting, etc. Dust mite allergy is said to occasionally cause coughing in pets. This is an uncommon primary cause for coughing in pets. Coughing can be a multi-faceted problem, and it is quite likely that allergies and irritants have made many of the cases of cough that I do see, worse. Read more about allergies in pets and what you can do about them here.
Coughs Due To Heartworm Disease:
Heartworms are transmitted to dogs and occasionally to cats by mosquitoes. The disease is considerably more common in dogs and than in cats and the signs of infection in dogs versus cats are quite different. Also cats tend to react considerably worse than dogs to medications that are administered to remove them. Mosquitoes that bites an infected pet, ingests microscopic heartworm larva (microfilaria). When they next bite a dog or cat these larva migrate through the new host’s body and lodge in the upper-right side of the heart. Depending on the number of heartworms present and the length of time they are there, the heart is slowly damaged and enlarges. The presence of heartworms also causes inflammatory changes in the lungs. In dogs, these changes, along with pressure from the enlarged heart on the windpipe cause a dry to moderately moist cough. In cats the signs are more similar to feline asthma. By the time a cough is present the disease is quite advanced and some of the changes to the heart and lungs are irreversible. Dogs with heartworm coughs are noticeably ill. They are thin over their back and their hair coat is dry and musty. They have a worn-out look about them and are often prematurely gray around their mussel and toes. If the disease is advanced, they are pot-bellied due to an enlarged liver and excess fluid in their abdomens. They will usually be positive on a heartworm antigen test. Their cough is worse when they lie down. These are pet’s that did not receive monthly heartworm preventative.
After assessing the degree of damage to the body, veterinarians treat most of these dogs with Immiticide®/Diroban®, an arsenic-containing medication that kills the adult parasites. The “three-shot” technique is the most effective for your dog if it can tolerate it. If the disease has caused marked damage to its liver and heart veterinarians often try to stabilize and improve your pet’s health before beginning these injections. If that cannot be done, there are other alternatives. Read about heartworm treatment in detail here. Although heartworm treatment eliminates all or most of the worms, it will not repair any damage already done to your pet’s heart – which would be the source of its cough. Read more about heartworm disease in dogs here. In cats here. In August of 2025, a Japanese veterinarian reported that ProHeart 6® (moxidectin) was just as effective in curing heartworm disease in a small study in dogs as the traditional FDA-approved melarsomine treatment. Read here. Time will tell if that is so.
Coughs Due To Congestive Heart Disease
Coughing is one of the most consistent signs of heart disease. The most common form of heart disease in dogs and cats begins with damage to the mitral valve on the left side of the heart. When I listen to the heart with my stethoscope, I can detect abnormal sounds on the left upper quadrant of the heart – the area where this valve is located. X-rays and ultrasonography of the pet’s heart show a typical rounded, enlarged heart shape with the trachea. Pressure on the trachea pushed abnormally high. Fluid will also be seen in the pet’s lungs. This fluid and pressure on the trachea are the primary causes of the cough. The pets’ gums are often bluish-gray (cyanotic) and slow to return to normal color when my fingers pinch them. The livers of these pets are enlarged with pooled blood, and they may have fluid in their abdomens. Mitral valve insufficiency is the most common heart disease in older dogs. It affects over one-third of the dogs that are older than ten.
Early in this condition, placing the pet on the diuretic, furosemide, eliminates the cough and improves the function of a weakened heart. These dogs and cats do well when placed on a sodium-restricted diet. As the disease progresses, your pet will need other medications. One of the most effective medications is the ACE inhibitor, enalapril maleate. Read some other more detailed article on the subject here, here & here
Coughs Due To Dilated Cardiomyopathy
Cardiomyopathy is a form of heart disease that affects larger breeds of dogs. Doberman Pinchers and boxers have a high incidence of this condition. In cats, it has long been associated with a lack of dietary taurine. It is very rare in dogs that weigh less than 30 pounds, and it is rare for it to be associated with a taurine deficiency in dogs. The onset of this disease is very rapid. Pets begin to cough and show general weakness and exercise intolerance all within a matter of weeks. When I listen to the chests of these dogs, their heart rate is very fast and weak. Often the heartbeat is very irregular. X-rays and ultrasound images of these pet’s chest show an enlarged heart – often with a distended left upper chamber (the atrium) and lungs filled with fluid. Read about this problem in detail here.
Coughs Due To Lungs Tumors:
Hacking coughs in old dogs and cats are also common when tumors are present in their lungs. These are always sad cases to deal with. When lung tumors are advance, pets may cough up blood as well as phlegm. Primary lung tumors are very rare in cats and dogs. These are generally secondary tumors that have moved to the lungs from another location.
Sometimes, if the disease is advanced, abnormal lung sounds or silent areas are present. But it is X-rays that are needed to identify the problem. Often the pet’s lungs show a shower of small tumors throughout the lung fields. The most common tumor type is adenocarcinoma. Although many vets refer these pets on to a veterinary oncologist, there is really no effective chemotherapy for dog or cats that I feel is worth the suffering they will experience in chemotherapy or the short extension of their lives that it might bring. Try to make their remaining life as pleasant as possible with cough suppressants, steroids and bronchodilators such as theophylline and lots of Love. Do not prolong their lives beyond their happiness.
Coughs Due To Laryngeal Paralysis:
This is a relatively rare condition in which the structures of the throat (larynx) become paralyzed allowing food and water to enter the lungs causing pneumonia. Large breeds of dogs (particularly Labrador Retrievers, Irish Setters and Springer Spaniels) can be affected. These dogs lose their ability to bark. They have reduced exercise tolerance and occasional fainting spells. They produce a roaring sound when they inhale. Mild cases can be managed with corticosteroids and cough suppressants such as butorphanol or codeine. The dogs need to be kept cool in the summer. Severe cases require surgery to widen the pet’s airway.
Coughs Due To Canine Distemper:
Distemper has become a rare disease in the USA in affluent areas because of vaccines against it are so effective.
The first sign of this disease is usually a soft, dry cough. Many dogs become listless and run fevers of 103-105 F /39.4 – 40.6 C. A thick, yellow discharge from nose and eyes is common. Most dogs recovered from distemper during a two-week period. But some dogs developed fatal neurological and intestinal disease. Because a virus causes distemper, antibiotics do not cure it. But we give antibiotics to prevent secondary infections. Fluids, good nurturing care and dealing with symptoms as they occur are our only treatment. Panleukopenia of cats is sometimes called feline distemper. That disease does not produce a cough. Read about feline distemper here. Canine distemper here.
Coughs Due To Lungworms:
The chief signs of lungworm infections in cats and dogs are coughing and a rise in the number of white blood cells called eosinophils. Lungworms are quite rare in an urban environment. Dogs become infected with a lungworm (Filaroides osleri) while cats become infected with Aelurostrongylus abstrusus. Adults of these parasites live in nodules in the windpipe where they pass living larva, which are coughed up. Some are spit out and others re-swallowed and pass out in the stool. Pups become infected by eating the saliva or feces of an infected dog. Cats obtain these parasites by eating birds or small rodents that have eaten an infected snail or slug. Many treat these worms with fenbendazole (Panacur®). Imidacloprid/moxidectin (Advantage-Multi) is also effective.