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Coughing shih tzu.

Species: Dog
Breed: Shih tzu
Age: 8-11 years
Louie has always gagged after drinking water, often clear watery mucous comes up. He sometimes throws up clear yellow mucousy liquid but not related to the water drinking episodes. Also, more often lately, has episodes of deep stomach wretching upon arising from a lying position usually, gagging and coughing and unable to stop any of it for several minutes, then sits quietly upset and soon it returns...he had the intermittent coughing, gaggin, wretching last night and did not settle down to sleep for several hours. He pants often at night and sits up to pant.

Louie has regular vet care but if I take him in without any idea of what is happening, they will run several hundred dollars worth of tests and xrays then tell me to take the info to a specialist. At that point they have spent my budget so I can't afford the specialist. (Happened with my cat last year, I think she had a blockage or cancer...I had to put her down without knowing why.))

I suspect Louie may have thyroid enlargement as his throat appears enlarged...I recently clipped him close for summer and noticed his throat seems bilaterally puffy. Do these symptoms sound as though there is a restriction, or reflux, or thyroid enlargement of could it be simply a short eosophagus on a long dog who is a few pounds overweight....but not obese. I am afraid to assume it is due to his 'short long pudgy build' as vet suggested the last couple of times I mentioned it.

I may need to respond to your response tomorrow as I have to be somewhere in one hour. Thanks.

Online vet, Dr. Marie

Dr. Marie replied:

Hmmm...thanks for your question. It sounds like Louie is definitely having some type of medical issue. I'll give you my thoughts and maybe you'll have a better idea of what you are in for at the vet's office.

My first thought was that Louie could have a problem with his heart. It is very common for a shih tzu to develop a heart problem. If the heart is having problems it can cause coughing for two reasons:

1. If a heart is struggling a little it can get enlarged. The enlarged heart will push up on the trachea (breathing tube) and can cause coughing.

2. If a heart is diseased there can be extra fluid in the chest which can cause coughing.

The first thing your vet will do is a physical exam. They'll have a good listen to Louie's heart and lungs. If he has a heart problem then there will probably be a heart murmur present. Now, some dogs can have a heart murmur and it's not necessarily an issue. If Louie has been to the vet before then they can compare and see if the murmur is worse than any previously noted murmurs.

If there is a heart murmur then they'll likely want to do chest xrays to see if there is heart disease. If so, they will prescribe one or more medicines to help his heart.

We don't see a lot of issues with dogs that could cause thyroid enlargement. A thyroid tumor could cause this but that is quite rare.

I'm wondering if what you are seeing as thyroid enlargement is actually submandibular lymph node enlargement? These lymph nodes sit on either side of the neck right behind the back of the lower jaw. If his lymph nodes are enlarged then the vet will likely do a test where they put a needle in and see what kind of cells are there. Some types of infections can cause lymph node enlargement, but the more common cause for this is some type of cancer. Hopefully that's not it.

Some dogs do just occasionally have coughing episodes, but if it is getting more and more frequent there's probably a reason for the coughing.

If the recent bouts of coughing came on suddenly then kennel cough could be an issue. You can read about kennel cough here.

Your vet may also want to do some basic blood tests as well to rule out infections and other conditions.

Hopefully this helps, but let me know if you have more questions!

Dr. Marie.

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Disclaimer: Although Dr. Marie is a qualified veterinarian, the information found on this site is not meant to replace the advice of your own veterinarian. and Dr. Marie do not accept any responsibility for any loss, damage, injury, death, or disease which may arise from reliance on information contained on this site. Do not use information found on this site for diagnosing or treating your pet. Anything you read here is for information only.

Customer reply:

Heart issue sounds possible. Louie had a murmur as a puppy but it has not been mentioned since. He is also quite lethargic. Sleeps about 20 hr out of 24. He can walk around the block but even though we go slow, he sometimes just sits down and I have to carry him home.

The coughing has always been there just getting worse and seems more severe the past month. He is seldom around any other dog and stays indoors in the air conditioning all day. He does not tolerate heat at all. And of course he is not spoiled at all!

I will make an appointment at his Vet tomorrow for a check up and let you know what they find out.

Thanks so much.

Customer reply:

Louie saw the vet Thursday. His heart and lung exam was inconclusive since he was growling. They kept him a couple hours to do xrays and observation. Xrays were digital and amazingly clear. His heart appeared "round" and enlarged on the right side. Treachea looked normal. Lungs appeared evenly covered with "fog". Submandibular lymph nodes looked normal. They put him on a heart rx Benazepril 5mg 1 x daily, as it appeared to be heart related. They wanted to send the films to a specialist to be sure. She called the following day and prescribed an antibiotic Baytril, as the specialist said the lungs were the immediate problem, the 'fogginess' appeared to be a bacterial infection so hold the heart meds for now and give 21 days of Baytril and then recheck and maybe bloodwork (he had annual bloodwork less than 2 months ago that was normal)....I hope this is a new problem he will get over. I am afraid he's had it a long time since he has had these 'episodes' sporadically for years and never been xrayed until now. Louie will be 11 years old Christmas and I'm very attached to him.

Thanks so much for making my trip to the vet more objective and my communication more informed. You were right on with just the verbal cues, you spotted a heart problem and that resulted in finding the probably more serious lung issue. I will let you know what happens in 3 wks. Caryl in Texas.

Online vet, Dr. Marie

Dr. Marie replied:

Thanks for the update. Sorry I could not reply sooner but I was in the hospital having a baby. :)

It sounds like your vet is doing a very thorough job.

Dr. Marie

Customer reply:

Congratulations on your baby! Nice you may be able to work from home for awhile with this great website.

Louie went back for his 3 week check up. Compared old xrays to new and his vet felt they were inconclusive, so she sent them again to the specialist. She called yesterday and Louie's lungs and heart look fine more wretching coughing. He has arthritis in his knees and hips. With Rimidyl and Glucosamine, he is much happier and active. No more limping and lethargy. I thank you for educating me prior to his visit to the vet.

Caryl Hubert
PS I visited Yarmouth Nova Scotia in August. Your country is beautiful.

Online vet, Dr. Marie

Dr. Marie replied:

Well this is good news! Thanks for letting me know!

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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.