Mysterious Coughing/retching

[christinepi]

Tracker, who is 10.5 years, started to VERY intermittently have cough/retch incidents; a day or two, or sometimes a week or more can go by w/o anything. When he does have an incident, it's usually one to three at a time. There's a sometime connection to eating grass, and mostly there's no connection to anything. This started in the fall of last year. A vet who saw him then for something else said since this is so intermittent it might be allergies. About three weeks ago, I finally took him to another vet to have him checked out more thoroughly, since the incidents had become somewhat more frequent, plus he's become more heat sensitive and started having a somewhat rasping pant when hot. She did a laryngoscopy and took a lung x-ray. She found no evidence of this clearly being established laryngeal paralysis (though she wouldn't fully rule out early LP), nor any tumors, thank God.

 

She noticed, though, that there wasn't as much motion during breathing in the larynx as she expected. She's not Greyhound savvy, so her theory is that since he IS a Greyhound, and therefore has an athlete's body, his trachea and larynx are so huge that the larynx's motion simply wouldn't be as noticeable as in "normal" dogs. What do forum members think? I'm just curious.

 

We still don't know what's causing this occasional cough/retch. I will get Hemopet involved to check for allergies and take it from there. But if anyone has any insight into the mysterious retch episodes, whatever caused them, that would be great. If it turns out not to be allergies, maybe he really IS in the beginning stages of LP. Sure hope not.

[macoduck]

Have your vet try him on Doxepin even though you don't have a definitive diagnosis for LP. This was suggested for my senior Percy by JJNg, who added that the sooner you started on it the better it worked. Percy did not have any testing for LP but the Doxepin worked within days. If we missed a dose the symptoms returned.

 

Can't hurt to give it a try on Tracker.

[christinepi]

Have your vet try him on Doxepin even though you don't have a definitive diagnosis for LP. This was suggested for my senior Percy by JJNg, who added that the sooner you started on it the better it worked. Percy did not have any testing for LP but the Doxepin worked within days. If we missed a dose the symptoms returned.

 

Can't hurt to give it a try on Tracker.

 

Doxepin is an antidepressant--what does it do to help with LP? Does it relax the body?

[greysmom]

Here's what a vet I found on Mr Google said:

 

Also, there have been some exciting anecdotal reports of a human tricyclic antidepressant being used to effectively treat laryngeal paralysis in dogs! This drug is called doxepin (trade name Sinequan in the USA but there is also a generic version available. The generic is available as 10, 25, 50, 75, 100, 150mg pills).
There have been no controlled studies on the use of this drug to treat laryngeal paralysis, but a US veterinarian who put a dog (who had LP) on this drug for another reason found that there was dramatic improvement of the LP,

Many other vets have since tried it and results have been encouraging.

With the small numbers of dogs this has been used on for this purpose, it seems that their response largely depends on the severity of laryngeal paralysis.

 

If there is total paralysis, then there are no medications that will help. If, however, it is partial paralysis, then often doxepin can be helpful. The dose being used in a large dog is 50-100mg given twice to three times daily. It can cause drowsiness in the first couple of weeks.

 

So not a real answer, but it has been used successsfully. We don't really know how anti-depressants work in the first place, especially with dogs, so new uses are always being uncovered.

[XTRAWLD]

Interesting findings. I'm going to keep watching this thread.

 

Ryder acts like this sometimes too, no excessive panting, but gags/retches intermittently. His lungs are clear as per his last annual visit, but every now and again, especially when eating a human snack for some reason, he often gags and coughs as if whatever size piece it is seems to always get stuck in his throat. Seemingly like his throat opening is just too small now for whatever reason.

[christinepi]

Here's what a vet I found on Mr Google said:

 

Also, there have been some exciting anecdotal reports of a human tricyclic antidepressant being used to effectively treat laryngeal paralysis in dogs! This drug is called doxepin (trade name Sinequan in the USA but there is also a generic version available. The generic is available as 10, 25, 50, 75, 100, 150mg pills).

There have been no controlled studies on the use of this drug to treat laryngeal paralysis, but a US veterinarian who put a dog (who had LP) on this drug for another reason found that there was dramatic improvement of the LP,

Many other vets have since tried it and results have been encouraging.

With the small numbers of dogs this has been used on for this purpose, it seems that their response largely depends on the severity of laryngeal paralysis.

 

If there is total paralysis, then there are no medications that will help. If, however, it is partial paralysis, then often doxepin can be helpful. The dose being used in a large dog is 50-100mg given twice to three times daily. It can cause drowsiness in the first couple of weeks.

 

So not a real answer, but it has been used successsfully. We don't really know how anti-depressants work in the first place, especially with dogs, so new uses are always being uncovered.

 

 

That's really helpful, thank you! I forwarded this to my vet. I'm still hoping that the allergy test reveals some allergy to some pollen or something, but if that's all negative, I'm hoping the vet will let me try Doxepin.

Interesting findings. I'm going to keep watching this thread.

 

Ryder acts like this sometimes too, no excessive panting, but gags/retches intermittently. His lungs are clear as per his last annual visit, but every now and again, especially when eating a human snack for some reason, he often gags and coughs as if whatever size piece it is seems to always get stuck in his throat. Seemingly like his throat opening is just too small now for whatever reason.

 

Did you test for allergies?

[XTRAWLD]

 

Did you test for allergies?

No I haven't. After going through it with extensively with Kasey, I'm not sure I'm ready to head down that path all over again..... To be fair though, I really don't think it could be allergies. What is it that leads you believe that is the potential in your case?

Edited June 19, 2017 by XTRAWLD

[LaFlaca]

_{Yikes! This sounds exactly what I just went through with Wendy. She'd been doing the cough-cough-gag thing for a couple of months. Exactly what Bordatella sounds like. Also some hoarseness when she barked. X-rays of neck, throat, larynx , pharynx all normal. Labs, all normal. Last week, she spiked a 106F temperature and spent 3 days in the hospital. We truly thought that Wendy would not survive. Thank God and our wonderful vet, she's fine now but we still don't know what happened; all tests were normal! I know this is no help to you except to know that you and your pup are not alone in going through something like this. Keep an eye out for fever. The vet thinks that Wendy was probably feverish for several days before reaching a critical temp. I now have a dog-only digital thermometer! Best of luck with Tracker.}

[christinepi]

No I haven't. After going through it with extensively with Kasey, I'm not sure I'm ready to head down that path all over again..... To be fair though, I really don't think it could be allergies. What is it that leads you believe that is the potential in your case?

 

I wrote Dr Dodds and described the symptoms. She suggested allergies, since the symptoms are so intermittent.

_{Yikes! This sounds exactly what I just went through with Wendy. She'd been doing the cough-cough-gag thing for a couple of months. Exactly what Bordatella sounds like. Also some hoarseness when she barked. X-rays of neck, throat, larynx , pharynx all normal. Labs, all normal. Last week, she spiked a 106F temperature and spent 3 days in the hospital. We truly thought that Wendy would not survive. Thank God and our wonderful vet, she's fine now but we still don't know what happened; all tests were normal! I know this is no help to you except to know that you and your pup are not alone in going through something like this. Keep an eye out for fever. The vet thinks that Wendy was probably feverish for several days before reaching a critical temp. I now have a dog-only digital thermometer! Best of luck with Tracker.}

 

How strange, but I'm glad Wendy is fine now.

[macoduck]

Christinepi, yes, this would be an off label use of the Doxepin. GT member JJNg is a vet and IIFC used it for one of her dogs. Taking info she provided by her to my vet, mine was willing to give it a try. Obviously not something carried by your vet but was rather inexpensive at the human pharmacy.

[JohnF]

Peggy does that occasionally in the early summer, so i think it's pollen-related making thicker mucus. A Bordatella retch is much deeper usually and sometimes they'll froth after exercize then. You are right to report it and keep a very close eye. Is the heart working OK still?

[christinepi]

Peggy does that occasionally in the early summer, so i think it's pollen-related making thicker mucus. A Bordatella retch is much deeper usually and sometimes they'll froth after exercize then. You are right to report it and keep a very close eye. Is the heart working OK still?

 

All the vitals are normal, incl. all blood work.

[LaFlaca]

Does anyone know how a vet would determine if the coughing and/or retching is allergy related? Wendy has a follow-up appointment in 3 weeks and I'd like to discuss the possibility of allergies. She actually just now retched seemingly out of the blue.

 

LP was discussed with the vet. She does not think that this is what's happening as Wendy is still able to easily run laps without experiencing any breathing difficulties.

Edited June 19, 2017 by LaFlaca

[christinepi]

Does anyone know how a vet would determine if the coughing and/or retching is allergy related? Wendy has a follow-up appointment in 3 weeks and I'd like to discuss the possibility of allergies. She actually just now retched seemingly out of the blue.

 

LP was discussed with the vet. She does not think that this is what's happening as Wendy is still able to easily run laps without experiencing any breathing difficulties.

 

The only thing I can think of is doing an allergy test and then perhaps treating with some drug, maybe antihistamine, and seeing whether symptoms go away? I had a serum sample sent to Hemopet today, and the test is for environmental allergies (Spectrum serum testing for inhalant and contact allergens). Sorry I can't be of help here.

[LaFlaca]

 

The only thing I can think of is doing an allergy test and then perhaps treating with some drug, maybe antihistamine, and seeing whether symptoms go away? I had a serum sample sent to Hemopet today, and the test is for environmental allergies (Spectrum serum testing for inhalant and contact allergens). Sorry I can't be of help here.

This is very helpful...thanks! At least I can discuss the appropriateness of the spectrum serum test in Wendy's case.

[3greytjoys]

Two of our Greyhounds (plus a foster) have had laryngeal paralysis (successfully managed carefully for many years). Both evolved into hind-end weakness that progressed from LP through the long vagus/sciatic nerves.

 

Greyhounds do normally have larger hearts than other breeds, but I'd question a comment re: a "huge trachea and larynx" as normal in Greyhounds(??).

Consider reviewing megaesophagus disease symptoms:

http://www.petmd.com/dog/conditions/digestive/c_dg_megaesophagus

 

 

Side notes: If early LP is even suspected, please use a harness instead of a collar for walks.

 

FWIW, since Arizona is sharing blistering heat with CA this week: LP dogs are extremely temperature sensitive. If moderate to advanced LP dogs overdo exercise in warm weather (e.g. above 60's to 70 degrees Fahrenheit, especially in sun); and/or appear extremely emotionally stressed; and/or pant excessively heavily in hot weather (heavy panting swells the throat which can partially block oxygen from reaching the airway), LP dogs can potentially enter a breathing crisis, which can quickly evolve into hyperthermia. Of course, if any dog suffers a breathing or overheating crisis, immediately transport dog in an air conditioned vehicle to an emergency hospital. Meanwhile, apply physical cooling techniques: use cool water to wet legs, neck, then gradually along body. (Avoid ice cold water which can shock the core body into retaining heat. Test hose water temperature with your hand first in case it's scalding hot.) Rubbing alcohol can be applied to dogs' paws/pads if cool water isn't available, but prevent dog from licking toxic alcohol. If a helper person is applying cool wet towels (e.g. during car ride), take a bucket of towels in cool water to change/refresh towels every 2-3 minutes (to prevent towels from trapping body heat); remain calm, and calm the dog's emotional state by removing dog from whatever the dog perceived as an excessively stressful environment.

 

Laflaca: I'm not aware of Wendy's situation before her life-threatening temperature spike, but if LP resurfaces as a possibility, her larynx (flap) movements would need to be examined while she is breathing under light anesthesia. (X-rays don't reveal LP.)

[LaFlaca]

Laflaca: I'm not aware of Wendy's situation before her life-threatening temperature spike, but if LP resurfaces as a possibility, her larynx (flap) movements would need to be examined while she is breathing under light anesthesia. (X-rays don't reveal LP.)

 

 

3greytjoys - Thank you for this information.

 

To this day, we do not know the cause of Wendy's high fever. All the tests that were done in office and sent out to a lab came back within normal parameters. She is in excellent condition at this time, taking into consideration her age (11 years).

 

However, and this concerns me, there has been something going on in the region of her throat for some time now. While she is no longer coughing and retching frequently, she does occasionally retch for no apparent reason and sometimes after eating dry treats/food. There is also occasional hoarseness, sometimes followed by retching when she barks. Throat irritation of some sort is what it "feels" like to me. Next Saturday is Wendy's 2nd follow-up after the FUO (fever of unknown origin) event. She will also receive her Bordatella vaccination. I am going to bring up the throat topic again with the vet although the symptoms are much improved and occur less frequently now after 2 weeks of antibiotics for the fever.

 

I am unsure if the symptoms are worth the risk of even light sedation on a geriatric Greyhound. Thoughts, anyone?

Edited June 24, 2017 by LaFlaca

[Mercsmom]

This thread is particularly pertinent as we just had a longggg night with Mercury coughing/gagging/retching. He acts like he has a piece of biscuit caught in his throat but this was (*yawn 3 a.m.) many hours after having anything.

Just now, while I was cleaning bile off the carpet, I noticed a couple of small biscuit pieces. He gulps his dinner and needs water in it to slow him down. It all looks like he's not swallowing properly.

[LaFlaca]

How many GT hounds does this make with the mystery cough-gag-retch? I think it's 4 so far - Tracker, Ryder, Mercury and Wendy. Huh. And no definite diagnosis. What the heck is going on? This thread bears continuing and monitoring.

[christinepi]

I know.

 

I will send Dr Couto the video of Tracker's laryngoscopy and ask him what HE thinks this "huge larynx" is about. And whether he thinks we're looking at early LP or not. Or megaesophagus. Or something else entirely, like, nothing. I'll keep you posted.

 

I also sent a serum sample to Dr Dodds to see about environmental allergies, but haven't heard yet.

[Neal]

Hi ,

 

I hope your Tracker is doing well and that you get to the bottom of it.

Is he on any medication already ?

After intermittent coughing, gagging but over all good health bar arthritis. And excellent regular blood tests.

My darling Ned just 11, was at the emergancy vet last weekend. The very long story short is that he had serious gastric /bleeding ulcer likely from the arthritis drugs used since February. In the weeks leading up, he had a bigger interest in grass, gagging a bit, nothing frequent. His overall excellent mood and energy gave me the impression that all was well. It wasn't..

I really hope its something simple and easily resolved. Just sharing the possibilty that the gagging/ coughing

can be reflux and related to stomach matters.

Taking it day by day here at the moment ..

[LaFlaca]

Hi ,

 

I hope your Tracker is doing well and that you get to the bottom of it.

Is he on any medication already ?

After intermittent coughing, gagging but over all good health bar arthritis. And excellent regular blood tests.

My darling Ned just 11, was at the emergancy vet last weekend. The very long story short is that he had serious gastric /bleeding ulcer likely from the arthritis drugs used since February. In the weeks leading up, he had a bigger interest in grass, gagging a bit, nothing frequent. His overall excellent mood and energy gave me the impression that all was well. It wasn't..

I really hope its something simple and easily resolved. Just sharing the possibilty that the gagging/ coughing

can be reflux and related to stomach matters.

Taking it day by day here at the moment ..

Wendy had a near-fatal gastric bleed from NSAIDS a while back. What a nightmare! Praying for a full recovery your dear Ned.

 

Reflux...never thought of that as a possibility but it makes sense. Thanks for the tip.

Edited June 24, 2017 by LaFlaca

[christinepi]

Neal,

 

I'm so sorry to hear this. Fingers crossed that Ned will recover. Thanks for letting me know about what arthritis drugs can do. Which drug was it? Tracker's not on anything yet, but I ordered Galliprant for him, because I read this:

 

 

A new arthritis drug for dogs called grapiprant (Galliprant®) is now available. Grapiprant works similarly to an NSAID but it targets just one specific pain receptor. Other NSAIDs also affect other similar receptors that are important to kidney health and the maintenance of the lining of the stomach, so those drugs have a higher risk for side effects to those organs. The FDA toxicity studies on grapiprant involved giving dogs 15 times the label dose with no fatalities or serious side effects. It should be a great choice for treating chronic pain in dogs who don’t tolerate other NSAIDs such as carprofen and deracoxib. Galliprant can be used off label for cats as well.

 

I'm hoping that'll lessen the risk for problems.

 

Question though: in Ned's case, did arthritis drugs come first, quite some time ago, which eventually triggered reflux, which caused his coughing/retching? Do I have the sequence correct?

 

All the best,

Christine

Edited June 24, 2017 by christinepi

[3greytjoys]

Quote: christinepi "... the incidents had become somewhat more frequent, plus he's become more heat sensitive and started having a somewhat rasping pant when hot.

She noticed, though, that there wasn't as much motion during breathing in the larynx as she expected."

 

Quote: LaFlaca "...there has been something going on in the region of her throat for some time now. While she is no longer coughing and retching frequently, she does occasionally retch for no apparent reason and sometimes after eating dry treats/food. There is also occasional hoarseness, sometimes followed by retching when she barks. Throat irritation of some sort is what it "feels" like to me.

 

I am unsure if the symptoms are worth the risk of even light sedation on a geriatric Greyhound. Thoughts, anyone?"

 

 

Our first LP hound's (advanced LP) symptoms were explained to regular vet after an out of town Greyhound play date (soon after adoption, age 6), but LP was not mentioned. The following year, same hound happened to have a summer vet appt.; vet heard LP symptoms. Dx was checked and confirmed during a (previously scheduled) dental surgery the following week.

 

LaFlaca: Hopefully Wendy's dx was limited to an infection that antibiotics resolved, but you know her best, and symptoms you describe are similar to LP. I would not do the light anesthesia test as a sole test for a potentially mild case that could be a different dx. I would ask vet to check her larynx movements whenever her next scheduled surgery occurs.

 

If any of these hounds happen to have early LP, it's slowly progressive, so I would remain observant, keep a dated e-record of symptoms (for future vet visits). I would be careful to keep hounds in cool, stress-free conditions; use harness instead of collar for walks; exercise during coolest times of early morning/night; and moisten kibble and treats with water to ease motility.

 

Hoarseness; voice bark change; raspy breathing; throat-clearing; coughing; gagging; heat/exercise intolerance; regurgitation, etc. become more apparent over time. Most important to monitor hound after exercising (especially if running) in potentially too warm conditions. Our first advanced LP hound's excessively labored, raspy, longer duration panting after running (cool season) raised a red flag when compared to our other normally panting hounds whose smoother panting calmed/stopped more quickly.

 

Side note: I'd update hound's accurate weight just before and immediately after Galliprant treatmant duration.

Edited June 25, 2017 by 3greytjoys

[christinepi]

3greatjoys: you wrote: I would ask vet to check her larynx movements whenever her next scheduled surgery occurs. What do you make of Tracker's lack of movements? That's something I don't get. The vet was really baffled by that.