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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 33259
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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Our 11 year old cocker spaniel has had a severe bronchial cough/bronchietisis(?)

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Our 11 year old cocker spaniel has had a severe bronchial cough/bronchietisis(?) since the beginning of the year. She has been examined under anaesthetic, had an x-ray + second opinion on the x-ray to confirm the initial diagnosis. She's been prescribed clavaseptin and then some stronger antbiotics plus powder to break up phlegm and also steriods. The condition has not improved one bit. We are currently giving her pholcodine, but again no improvement. Frustrating after spending £600 + on vets' fees.
Our dog is well despite this persistent problem - eating, drinking and exercising normally The cough is quite distressing to hear.
Any ideas, please?
Many thanks,
Rob Pugh
Aloha! You're speaking to Dr. Michael Salkin
I'm sorry to hear of this with Ruby and I understand your frustration. Cocker spaniels as a breed are overrepresented with bronchiectasis. This is an irreversible pathologic dilation of airways due to destruction of the elastic and muscular components of the airway walls. Treatment should focus on identifying and treating an underlying cause of chronic inflammation (e.g., chronic bronchitis, infection) if present. Long-term managment is focused on decreasing inflammation, enhancing mucociliary clearance, and appropriate antimicrobial treatment of secondary infection - all of which you've mentioned in the history you provided.

I don't see mention of humidification or nebulization which enhances mucociliary function by increasing water content of the mucociliary blanket. I would also consider inhalant therapy in a dog who hasn't improved with current therapy. Please discuss with Ruby's vet the use of a metered dose inhalant glucocorticoid (e.g., flunisolide: empirically start at 110mcg/actuation, one puff using a spacer every 12 hours; decrease to 44mcg/actuation, one puff using a spacer every 12 hours thereafter). Avoid cough suppressants because they further impair mucocilary clearance.

I regret that Ruby can't be cured (unless her bronchietasis were focal and the lung removed) and must be treated chronically by balancing antibiotics for secondary infections and antiinflammatory doses of corticosteroids. In the absence of life-threatening infection or serious underlying disease (e.g., neoplasia) long-term survival is possible.

Please respond with further questions or concerns if you wish.
Dr. Michael Salkin and 3 other Dog Specialists are ready to help you
Thank you for your kind accept. I appreciate it.

I'm going to check back with you in a few weeks for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Please disregard the info request.