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Dr. Joey
Dr. Joey, Board Certified
Category: Dog
Satisfied Customers: 4943
Experience:  15 yrs in practice, specialist canine/feline medicine
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I have a King Charles cavalier 6 yrs, he has been coughing/gagging.

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I have a King Charles cavalier 6 yrs, he has been coughing/gagging. The vet has diagnosed an enlarged heart and fluid in the lungs. On Thursday he had an X-ray& 2 injections and he now takes 5mg of cardisure. The coughing is now more regular, at least once an hour, especially when he gets excited, walks and feeding. Should I go back? Is he going to die? I'm really upset. We live in Germany and would like an honest answer. Hope you can help.

Dr. Joey :

Hello I am Dr. Joey. Thanks for trusting me to help you and your pet today. I am a licensed veterinarian with over 15 years of experience. I look forward to working with you.

Dr. Joey :

THis does sound quite concerning for Ollie. The question with the coughing is if he is in congestive heart failure, which means his current medication is not treating him (usually this requires a diuretic in addition to pimobendan, although pimobendan is a wonderful drug) or if he is coughing because his heart is enlarged and pushing on his airway, which requires a drug to suppress the cough such as hydrocodone.

How is his gum color (should be pink, not muddy/puple/pale)? What is his resting (non-active) respiratory rate per minutes?

Dr. Joey :

And in addition to his resting respiratory rate, is he having any increased effort to breathing (looks like he is having trouble sucking in air)?

Customer: His gum colour is pale pink we are counting the beats now
Customer: when he breathes it sounds like snoring
Dr. Joey :

That is reassuring that he is pink, and probably indicates his heart is providing reasonable to good ciruclation. However, if he is having obvious wheezing when he breaths (and this is abnormal) then that greatly concerns me that he may have congestive heart failure. Congestive heart failure means fluid accumulation in his lungs (my suspicion is that perhaps your vet administered him a diuretic in the "injections" he received? And if so I wonder why this was not prescribed to continue because that injection wears off within 8 hours and the fluid will return).

Customer: In one minute he had 96 heart beats.
Dr. Joey :

That is a good heart rate. How about his breathing rate?

Customer: how do we measure that
Dr. Joey :

You simple watch his chest rise and fall (I count in a 15-second increment and then multiply by four).

Customer: 9x4=36
Customer: When he gets up to walk he coughs. The has drooling
Dr. Joey :

That is a very reasonable respiratory rate.Therefore, his parameters are okay. I am still concerned that he cannot move without coughing. He may not be in congestive failure but just that the heart is so big that it pushes on his airway when he moves. This will need medication, but is not an emergency (could wait until tomorrow to have him rechecked). But if he has any other issues such as difficulty moving air (struggling to breathe with a lot of open-mouth breathing or his gum color turns blue/muddy and not a nice healthy pink, then these are signs to rush him in on emergency today.

I suspect he needs another medication to help. I also want to comment that one of the odd side effects of pimobendan is to INCREASE coughing. I had this happen in a handful of patients. Stopping the medication and changing to something different really helped. But I do not want you to stop this without a veterinarian that examines him tells you. I do, however, recommend you ask about this.

Customer: That is really helpful as it has definitely increased. We were told to go back in 2 weeks but I will return on Monday. Should we take him on walks? When we get the lead out his coughing is really bad! What could we do to ease him during an attack?
Dr. Joey :

I do not recommend exercising him at all since he will probably cough and be uncomfortable the entire time. Instead, encourage him to rest today and monitor those parameters you just checked. INdications for an emergeny is purple/muddy/blue gums, struggle to breathe, respiratory rate at rest higher than 50 and heart rare higher than 140/minute.

There is not much I can recommend over-the-counter for the coughing unfortunately other than rest.

Customer: That's fine we just sit, cuddle and rub.
Customer: Can I ask the awful question, I have children and need to prepare, how long does he have?
Dr. Joey :

This really does depend on his disease (exact cause of the heart issues which in this breed is usually mitral valve disease; if he has congestive heart failure and his blood pressure, etc). Many cardiologists would conservatively say 3-6 months once a dog has the onset of congestive heart failure, but I have had King Charles Cavaliers that live with controlled heart disease for years. So, the answer is all about what exactly is going on and his management. I am an advcoate of referral to see a cardiologist, if that is an option for you in your area. That may really help to get him managed the best possible and give him the best potential for the longest outcome. I am sorry this is not definitive.

Customer: That's fine. It's what I have read. Oh well I will have to get a clearer prognosis tomorrow. You have been very helpful and I am glad I don't have to wait, I will go back tomorrow. Thanks again jo
Dr. Joey :

Yes, please have him seen tomorrow (and do not forget to ask about the odd side effect of pimobendan). Please keep me posted. I am always happy to answer followup questions. You can reply to this question at any time to submit a followup. My goal is to provide you with excellent service today. If there’s anything else I can do, let me know – it’s been a pleasure working with you and I hope to assist you again soon! Kindly submit a rating as you exit our chat.

Customer: Thankyou again
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