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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Vet
Satisfied Customers: 33307
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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11year old Tibetan terrier has had cough for months. When not

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11year old Tibetan terrier has had cough for months. When not coughing is as lively as ever and never coughs when out walking. Has had heart X-rays which show just a slightly enlarged heart (for which he takes vetmedin) and throat endoscopy (which showed up slight irritation) only by taking him outside can we stop his rhythmical coughing spasm. Can you suggest any other avenues we can explore - it's so distressing not to be able to help him.
Thanks derek jones
Aloha! You're speaking with Dr. Michael Salkin
I'm sorry that your question wasn't answered in a timely manner, Derek. It's a puzzler because the symptoms of both cardiac and respiratory disorders are usually exacerbated upon exercise rather than while inside. I have a few considerations...

1) The finding of an enlarged heart is circumspect without supporting evidence. Does Ruff have a murmur? I'd like for you to have his X-rays reviewed by a specialist veterinary radiologist. Subtle changes are easy to miss. In addition, 10 different vets may give you 10 different answers when asked if cardiomegaly (enlarged heart) exists. Ruff's vet is likely to have a radiologist on call who will review those films.
2) His becoming symptomatic only inside suggests an irritant or allergen present inside but not outside. Is smoking allowed in the house? Are there house plants to be concerned about? Have you considered an air filter (HEPA quality) - either for the entire house or in a room in which Ruff spends most of his time?
3) When Ruff was scoped, was a tracheal wash performed and cultured with its cytology (cells) examined by a pathologist?

I'll await your reply. I understand that you're not likely to awake at this time in the UK and so I'll watch for your reply later. I'm in California currently.
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Customer: replied 3 years ago.
Ruff has had three X-rays -,little change between them and a lung wash again all clear. X-rays been looked at by vet specialist.
Is there something like a cough suppresant or a desensitizer which we can try?
He is so active chasing his brother around etc the heart problems seem so unlikely as the cause.
Any more thoughts?
Thanks again
Customer: replied 3 years ago.
Sorry forgot to mention following
He is taking Loxicom to treat the throat irritation
Also he has tendency to lick his anal glands , could this be irritating the membranes? We have emptied his glands occasionally
Thank you for the additional information. I agree that a heart condition is unlikely unless the heart is so enlarged that it's pressing on the main stem bronchi and causing that coughing. But why wouldn't that occur outside? An echocardiogram (ultrasound of the heart) is indicated.
Yes, if meloxicam (Loxicam) isn't helpful, a narcotic cough suppressant can be administered. Butorphanol and codeine are most effective. Over the counter products containing dextromethorphan haven't been shown to be efficacious and should be avoided. No, I wouldn't incriminate his anal glands. Consider an air filter for the home. Please continue our conversation if you wish.
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.
Customer: replied 3 years ago.
Thanks for help. Looks like he has had the correct treatment from local vet although the search for cause and treatment goes on - he seems to be worse in warm weather . Distraction sometimes helps
Thanks for your help
Further thoughts?
If weather is a factor, lower respiratory disease such as a sterile bronchitis, bronchiectasis, or pleuritis should be considered. A week's trial of prednisolone might be informative in case allergy is responsible.