Our question this week was:Hi Dr. Jon.
I have a question....my dog has had a cough for months, after going back and forth to the vet for the cough and being on different antibiotics. Faith started to cough up blood clots. We took her to a specialist and he did a wash and said she had an infection in her lungs. She's been on baytril for about a month, if I don't miss a day on it she may cough not so dramatically, but I found if I missed a day, due to being away and no one else can give her the pills (she's difficult with them, believe me I've tried everything (putting them in food, in peanut butter, whatever) to get them in her, she manages to spit them out, but have found crushing them to a powder and getting in her mouth is the only way to get most of it in) she goes back to the dramatic coughing, puffing, eye rolling, I find if I rub her throat at the bottom, you know where those 2 bones in the chest meet, it calms it.
The vet told me if the baytril didn't work, he'd try something else such keeping her on prednisone which by the way she responded to perfectly in the past with no coughing at all. But the minute she came off of it the coughing started the exact day she stopped the meds. I worry about long term effects of a steroid. Do you have any suggestions? This is very frustrating.
Hi – thanks for your email. This case sounds quite complicated and frustrating. I'd recommend talking to your veterinarian about the pros and cons of steroids. It really all depends on the underlying diagnosis. I would guess she has had several diagnostic tests including x-rays, a tracheal wash with culture and sensitivity and maybe a bronchoscopy? If not, maybe you should discuss those. I've heard stories about dogs with chronic respiratory problems that had foreign bodies caught in their airways that were diagnosed with bronchoscopy.
As far as treatment and steroids, it really depends on the underlying diagnosis. I'd recommend having her re-evaluated to ensure there is no infection. If they do a culture and there is no bacteria, it may be an inflammatory condition that will respond nicely to steroids.
As far as the pros and cons, honestly if your dog responded well and has a treatable inflammatory condition, the risks of steroids are probably worth the comfort she will get from them. Your dog sounds miserable at times.
One thing to consider is also seeking another opinion. If you are not 100% confident about the opinion you got or want a second opinion, there is no harm in that.
Best of luck!
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