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Coughing and Chronic Bronchitis in Dogs

  • April 12, 2016 1:53 PM EDT

    This week's Evidence Based Update is on the topic of coughing in dogs, with a specific focus on canine chronic bronchitis and some exciting information about a novel therapy for managing patients.

    Coughing is a syndrome or clinical sign associated with an underlying disease process. Because there are many possible causes for chronic coughing, it behooves the clinician to recommend and perform a thorough diagnostic work-up of affected patients. Although this is not an exhaustive list, some of the causes include:

    • Infectious diseases - including (among others) Canine Infectious Respiratory Disease ComplexBordetella bronchiseptica, Mycoplasma, Canine Influenza Virus; systemic fungal diseases (e.g. Coccidioidomycosis), etc.
    • Inflammatory diseases - Canine Chronic Bronchitis (CCB); tracheobronchitis; esophageal dysfunction and gastroesophageal reflux, etc.
    • Neoplasia - lung tumors (e.g. bronchial adenocarcinoma)
    • Cardiovascular disease - e.g. heart failure; pulmonary edema
    • Allergic disease - e.g. Eosinophilic infiltrative disease or pneumonitis
    • Parasitic disease - e.g. Capillaria aerophilia, Dirofilaria immitis, Paragonimus spp (lung fluke), etc.

    The clinical approach to the dog with chronic coughing should be tailored to the individual based on its history and physical examination findings. Testing may include:

    1. Baseline laboratory testing (CBC, Biochemistry Profile, and Urinalysis), heartworm antigen testing, fecal analysis, and NT pro-BNP assay
    2. Diagnostic imaging - thoracic radiographs; bronchoscopy 
    3. Airway sampling - bronchoalveolar lavage for performing cytology & culture

    Treatment should be specific to the diagnosis. In the case of dogs with chronic bronchitis, treatment goals include controlling inflammation and the cough. Dogs commonly require lifelong treatment. In addition to pharmacologic interventions, environmental irritants should be identified and eliminated, weight control should be instituted, and a harness should be recommended in place of a collar for leash walks.

    In this week's Evidence Based Update we discuss findings of a recent study that examined the use and efficacy of a novel therapy for dogs with chronic bronchitis. Discussion includes:

    • Clinical and pathologic features of canine chronic bronchitis
    • Overview of the cough reflex
    • Treating canine chronic bronchitis
    • Clinical uses and effects of NK-1 Receptor antagonists
    • The Specialist's Spin on the chronically coughing dog, cough suppressant options and considerations for the clinician, and recommendations based on the findings of this study

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    Reference: Investigation of Neurokinin-1 Receptor Antagonism as a Novel Treatment for Chronic Bronchitis in Dogs. J Vet Intern Med 2016. Authors: M. Grobman, C. Reinero