Listening to a Hack

If you have a cat (and possibly even if you don’t), you know how a hairball cough looks and sounds: the cat crouches down; extends its head and neck to make a long, fairly straight body; and then has a dry, hacking cough. Sometimes there is gagging afterwards and a hairball might come up, but often you just hear the noise and then the cat is fine. Many people don’t realize that their cat is actually coughing and not trying to bring up a hairball. Vomiting up hairballs happens in most cats, but shouldn’t happen more than one or two times per month, and it’s a different action from a cough.

Coughing in dogs sounds more like a cough that a human would make, but dogs can make weird noises that some people describe as a cough that doesn’t involve the lungs. A reverse sneeze is irritation in the back of the throat/pharynx area and isn’t forceful like a cough. The dog sounds like it’s in distress, but it’s more the equivalent of a sneezing fit when you have allergies. A dog with a collapsing trachea will make a coughing sound, but it’s more of a honk. In this condition, some of the cartilage rings around the trachea weaken. When the affected dog breathes in, the trachea flattens, preventing the air from getting through. The dog will then have a dry, harsh cough, often described as a goose honk. Collapsing trachea coughs are worse with excitement, when the dog is trying to breathe in more air, or when a collar is pulled.

Cats don’t usually cough, so if you hear what you think might be hairballs, there’s a good chance it has feline asthma, or feline allergic bronchitis. Dogs are also commonly affected by this disease. Bronchitis, like other -itises, is inflammation of the bronchi, or the airways in the lungs. If the cat or dog is sensitive to allergens or other irritants in the air, the airways produce more mucus and will spasm, decreasing the amount of air into the lungs and causing a cough and wheezing noise. Over time, the mucus starts to accumulate in the lungs, which can lead to secondary bacterial infections. Eventually there will be lung damage, and the pet will be unable to get enough oxygen.

Common irritants include cigarette smoke, room deodorizers, dust from litter boxes, air pollution, essential-oil diffusers, perfumes, scented laundry detergent, mold, and mildew. Seasonal allergies from pollen can also cause inflammation in the airways. Cat dander can be an inciting cause in some dogs, though it’s not a reason to give up your cat!

While any cat can develop asthma, it’s most frequently seen in cats between two and eight years old. Siamese cats seem to be at higher risk. Asthma is also seen more frequently in overweight or obese cats. For dogs, bronchitis is more commonly diagnosed in smaller breeds also between two and eight years old.

If your pet is coughing, it’s important to get her checked out by a veterinarian. If you can get the coughing on video, that can be helpful (they never cough in the exam room!). Although bronchitis is the most common cause of coughing in cats and can affect dogs, it’s important to rule out other causes. Heartworm disease in cats often causes coughing; a blood test can quickly check for that. Dogs with heartworm don’t usually cough until late in the disease, when the heart is in failure or if the dog is too active after being treated for the disease. Lungworms, which are seen in cats worldwide, can cause coughing. Cats are infected with lungworms by eating intermediate hosts (slugs and snails) or by eating transport hosts (birds, rodents, frogs, and lizards). Dogs can also get lungworms, but it’s much less common compared to cats. Pneumonia will cause coughing, particularly in dogs. Dogs with congestive heart failure cough due to the enlarged heart pushing on cough receptors on the trachea and because of fluid accumulation in the lungs. Primary or metastatic lung cancer will also lead to coughing. Dogs with an upper respiratory infection, such as kennel cough, will present with a deep, hacking cough too.

Chest x-rays are an important diagnostic tool for coughing animals. Bloodwork to look for heartworms or check for increased white blood cells may be performed. A fecal check or giving the cat a deworming medication is worthwhile. Your vet may recommend doing a tracheal wash with the cat under sedation to collect some of the mucus in the airways to look for certain types of white blood cells (eosinophils) or bacteria. If a dog is suspected to have kennel cough, sometimes antibiotics or cough suppressants are prescribed. Kennel cough is often due to viruses, but secondary bacterial infections can occur. (The kennel cough vaccine is against the bacteria Bordetella bronchiseptica, which can worsen the disease. Unfortunately the Bordetella vaccine doesn’t prevent kennel cough itself.)

Treatment of bronchitis often involves the use of steroids. Sometimes a course of doxycycline or other antibiotic will be given first in case there is a secondary infection. Doxycycline has some anti-inflammatory properties, so that may be enough to decrease the coughing. Oral steroids or injectable steroids are often given and may be needed long-term to control the inflammation. Some cats and dogs with severe asthma may need an inhaler containing both a steroid and a bronchodilator. While the inhaler used by people suffering from asthma is often prescribed, cats and dogs need a spacing device which allows the medication to be inhaled through a mask. Needless to say, cats (and most dogs) don’t tolerate having something placed over their nose and mouth, so it takes time, training, and something yummy smeared on the inside of the mask before the cat will allow for this treatment.

Cats don’t normally cough, so it’s a good idea to get your cat checked out if you hear noises that make you think a hairball is in the offing. If your dog or cat is coughing multiple days in a row or is lethargic or not moving much, it’s important to get them seen by a veterinarian soon.

Lori Scarlett, DVM, is the owner and veterinarian at Four Lakes Veterinary Clinic. For more information, visit fourlakesvet.com .

Photograph by Brenda Eckhardt