Laurie Anne Walden, DVM Image by VBlock on Pixabay Cats with heart disease often don’t show any signs of illness. Sometimes the very first sign that a cat has heart disease is a sudden life-threatening condition like arterial thromboembolism (blood clot) or even sudden death. These are some other signs that a cat might have heart trouble:
Different terms are used to describe the severity of heart problems. Heart disease means that something about the heart is not normal, but the heart is still pumping blood as it should. Heart failure means that the heart disease has gotten worse and the heart is no longer pumping blood normally. Congestive heart failure is a more severe form of heart failure in which fluid builds up in the lungs. The best way to diagnose and stage heart disease is with echocardiography (ultrasound of the heart) by a veterinary cardiologist. Chest radiographs are used to measure the size of the heart and detect fluid in the lungs. Blood tests are sometimes used to screen cats for evidence of heart failure. Hypertrophic Cardiomyopathy Hypertrophic cardiomyopathy is the most common heart disease in cats. The disease can affect cats of any breed, but it has a known genetic link in Maine coon cats and Ragdolls. In this disease, the heart walls become thickened and stiff and can’t pump blood effectively. The disease eventually causes congestive heart failure. Treatment depends on the cat’s stage of heart disease. Cats with hypertrophic cardiomyopathy are at risk of arterial thromboembolism, a painful condition in which a blood clot blocks blood supply to one or more legs. Cats with arterial thromboembolism are often euthanized because of the guarded to poor prognosis. Their best chance of survival is hospitalization at a 24-hour facility that can provide specialized care. Restrictive Cardiomyopathy Restrictive cardiomyopathy is caused by scar tissue in the heart muscle. The cause is not known. The scar tissue prevents the heart muscle from contracting normally, affecting its ability to pump blood. Dilated Cardiomyopathy Dilated cardiomyopathy used to be more common in cats than it is now. In cats, this condition is caused by low levels of taurine (an amino acid) in the diet. Commercial cat foods are now required to contain a minimum level of taurine, so dilated cardiomyopathy has become rare in cats. Cats that eat homemade or vegetarian diets might not be getting enough taurine, in which case they are at risk of developing dilated cardiomyopathy. Dilated cardiomyopathy causes the heart walls to become thinner and weaker. The heart enlarges, and the weak heart walls can’t pump blood normally. Congenital Heart Disorders Congenital heart disorders are present at the time of birth. The most common type in cats is ventricular septal defect, which is a hole between the lower chambers of the heart. Some kittens with a congenital heart disorder lead normal lives; others are severely affected. Treatment might be medical or surgical, depending on the type and severity of the disorder. More Information See the HeartSmart website (Tufts University School of Veterinary Medicine) to find out more about heart diseases in cats and dogs: https://vet.tufts.edu/foster-hospital-small-animals/specialty-services/cardiology/heartsmart Image source: https://pixabay.com/photos/maine-coon-cat-pet-animal-feline-7222631/ Laurie Anne Walden, DVM Photo by noelle on Unsplash In cats, unlike humans, allergies don’t typically cause sneezing and runny eyes. Cats with allergies are more likely to have itching and skin disease. Some allergies in cats cause asthma and digestive tract disorders.
The most common allergies in cats are flea allergy, allergies to substances in the environment, and food allergies. Some cats have more than one kind of allergy. Flea Allergy For cats with flea allergy, even a few flea bites cause significant itching and skin disease. Signs include hair loss, broken hairs, scratches on the skin, scabs, or raised pink or red bumps. Fleas are hard to find on cats because cats remove them when they groom, so you might not actually see any fleas on a cat whose skin disease is caused by a flea allergy. The pattern of hair loss is one clue to the diagnosis; hair loss on the lower back is usually related to fleas. Because flea-related dermatitis is so common, flea treatment is standard care for cats with skin disease. Unlike many allergy triggers, fleas can be eliminated from a cat’s environment. The best type of flea prevention to use depends on the individual cat, the cat’s lifestyle and environment, and contact animals. Your veterinarian can recommend products for your own cat. It’s easier to prevent a flea infestation than to eliminate one. In general, the most reliable way to avoid flea problems is to give effective (this often means prescription) flea prevention all year round to all cats and dogs in the household. Environmental Allergies The same substances in the environment that cause allergies in people also cause allergies in cats. Some allergy triggers (like grasses and trees) are seasonal; others (like dust mites and mold spores) are present year round. In cats, environmental allergies most often cause skin problems but are also linked to asthma. Environmental allergies cause the same signs of skin disease as flea allergy. Allergies can also cause eosinophilic dermatitis, a type of inflammatory skin disease with red, scabbed, or oozy patches on the haired skin or the edges of the lips. Asthma is fairly common in cats. Asthma flares can be seasonal in cats with environmental allergies. Signs include coughing, wheezing, and open-mouth breathing or panting; emergency signs are difficulty breathing and purple or blue gums. Environmental allergy triggers typically can’t be eliminated. Cats with these allergies receive symptom relief (anti-itch medication) and treatment for the skin infections that are very common in animals with allergic skin disease. Cats with asthma need steroids, often delivered by inhaler. Immunotherapy (“allergy shots”) from a veterinary dermatologist can be used to treat environmental allergies if the exact triggers can be identified with a skin test. Food Allergies Allergies to food ingredients most often cause digestive tract problems like vomiting and diarrhea. In cats, food allergies can also cause skin disease. Vomiting and diarrhea have many possible causes, some of which are very serious, so cats with chronic (long-term) digestive tract symptoms need a full medical work-up. Food allergies can be triggered by a wide variety of proteins and carbohydrates. Simply switching the brand or flavor of cat food—or switching to a homemade diet—won’t tell you if a cat has a food allergy. The only way to diagnose a food allergy is with a diet trial, which means feeding only an elimination diet (a prescription diet formulated to eliminate possible allergy triggers) for several weeks. For cats with food allergy, symptoms greatly improve if the problem ingredient is identified and eliminated. Image source: https://unsplash.com/photos/orange-tabby-cat-on-gray-concrete-floor-bTw1Ug-Wlio Laurie Anne Walden, DVM Photo by TJH1976 on Flickr Stomatitis is severe inflammation of the inside of the mouth. In cats, this painful condition is caused by an abnormal immune system response. Most cats with stomatitis need to have many or all of their teeth extracted to have a good quality of life.
Stomatitis is more severe than gingivitis (inflammation of the gums) and periodontal disease (inflammation of the structures around the tooth roots). In cats, stomatitis starts at the gums and tooth roots but eventually extends to the back of the mouth, the roof of the mouth, the tongue, and the area under the tongue. Causes The exact reason for the abnormal immune response isn’t known. Plaque—a biofilm produced by bacteria in the mouth—triggers stomatitis in most affected cats. Viruses (especially feline immunodeficiency virus and feline calicivirus) and various oral bacteria are also involved in many cases. Signs Cats with stomatitis can’t eat, groom themselves, or even yawn without pain. Because cats by nature hide their signs of pain, we humans often don’t notice the signs of stomatitis until it’s severe and significantly affecting a cat’s behavior. These are some of the signs of stomatitis in cats:
Diagnosis Stomatitis can usually be diagnosed just by the appearance of the mouth during a physical examination. However, oral examination can be very painful for an affected cat, so the extent of disease might not be known until the cat is sedated or under anesthesia. Cats with stomatitis have laboratory tests (baseline bloodwork, tests for feline leukemia virus and feline immunodeficiency virus, and urinalysis) to assess their overall health and look for other problems that might be causing—or caused by—the immune system disorder. Dental radiographs taken under anesthesia show which tooth roots are affected by the disease. Treatment The goals of treatment are to manage pain and reduce inflammation. Medical treatments might include pain medications, antibiotics, and immunosuppressive or anti-inflammatory medications. Cats often need nutrition support. Because plaque is a trigger, affected cats need a complete dental cleaning under general anesthesia, followed by home dental care once the cat’s mouth is comfortable enough to allow it. Some cats have laser therapy to remove inflammatory tissue in the mouth. For most cats with stomatitis, medical treatment and dental cleaning aren’t enough to manage the disease. The prognosis is best if plaque-collecting surfaces are removed from the mouth, which means surgically removing teeth. Some cats do well with only the back teeth extracted (leaving the incisors and fang-like canine teeth at the front of the mouth in place), but many cats need to have all of their teeth removed. Some cats need to continue medical treatments even after all of their teeth are extracted. Cats that have had full-mouth tooth extractions can eat cat food; they just can’t disembowel a wildebeest anymore. These cats are much happier once their teeth are out and their mouths have stopped hurting. Image source: https://www.flickr.com/photos/57764574@N03/26233750210/ Laurie Anne Walden, DVM Photo by Tracy Anderson on Unsplash A heart murmur is an abnormal whooshing heart sound. A heart murmur isn’t a diagnosis of heart disease; it’s a clinical sign showing that something has made blood flow within the heart turbulent. Some of the things that cause heart murmurs are benign and don’t need treatment. Others are serious conditions that can lead to heart disease and heart failure.
Causes Anything that alters the flow of blood inside the heart can cause a murmur. Leaky heart valves (flaps that control blood flow between heart chambers) and disorders of the heart muscle are the most common causes of murmurs in adult dogs and cats. Examples are mitral valve degeneration, usually in older dogs or inherited in Cavalier King Charles spaniels, and hypertrophic cardiomyopathy in cats. Anemia—“thin” blood with a low red blood cell count—can also cause a murmur because of the change in blood consistency. Young puppies and kittens sometimes have congenital heart murmurs, which are murmurs present from birth. These murmurs are usually benign and disappear on their own as the animal grows. However, some congenital murmurs are caused by structural defects of the heart or the large blood vessels around the heart, and these defects can have severe consequences if they aren’t (or can’t be) repaired. Signs Heart murmurs are usually heard for the first time during routine wellness examinations in animals with no signs of heart problems. Early diagnosis and treatment improves the prognosis for animals with heart disease, so listening to the heart with a stethoscope is a crucial part of the annual examination. Heart murmurs are graded according to their loudness, ranging from barely audible to so loud they can actually be felt with a hand placed on the rib cage. The loudness of a murmur doesn’t necessarily correspond to the severity of the condition that caused it (serious conditions can cause quiet murmurs). These are some signs of heart disease and heart failure:
Diagnosis The best way to identify the source of a heart murmur is with an echocardiogram, an ultrasound study of the heart. An echocardiogram, usually performed by a veterinary cardiologist, shows the shape of the heart valves, thickness of the heart muscle, blood flow within the heart, and measures of heart function. Chest radiographs (x-ray images) can be used to diagnose heart disease once the disease has progressed to the point of changing the size and shape of the heart chambers. A blood test that can be used to screen for heart disease is the concentration of NT-proBNP (N-terminal pro–brain natriuretic peptide), a substance released by heart muscle cells in response to excessive stretch and strain. If your pet has a heart murmur, start monitoring the sleeping respiratory rate. An increased sleeping respiratory rate can be a sign of heart disease. Wait until your pet is asleep, count the number of breaths (each rise of the chest) in 15 seconds, and multiply by 4 to calculate the number of breaths per minute. A sleeping rate of more than 35 breaths per minute or a rate that’s increasing over time warrants a visit to your veterinarian. Treatment Treatment depends on the cause of the heart murmur and whether the animal has heart disease. Heart disease is treated with medications and possibly prescription diets. Dogs and cats don’t get coronary artery disease (plaque in the arteries) like humans do, so the treatments and dietary recommendations are not the same for animals as they are for humans with heart disease. All animals with murmurs, whether the cause is serious or thought to be benign, need regular monitoring (sleeping respiratory rate, veterinary examinations, and possibly follow-up echocardiography) so changes in heart function can be identified and treated promptly. Image source: https://unsplash.com/photos/a-brown-and-white-dog-sitting-on-top-of-a-wooden-floor-OktYfwY5ZQI Laurie Anne Walden, DVM Photo by Zoë Gayah Jonker on Unsplash Asthma is one of the most common respiratory diseases in cats. It isn’t curable but can be managed with medication. Many cats are treated with inhalers attached to a face mask delivery system developed specifically for cats.
Causes Asthma is caused by an allergic response to something a cat has inhaled, like smoke, vapors, dust, pollens, or other substances. The resulting inflammation inside the airways causes swelling, mucus production, and airway constriction (muscle spasm), all of which reduce airflow. Cats of any age can have asthma, but it’s most often diagnosed in young adults. Asthma episodes can be triggered by stress and exertion as well as by substances in the environment. Signs Some cats with asthma cough every day; others have only occasional episodes. Cats with asthma can suddenly develop life-threatening respiratory distress at any time if something triggers airway constriction, even if their condition is usually mild. These are the typical signs of asthma in cats:
In cats, coughing can easily be mistaken for hacking up a hairball or vomiting. If you’re not sure whether your cat is coughing or vomiting, take a video if possible and schedule a veterinary examination without delay. Diagnosis Making a diagnosis of asthma can be complicated because the signs are very similar to those of other heart and lung disorders, like heart disease, chronic bronchitis, infections (bacterial, viral, fungal, or parasitic), cancer, and heartworm disease. Physical examination sometimes but not always reveals changes in breathing pattern and lung sounds. In many cats with asthma, chest radiographs show evidence of airway thickening. However, radiographs can look completely normal in cats with asthma. Additional tests are used to rule out other disorders. Some cats need advanced procedures like bronchoscopy. Response to treatment can support a diagnosis of asthma. Airway constriction is partly reversible with medication. For cats with respiratory distress caused by asthma, emergency injection of a bronchodilating drug typically improves breathing within a few minutes. Treatment Cats with severe asthma and respiratory distress need emergency care including oxygen, bronchodilators, and other medications. They must be handled carefully to minimize stress. The goals of asthma management are to reduce airway inflammation and treat airway constriction. Owners of cats with asthma need to remove as many environmental triggers as possible:
Cats with asthma need corticosteroids for life to reduce airway inflammation. Some cats also need long-term bronchodilator therapy to reduce airway constriction. However, many cats do well with steroid therapy alone, and their owners keep a bronchodilator on hand to give as rescue therapy during asthma events. Metered dose inhalers (the same ones used by people) are a good option for many cats. Inhaled corticosteroids are delivered directly to the airways and are less likely to cause the adverse effects that long-term oral or injectable steroid therapy can cause in cats. It takes time for inhaled corticosteroids to reach full effect, so cats need to start with an oral or injectable form and transition to inhaled medication over a couple of weeks. Bronchodilators are also available as inhalants. Just like small children with asthma, cats can’t time their breathing to inhale exactly when someone puffs an inhaler at them. Spacers were invented to solve this problem for children, and they’re available for cats too. Spacers are chambers with an inhaler attached to one end and a face mask attached to the other. The medication puffed from the inhaler stays inside the chamber until the child (or cat) inhales it by taking several normal breaths through the mask. Cats can be trained to accept the face mask and spacer. The training process takes time; you do not want to slap a device straight onto the face of an unprepared cat who needs to avoid stress. More Information
Image source: https://unsplash.com/photos/shallow-focus-photo-of-orange-cat-uhnbTZC7N9k Laurie Anne Walden, DVM Photo by Grant Durr on Unsplash Injury of the cranial cruciate ligament in the knee is a common cause of hind limb lameness in dogs. Surgery is often the best treatment option.
The cranial cruciate ligament is one of the main structures that stabilizes the knee joint. This ligament is called the anterior cruciate ligament in humans. In humans, injury to this ligament is usually caused by trauma, especially while playing sports. In dogs, cranial cruciate ligament injury is more often caused by long-term, gradual degeneration that results in a partial or full ligament tear. Some of the factors involved in cranial cruciate ligament degeneration in dogs are age, knee conformation, genetics, and body weight. Because these factors affect both knees, many dogs with a ligament tear in one knee develop the same problem in the other knee within a year or two. Many dogs with cranial cruciate ligament injury also have a torn meniscus in the knee. The meniscus is a cartilage pad that provides cushioning between the femur (upper leg bone) and tibia (lower leg bone). A torn meniscus is painful. A meniscal tear can happen at the same time as the injury to the cranial cruciate ligament or much later as a result of knee instability. Cranial cruciate ligament injury causes knee arthritis. The rate of progression of the arthritis partly depends on how the cruciate ligament injury is treated (with surgery or with medical management alone), meaning how soon the knee joint is stabilized. Signs A sudden full tear of the cranial cruciate ligament causes significant lameness; dogs are often unable to bear any weight on the affected leg. The signs of partial ligament tears and chronic ligament degeneration are less obvious. In these cases the lameness might improve with rest but doesn’t entirely disappear. Meniscal tears can cause a clicking sound in the knee joint. Arthritis resulting from chronic cruciate ligament injury eventually causes thickening of the knee joint. Diagnosis Full cranial cruciate ligament tears can often be diagnosed during a physical examination with tests that reveal instability in the knee joint. However, dogs are sometimes too tense (because of knee pain) for these tests. X-ray images sometimes show evidence of cruciate ligament rupture and can also help rule out other possible causes of the lameness. Partial tears and meniscal tears are harder to diagnose and are typically found with advanced imaging techniques or seen during knee surgery. Treatment Cranial cruciate ligament injury is treated either surgically or with medical management alone. The choice of treatment for an individual dog depends on the type of injury; the dog’s size, age, activity level, and state of health; and the owner’s preferences and financial resources. For dogs with a complete ligament tear, surgical treatment followed by physical rehabilitation usually yields the best functional result. A number of surgical options are available and are typically performed by a veterinary surgery specialist. The torn ligament can’t actually be repaired, so the goals of surgery are to stabilize the joint and remove damaged (painful) parts of the meniscus. Some surgical techniques change the biomechanics of the knee joint by cutting into the tibia to adjust the way the large leg muscles attach to the front of the knee. Other techniques use suture material to mimic the function of the cranial cruciate ligament. All surgical options require strict exercise restriction for several weeks to a few months after the procedure. Medical management involves exercise restriction and anti-inflammatory medication. Physical rehabilitation and custom orthotics, or knee braces, might help some dogs. Weight management is crucial for overweight dogs with knee ligament injuries. For more information about treatment options, see the American College of Veterinary Surgeons website: https://www.acvs.org/small-animal/cranial-cruciate-ligament-disease/ Image source: https://unsplash.com/photos/yellow-labrador-retriever-puppy-lying-on-white-textile-biW4WcdmZyA Laurie Anne Walden, DVM Photo by Borna Bevanda on Unsplash Feline infectious peritonitis (FIP) is a viral disease that until recently was untreatable and almost always fatal in cats. An effective antiviral drug emerged a few years ago but was legally unavailable in the United States. Some cat owners bought the drug at high cost on the international black market, but this product was unregulated, untested, and possibly unsafe.
A compounded version of this antiviral drug, GS-441524, is now available in the United States by veterinary prescription. This means that FIP has become a treatable disease instead of a near-certain death warrant for cats. The US Food and Drug Administration (FDA) hasn’t officially approved the compounded product for use in cats. However, the FDA announced that because no approved drug is available, it won’t enforce drug approval requirements when a veterinarian prescribes this product for an individual cat.[1] Signs and Diagnosis of FIP The virus that causes FIP is a coronavirus. Feline coronavirus infection is very common in cats. The virus typically lives in the intestines without causing much trouble. In some cats, feline coronavirus mutates into a disease-causing strain that spreads through the body. This disease is FIP. The signs of FIP depend on whether a cat has the “wet” form (with fluid accumulation in the chest and abdomen) or the “dry” form (with inflammatory masses and other changes in the eyes, nervous system, kidneys, liver, or other organs). Some of the signs are swollen belly, decreased appetite, decreased energy, weight loss, fever, labored breathing, blindness, and seizures. Because the signs of FIP are nonspecific and because so many cats have been infected with feline coronavirus, diagnosis is not simple. The diagnosis is often presumptive, meaning that it’s not confirmed by definite tests but is suspected on the basis of clinical signs and the results of blood and urine tests, imaging studies, fluid analysis, and biopsy. Treatment GS-441524 is a metabolite of remdesivir. Remdesivir is used to treat COVID-19 in humans, but it’s not licensed for use in animals. Veterinarians can treat animals off label with drugs licensed for humans, so remdesivir is technically a treatment option for cats but it’s hard for veterinarians to access. Unlike remdesivir (an injectable product), compounded GS-441524 is a tuna-flavored tablet. It’s already being used to treat cats in Australia and the United Kingdom. The dose depends on the cat’s clinical signs, and the current recommendation is to continue treatment for 12 weeks. Reported survival rates for cats treated with GS-441524 range from 81% to 100%.[2] Without this treatment—or a similar antiviral drug if one becomes available—the prognosis is grim. References 1. FDA announces position on use of compounded GS-441524 to treat FIP. US Food and Drug Administration. May 10, 2024. Accessed September 3, 2024. https://www.fda.gov/animal-veterinary/cvm-updates/fda-announces-position-use-compounded-gs-441524-treat-fip 2. Tasker S, Addie DD, Egberink H, et al. Feline infectious peritonitis: European Advisory Board on Cat Diseases guidelines. Viruses. 2023;15(9):1847. doi:10.3390/v15091847 Image source: https://unsplash.com/photos/gray-tabby-kitten-leaning-on-white-wall-VwqecUsYKvs Laurie Anne Walden, DVM Image by Chris Murphy on Flickr Cleaning the litter box might not be your favorite chore, but it has a major benefit: it helps you monitor your cat’s health. Some serious illnesses that are common in cats affect their toileting behavior, urine output, and stool consistency. By scooping the litter box a couple of times a day, you can find evidence of these problems much sooner than you would if your cat toileted outdoors.
Signs to Watch For Contact your veterinarian if your cat shows any of these signs:
You don’t need to use specialty products like color-changing cat litter (marketed as a health screening tool) to detect problems. If you decide to try cat litter that changes color according to pH or other chemical factors, keep a couple of cautions in mind. First, be sure your cat is willing to use the litter. The right kind of litter is whatever kind your cat is comfortable with. For most cats, this means unscented litter that is scooped daily and replaced regularly. Second, don’t rely on the litter to rule out a medical problem. Color-changing litter can’t be used for diagnosis and might not be accurate even for screening. If your cat shows signs of a problem but the litter’s color indicator hasn’t changed, contact your veterinarian anyway. What Urine and Stool Changes Might Mean Toileting Behavior Cats tend to hide signs of illness and pain, so we need to watch for subtle behavior changes as clues to medical problems. Visiting the litter box more often might be caused by increased urinary urgency, increased urine volume, or diarrhea. Visiting the litter box less often could indicate arthritis, other mobility problems, stress, general illness, or competition from other pets. Urinating and defecating outside the litter box have lots of possible medical causes, so don’t assume your cat is just being spiteful (cats don’t feel that kind of emotion). Urine Clumps When you scoop the litter, pay attention to the size of the urine clumps. Clumps getting bigger over time could mean that your cat’s urine volume has increased. Kidney disease, diabetes, and thyroid disease are all common in cats and cause increased urine volume. A decrease in size or number of urine clumps might mean that your cat is urinating somewhere else in the house. Male cats with urinary blockage (a life-threatening emergency) produce no or very small amounts of urine. Stool Signs of urinary problems (like straining or frequent squatting in the litter box) can be mistaken for constipation. Cats with constipation produce either small hard stools or no stools. Soft stool and diarrhea are more common than constipation in cats and have many possible causes. If your cat has soft stool that lasts for more than a day, blood in the stool, or small hard stools, contact your veterinarian. Save a sample of stool that’s less than 24 hours old in case your veterinarian needs it for testing. Image source: https://www.flickr.com/photos/134294785@N06/21911087653/ Laurie Anne Walden, DVM Uffizo, a 13-week-old Maine coon, is examined by Capt. Sarah Bohac at the Fort Knox veterinary clinic. Photo by Jaden Whiteman, CST Public Affairs Office. A hands-on physical examination is a valuable part of annual wellness visits as well as sick-animal visits. Examinations during wellness visits often uncover problems that weren’t obvious at home. That is the point of a wellness exam: we want to find problems early, before they become more serious and harder to treat. Wellness exams also let us track an animal’s changes over time. For sick animals, the physical exam is a crucial part of the diagnostic workup.
Not all veterinary visits involve a full physical exam. Recheck visits typically include assessment of only a single area (like the ears). And high-volume, limited-service settings like vaccine clinics generally don’t offer full physical exams. A veterinarian can often complete a physical exam within a few minutes, so you might not realize how much information your veterinarian is gathering by looking at, touching, and even smelling your pet. The following basic assessments are part of a comprehensive physical examination. Breathing effort, mental status, posture, gait, general appearance, and reaction to clinic environment: The veterinarian assesses these elements before ever touching the animal. These items are clues to the urgency of a sick animal’s condition and also tell us an animal’s overall state of health, basic neurologic status, and anxiety level. If an animal without an urgent medical problem shows signs of significant fear and anxiety in the clinic, the veterinarian might stop the examination at this point and recommend returning another day with previsit antianxiety medication. Temperature, pulse, and respirations (TPR): The TPR is part of the standard vital sign assessment, along with mucous membrane color and capillary refill time (assessed with a quick touch of the gums). Some animals object to rectal thermometers, and other types of thermometers aren’t always accurate, so the veterinarian might skip temperature measurement for a well animal. Eyes, ears, nose, and oral cavity: Dental disease is very common in dogs and cats, and external ear disease is common in dogs. These problems are often first noticed during wellness exams. The veterinarian might or might not use an ophthalmoscope and otoscope to examine the eyes and ears, depending on the animal’s clinical signs and comfort level (inserting an otoscope into an inflamed ear canal could be painful). Chest: The veterinarian listens to the heart and lungs with a stethoscope to check heart rate and rhythm, identify abnormal heart sounds like murmurs, and assess lung sounds. Abdomen: Gentle palpation of the abdomen can reveal discomfort and possibly abnormal size of individual organs. Musculoskeletal system: The veterinarian assesses muscle mass, especially in senior animals that might have arthritis, and checks the joints for common problems like patellar luxation. Animals that are limping receive a more comprehensive orthopedic examination including range-of-motion tests of multiple joints unless this would be too painful without sedation. Skin and lymph nodes: The veterinarian looks for external parasites like fleas, evidence of itching (saliva staining of the paws, for example), hair loss, signs of skin infection, skin lumps, mammary gland masses, and enlarged lymph nodes. Skin problems are very common in dogs and cats and often turn up during wellness examinations. Many skin problems need further diagnostics, such as looking at a sample of cells through a microscope. Neurologic system: For well animals with no signs of neurologic disease, the veterinarian assesses basic neurologic function and mental status. A more comprehensive neurologic examination includes tests of nerve function of the head and limbs. For animals with neck or back pain, the veterinarian carefully palpates the spine to pinpoint the location of the pain. Urogenital system: Male dogs that have not been castrated have their testicles checked. They might also have rectal palpation to evaluate the prostate. Female dogs and castrated male dogs get a quick glance at the external genitalia and receive a more thorough examination if they have signs of a problem. Image source: https://www.flickr.com/photos/armyrotc/52943246855/ Laurie Anne Walden, DVM Photo by Sophie Shankey on Unsplash Tracheal collapse causes a chronic dry cough that sounds similar to a goose honk. The disease tends to get worse with time. Tracheal collapse can’t be cured, but for most patients, medical treatment reduces the severity of the cough. In the most serious cases, tracheal collapse interferes with breathing and requires emergency care.
Tracheal collapse can affect dogs of any breed but is most common in small-breed dogs like Yorkshire terriers and Pomeranians. It’s rare in cats. Cause The trachea (windpipe) is a tube held open by rings of cartilage. In animals with tracheal collapse, the cartilage rings soften and become weakened over time. The cartilage rings lose their ability to hold the trachea open and the trachea flattens during breathing or coughing, blocking the flow of air. The severity of the signs depends on the percentage of airway that’s blocked. The signs also partly depend on the location of the affected section of trachea: outside the rib cage (in the neck) versus within the rib cage. In dogs with tracheal collapse, coughing is made worse by pressure on the neck, excess weight, stress, excitement, exercise, respiratory irritants like smoke, and respiratory infections. Some dogs with tracheal collapse also have abnormalities of the larynx and the bronchi (airways inside the lungs). Chronic coughing causes airway inflammation, which in turn leads to more coughing. Tracheal collapse and heart disease are both common in middle-aged and older small-breed dogs, so many dogs have both diseases at the same time. Both diseases cause coughing and exercise intolerance. Figuring out which disease is most responsible for the cough can be a bit of a diagnostic challenge. Signs
Diagnosis Tracheal collapse is suspected on the basis of the patient’s history, the sound of the cough, and physical examination findings. A definite diagnosis is made with imaging studies. Radiographs (x-ray images) sometimes show a collapsed trachea and are also used to evaluate heart size and the appearance of the lungs. In many dogs the trachea collapses only on inhalation or only on exhalation, so fluoroscopy—an x-ray “movie”—can reveal collapse that doesn’t appear on radiographs. Tracheoscopy is examination of the inside of the trachea and bronchi with a fiber optic camera in an endoscopy tube. An advantage of tracheoscopy is that it allows samples from inside the trachea to be collected for laboratory analysis; a disadvantage is that it requires general anesthesia. Dogs with tracheal collapse might have bloodwork to assess their overall condition, especially if they are older or have concerning clinical signs. Because the signs of tracheal collapse and heart disease overlap, dogs with suspected or known heart disease also benefit from echocardiography to evaluate heart function. Treatment Tracheal collapse isn’t curable, so medical treatment needs to continue for life. Medications chosen for an individual patient might include cough suppressants to break the cough cycle, corticosteroids to reduce airway inflammation, bronchodilators, and antianxiety medications or sedatives to reduce stress. The choice of medication can change over time as the dog’s disease progresses. Nonmedical management is crucial for dogs with tracheal collapse and includes the following:
Surgical procedures like tracheal stent placement are available for dogs with severe signs. However, surgical options don’t cure the underlying tracheal problem and might not eliminate the cough. Image source: https://unsplash.com/photos/a-small-dog-standing-under-a-wooden-bench-HSs4t4TWPFg |
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March 2025
The contents of this blog are for information only and should not substitute for advice from a veterinarian who has examined the animal. All blog content is copyrighted by Mallard Creek Animal Hospital and may not be copied, reproduced, transmitted, or distributed without permission.
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