When should you be concerned that your pet is not breathing well? Difficulty breathing is usually due to a problem with the heart, lungs or respiratory system but can also occur in anemic pets when their blood oxygen levels are low. There are several indications that your pet needs emergency attention due to difficulty breathing:

• Bluish or purplish gum color
• A respiratory rate higher than 60 breaths per minute
• Deep breathing with contraction of abdominal muscles
• Noisy breathing
• Outstretched neck
• Prolonged open-mouthed breathing in cats
• Coughing, especially if your pet is coughing blood or other fluid
• Fluid leaking from the nose

What Causes Difficulty Breathing?

Several specific causes of breathing difficulties include anemia (low red blood cell count), congestive heart failure, respiratory disease or infections, asthma and bronchitis, heatstroke and pneumonia—all of which can affect dogs and cats. Tracheal collapse, another condition causing coughing and difficulty breathing, most commonly affects toy and small breed dogs and is more rare in cats and in large and giant breed dogs.

Anemia

With anemia, the low blood count decreases the amount of oxygen that can be transported around the body. Subsequently, pets will feel short of breath or even struggle to breathe. Normal gum color is a nice pink, like in people, but in pets with low blood counts, their gums may be light pink, very pale or even white. Low blood counts can be due to blood loss (bleeding internally or from external wounds), lack of production of blood cells (bone marrow diseases or advanced kidney disease) or destruction of red blood cells by parasites or immune-mediated diseases. Hookworms and fleas ingest blood meals, so overwhelming parasite infections can result in anemia and difficulty breathing. If your pet is having difficulty breathing due to anemia, a blood transfusion in addition to oxygen therapy may be necessary.

Congestive Heart Failure

Congestive heart failure is a common cause of difficulty breathing and will typically cause your pet to cough; you may even seen clear or bloody fluid coming from your pet’s nose. As heart disease advances, the heart cannot adequately pump blood forward through the body so fluid buildup occurs backwards from the heart. This fluid moves into the lungs and is called pulmonary edema. If your veterinarian diagnoses congestive heart failure, your pet will be started on diuretic therapy to remove the pulmonary edema and on oxygen therapy. Additional medications may help the heart pump stronger to prevent future fluid buildup in the lungs and may even slow the progression of heart disease. Congestive heart failure can become fatal rapidly without aggressive treatment. Pets with heart disease should always be examined if they are ever breathing heavily or coughing. An adjustment in your pet’s cardiac medications may be needed.

Respiratory Diseases

Respiratory diseases that cause difficulty breathing include tracheal foreign bodies (choking), pneumonia, cancer, tracheal collapse and laryngeal paralysis. If your pet is choking and you cannot see the foreign object in his mouth, do not attempt to stick your fingers down his throat to retrieve it. You risk being bitten and may also push the object further down his trachea. Instead, immediately transport your pet to the nearest veterinary hospital and call the clinic to let them know you are coming so that oxygen therapy can be set up and ready.

Asthma and Bronchitis

Asthma and bronchitis may be allergy-related or due to inflammation. Both diseases tend to be chronic but can have flare-ups during which emergency treatment is needed. Treatment is usually oxygen and a steroid and may include inhaler therapy. Special adaptors (Aerokat and Aerodawg) fit into human inhalers for pets with chronic airway disease. Typically pets tolerate inhaler therapy very well after they become accustomed to the mask and puff sensation. If your pet has chronic airway disease, air purifiers may be another way to minimize acute flare-ups.

Tracheal Collapse & Laryngeal Paralysis

Tracheal collapse and laryngeal paralysis are obstructive processes, and both can completely close off a pet’s airway. Tracheal collapse is common in middle- to older-aged small breed dogs, and laryngeal paralysis is more common in older large breed dogs. A dog suffering from tracheal collapse typically coughs and cannot catch their breath; a dog with laryngeal paralysis has very noisy breathing similar to a “goose honk.” Both dogs commonly need emergency treatment with sedatives and oxygen and may need to be intubated to open up the airway.

Tracheal collapse can be managed medically in mild to moderately affected dogs. Typically, medical management includes maintaining a healthy weight, cough suppressants, occasional steroid use, minimizing strenuous activity and using harnesses rather than neck leads. Glucosamine supplements have also been shown to be useful in some dogs. In severe cases when the tracheal collapse is occurring in the neck, surgical implants called tracheal stents can be placed by a soft tissue surgeon. Tracheal stenting has limitations; currently the procedure is only completed at referral facilities, the stents can break and fail, and the procedure is very expensive. Tracheal stenting is not an option for tracheal collapses that occur in the airways located in the chest.

Pneumonia

Pneumonia occurs after infection with bacteria, viruses or, less commonly, fungus. Kennel cough and distemper virus are common causes of pneumonia. Pneumonia also may develop if a pet has been vomiting and inhales some of the vomitus down the airway; this is called aspiration pneumonia. A pet with pneumonia may not always cough, and many pets do not have a fever. A pet that is very ill with pneumonia is typically hospitalized for aggressive antibiotic therapy, nebulization, oxygen and IV fluids. Less severe cases of pneumonia are treated with antibiotics at home. Pneumonia can take weeks to fully resolve, and your veterinarian may want to monitor progression with repeated X-rays.

Metastatic Lung Cancer

Metastatic lung cancer occurs when cancer that has originated in a separate area of the body spreads to the lungs. When this occurs, the affected lung tissue can no longer fill with oxygen and inflate normally. Pets with metastatic lung cancer will feel short of breath and have difficulty breathing. Unfortunately, metastatic lung disease is associated with advanced cancer, and treatment options typically are aimed at maintaining quality of life at that point, as metastatic lung cancer cannot be cured.

Your pet will be immediately assessed when you arrive at your veterinary or emergency clinic. If he or she is having difficulty breathing, your pet may be taken and placed in oxygen before you speak with a veterinarian. Many times a full examination is delayed until your pet is breathing more normally. Depending on the cause of the difficult breathing, an immediate injection of a diuretic to remove fluid buildup or a sedative may be appropriate. A pet that is struggling to breathe may have to be immediately placed under anesthesia and intubated. Once your pet is more stable, X-rays will be completed. It is not uncommon for pets that are admitted to the hospital due to difficulty breathing to remain in the hospital for observation for a period of time even after they are breathing normally. Once your veterinarian is comfortable that your pet is out of danger, he or she will speak with you about your pet’s diagnosis and treatment plan.