We have had a LOT of coughing dogs this past week. A few of the owners that have come in saying that Kennel Cough is going around the dog parks in North York/Toronto. I cannot seem to find any current news on this - except this article from PEI.
Most are young dogs that present to us with a history of coughing, maybe coughing up phlegm, seemingly trying to cough something up. Their coughing is keeping these pups up at night, but also waking up their owners.
Often they had visited a dog park where friends of theirs mentioned kennel cough is going around.
What is Kennel Cough?
Kennel Cough is a complex typically with viral and bacterial component. Viral infections do not have specific treatments. However, most dogs are vaccinated for a few of the viruses that can be part of the Canine Infectious Respiratory Disease (CIRD) or infectious tracheobronchitis - commonly known as Kennel Cough. Some of these viruses are canine parainfluenza virus, canine distemper, canine adenovirus 2 (these three viruses are in your standard vaccines for dogs), in addition to canine herpes virus, canine respiratory coronavirus, canine influenza amongst others. Which viruses are part of the CIRD complex will be dependent on where you live. Either way, they are highly contagious. On top of these viruses, we add in bacterial organisms: Bordetella bronchiseptica and Streptococcus equi subsp zooepidemicus, and Mycoplasma spp. In Canada, we have a vaccine for Bordetella - which can be administered intranasally, orally or by subcutaneous injection - depending on your veterinarian's supplier.
Vaccination of your dog does not mean that they cannot get Kennel Cough, it just means that they will have some antibodies to target these organisms, allowing their immune system to respond quicker. This tends to allow them to not be ill for a long duration of time, and not have severe symptoms of lethargy and fever (Ellis et al, 2001). Additionally, there are asymptomatic carriers (just as there are for COVID-19 in people). Approximately 50% of dogs with no symptoms will test positive for one of the viruses or bacteria, with about 13% of them carrying at least two of these bugs (Lavan and Knesl, 2015).
How do we treat Kennel Cough?
Most of the time, these patients do not require antibiotics. If you think about the common cold in people, similarly, you do not need antibiotics for these people either. Many of these cases are due to viral pathogens that do not respond to antibiotics. However, if the patient is at a higher risk of development of secondary opportunistic bacterial pneumonia, then we may do a short course of antibiotics.
Many of these puppies that come in are healthy, happy, bouncy puppies ages ranging from 6 to 10 months, with likely first time exposure to Kennel Cough. When they are willing to eat treats and socialize with our staff, but cannot sleep at night due to their cough, I will prescribe a cough suppressant medication. These pets have clear lungs, and their only symptom is a cough. Most clear the infection on their own after 7 to 10 days.
What about Older Dogs with a Cough?
Also this week, I had a 14-year-old FS Shih Tzu mix present with a cough. The owner mentioned that kennel cough is going around, and she had a new puppy that had a runny nose. Perhaps the new puppy gave the older dog kennel cough. The difference with this case is that the patient had other clinical signs that are not typical of kennel cough. She had vomited some clear fluid and she was not eating her regular meal. On physical examination, she had a tense abdomen, and her cough was elicited by pressure on her abdomen, but not on palpation of her trachea. Therefore, in this case, chest x-rays and blood work are warranted prior to any cough suppressant medication.
In another case of an older patient with a cough, we have an 8-year-old MN Samoyed present with coughing with activity and not able to go on long walks. On examination, when I pushed on his abdomen he started to have increased issues with breathing. No coughing was observed during his examination. After x-rays and sending these off to a radiologist, he was diagnosed with a spontaneous pneumothorax from a partial rupture of an air sac (bullae) in a lung lobe.
This is a lesson to future veterinarians. Always take a thorough history and then use that in the context of your physical exam findings prior to making a decision on your diagnosis.
Prevention of Kennel Cough
Ensure your pup is up to date with its core viral vaccines. If your dog is at high risk, then have your pup vaccinated for Bordetella.
If your dog has a sudden onset of coughing, do not take your dog to the dog park. Please do your due diligence and avoid social contact with other dogs. Let other dog owners know in your neighbourhood that your dog has been coughing and could potentially have Kennel Cough.
Do not let your dog go on its walks with the dog walker. Do not let your dog go to daycare. Do not let your dog go into another dog's bubble. Nose to nose contact is all it takes to spread the disease.
Do not assume it is Kennel Cough - especially if you have an older dog. Take your dog to your veterinarian for an assessment. Any other signs like loss of appetite, vomiting, fever, or lethargy should be assessment by a veterinarian.