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Keeps coughing/gagging. Nose surgery necessary? please help!!!

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Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  puglove on 4/19/2012, 7:11 pm

Hello, this is my first forum topic.
I am 25 years old and have a 1 year 5 month old black male pug that has been gagging/coughing lately which has been noticeably increasing. It sounds almost like he is coughing up a hairball. It seems to be worse when he is active.

I know he is a brachycephalic breed (smushed face) and a very reputable doctor in Boston told us that his nasal passage is narrow even for a pug. I am worried that he has brachycephalic syndrome? The doctor told me I should have surgery on his nose since he has an even HARDER time breathing than most pugs (its bad enough just being a pug). The nose surgery would cost around 1,300$. He was just neutered 2 days ago (which in itself was 450$). I just don't have almost 2,000$ to spend on him right now and the doctor said its not good to put them under anesthesia very much. He also received a rabies shot and heart worm check. Everything went great and I always give him his tick medication. I skipped a month on his heartworm but the test came back normal so I dont think it is that. I do smoke cigarettes once in a while and have stopped smoking around him. I admit that he may have been subject to second hand smoke a little (please no comments about how bad it is for him as I already know and have stopped smoking anywhere near him).

Everyone tells me I am a worry-wort but my dog is MY LIFE and if anything ever happened to him I would be heart broken. Any suggestions or thoughts would be so appreciated. Just a mommy that wants to do right for her baby boy!!!

xoxo
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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  Aussie Witch on 4/20/2012, 7:15 am

Hi and welcome, I am sorry your obviously very much loved boy is having problems.

I would firstly establish exactly what is going on and then look at your options. He could have an elongated soft palate or a collapsing trachea. You need a vet to take a good look (maybe even with an endoscope). Also (and much easier to fix) he might have an upper-respitory infection that needs some antibiotics. I would schedule an appointment with a vet to see what's going on. That's the most important first step. It's a pity you didn't get the vet to check his palate and trachea while he was under.

If he does need surgery it's best to get it done sooner rather than later, as it can be harder to treat the longer it is left and the outcome is not as favourable. I understand money can be a problem, but try anything you can to raise funds - friends, family, a special credit card - if he needs it get it done a.s.a.p.

The very best wishes to you and I hope you find some good solutions. Please let us know how you go. Hopefully other people will chime in with some advice.
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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  ocnside on 4/20/2012, 8:06 am

Hi, you have already received the best advice on what your next step should be. Financial costs of a pug can be enormous as they are more needy, if you will, than other breeds because they are brachycephalic. I have Embrace pet insurance, that may be an option for you with the talk of upcoming Nares surgery. My Julian had to have it at 4 months old; I believe it saved his life and most of my nerves!

Here is the skinny:



DOGS WITH SPECIAL FACES


Most people are not familiar with the term
"Brachycephalic," but if you own a Pug, Boston Terrier, Pekingese,
Boxer, Bulldog, Shih tzu or any one of the other breeds with "pushed
in" faces, you should become familiar with this word. The word comes from
Greek roots "Brachy," meaning short and "cephalic," meaning
head.





Brachycephalic dogs have been bred so as to possess a normal
lower jaw, that is, one in proportion to their body size, and a compressed
upper jaw. In producing this cosmetic appearance, we have compromised these
animals in many important ways and you, as an owner, must be familiar with the
special needs of your pet.





THE RESPIRATORY SYSTEM


Brachycephalic breeds are characterized by
"brachycephalic respiratory syndrome," which affects the different
areas of the respiratory tract. Fortunately, most dogs do not suffer from all
aspects of the syndrome but you should be aware of which your particular pet
may have.





STENOTIC NARES - This is a fancy name for narrowed nostrils.
The brachycephalic dogs begins by having very small nasal openings for
breathing. If this is severe, surgical correction is possible.





ELONGATED SOFT PALATE - It is difficult to fit the soft
tissues of the canine mouth and throat into the brachycephalic's short face. As
a result, the soft palate, which separates nasal passage from oral cavity,
flaps loosely down into the throat creating snorting sounds. Virtually all
brachycephalics suffer from this but actual respiratory distress is rare except
in English Bulldogs. The English Bulldog tends to have more severe symptoms in
almost all aspects of brachycephalic syndrome. Excess barking or panting may
lead to swelling in the throat which can, in turn, lead to trouble. Again, the
soft palate can be surgically trimmed.





TRACHEAL STENOSIS - The brachycephalic dog's windpipe may be
dangerously narrowed in places. This condition creates tremendous anesthetic
risk and should be ruled out by chest radiographs prior to any surgical
procedures.





EVERTED LARYNGEAL SACCULES - The normal larynx has two small
pockets called “ventricles” or “saccules.” When a dog has increased effort in
breathing, over time these little pockets will actually turn inside out inside
the throat. When this occurs, the protuberances need to be surgically snipped.
In fact, this finding indicates that surgery for the stenotic nares and
elongated soft palate is also warranted lest it progress to a full laryngeal
collapse.


HEAT STRESS - Because of all these upper respiratory
obstructions, the brachycephalic dog is an inefficient panter. A dog with a
more conventional face and throat is able to pass air quickly over the tongue
through panting. Saliva evaporates from the tongue as air is passed across and
the blood circulating through the tongue is efficiently cooled and circulated
back to the rest of the body.





In the brachycephalic dog, so much extra work is required to
move the same amount of air that the airways become inflamed and swollen. This
leads to a more severe obstruction, distress, and further over-heating.


Hope that helped!
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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  Pugsavers on 4/20/2012, 10:15 am

Is this coughing/gagging something new since his neuter? Some of it might be because he just had a tube down his throat for the surgery. Or he could have gotten an infection of some type at the vet's office. I would look into all possible causes before running him back into surgery.

And for financing vet procedures there is something called "Care Credit". It is a credit card specifically for vet bills..you might want to look into that just in case.

Good luck with your little man!
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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  Aussie Witch on 4/20/2012, 3:45 pm

Good call Roxane - this is happening so close after his surgery, it is more than likely a throat irritation from the breathing tube and the coughing is making it worse and more irritated. Make a quick call to the vet. If he seems to be depressed and stops eating, then it is definitely necessary to schedule an appointment. Coughing after surgery is very common.
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Thank you for all the great advice!!!

Post  puglove on 4/20/2012, 5:11 pm

I didn't think I would receive such great feedback from everyone! Thank you truly. It is a good call that the gagging could be something due to surgery. However, he has done it before but lately it has just been more noticeable. He overheats VERY EASILY. Easier than most pugs I believe. He cant even be outside on a brisk walk for more than 5 or 10 minutes on a 70/75 degree day. As soon as he starts to sound like someone having an asthma attack we head back inside.

The doctor has suggested surgery for his nose. I am going to post a picture of him as my default picture after I am done writing this so you can see how narrow his nostrils, or stenotic nares :). I can definitely afford it if I need to but the care credit was a great idea that I will look into! I just didn't see the breathing issue as such a problem until recently as he has been getting a little older so I put it on the back burner (and my boyfriend constantly reassures me that nothing is wrong even though he doesn't understand the pug breed or a mommy that loves her pug!).

I truly appreciate all the feedback it has definitely given me a direction to go in. I think I should get a couple x-rays of his trachea to see if there is any underlying problems besides his narrow nostrils to see how urgent the issue really is.

Could his "stenotic nares" become a serious issue if untreated? Obviously if thats what my boy needs Ill do it but I will have to wait a little while because he just went under anesthesia and just putting him under in itself is scary!!!

THANKS AGAIN!!!





puglove wrote:Hello, this is my first forum topic.
I am 25 years old and have a 1 year 5 month old black male pug that has been gagging/coughing lately which has been noticeably increasing. It sounds almost like he is coughing up a hairball. It seems to be worse when he is active.

I know he is a brachycephalic breed (smushed face) and a very reputable doctor in Boston told us that his nasal passage is narrow even for a pug. I am worried that he has brachycephalic syndrome? The doctor told me I should have surgery on his nose since he has an even HARDER time breathing than most pugs (its bad enough just being a pug). The nose surgery would cost around 1,300$. He was just neutered 2 days ago (which in itself was 450$). I just don't have almost 2,000$ to spend on him right now and the doctor said its not good to put them under anesthesia very much. He also received a rabies shot and heart worm check. Everything went great and I always give him his tick medication. I skipped a month on his heartworm but the test came back normal so I dont think it is that. I do smoke cigarettes once in a while and have stopped smoking around him. I admit that he may have been subject to second hand smoke a little (please no comments about how bad it is for him as I already know and have stopped smoking anywhere near him).

Everyone tells me I am a worry-wort but my dog is MY LIFE and if anything ever happened to him I would be heart broken. Any suggestions or thoughts would be so appreciated. Just a mommy that wants to do right for her baby boy!!!

xoxo
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puglove
 
 

Number of posts : 4
Location : Western Massachusetts

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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  Renee on 4/20/2012, 7:52 pm

From your picture, he looks like has a pretty smushed in face. I can't tell if he is overweight or not, but that would be a huge factor in breathing ability as well. When my pugs were fatter, they could barely survive a walk. Now they are all slim and trim, and they love to go on walks.

Getting a second opinion is always, always a good idea. Do not let your vet lead you to think that you should not get one. More information is better, and it helps you make the right decision. Whenever I am unsure about a diagnosis or recommendation from my vet, I get a second opinion. It really helps. A good vet will encourage you to get one, especially if you go see a specialist.
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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  Aussie Witch on 4/20/2012, 9:47 pm

Ashlee, it's just about impossible to tell from looking at a Pug's nose if that is what is causing a problem to breathing. You can look at some Pug's noses and you can't imagine how air could get in and out and yet it does - extremely well! Some never have any breathing issues with the tiniest of nostrils. I think most of what you describe is caused by an elongated soft palate and/or a narrowed/collapsing trachea, two things that need to be properly assessed by a specialist. Trimming the palate does have good results. The trachea is another issue that is more difficult.

From what you say, as this has been going on for some time and seems to be getting worse (although I would put money on Roxane's suggestion of the breathing tube during surgery being the current culprit to making it worse), it does sound like he is a candidate for further investigation into what is going on inside. Let him recover from the surgery and see if the coughing does resolve. It can take a week or more. Of course, if he becomes distressed and things are getting markedly worse, straight back to the vet. I would ask your vet for a referral to a specialist, most importantly one very experienced in dealing with Pugs and doing this sort of surgery. From what you say in your introductory post I assume you got him from a breeder that exhibits - sounds like that person is most probably a responsible and ethical breeder and they might have the name of a good vet for Pugs.

I've copied/pasted this article about ESP's that you might find helpful. I think you will recognise a lot of the signs they mention.

Dogs that are brachycephalic, also known as pug nosed or short muzzled,
are particularly prone to several different respiratory problems due to
the shape of their heads. The most commonly affected breeds include the
Shih Tzu, Boston Terrier, Pug, Pekingese, Bulldog, and Boxer. These
breeds have problems with collapsed tracheas, heatstroke, and a
congenital problem known as elongated soft palate.

The soft
palate is a flap of tissue that is located at the upper back part of the
throat. A normal functioning and positioned soft palate acts like a
flap or block to prevent food or liquid that the dog is swallowing from
accidentally entering the air passage, also known as the nasopharnyx.
The soft palate touches the epiglottis, which in turn is attached to the
base of the tongue in dogs with a normal formation.

In pug nosed
or brachychalic breeds, the lower jaw is normally developed but the
upper jaw is recessed, giving the well-known pug nosed appearance. This
recession of the upper jaw into the skull can cause the soft palate to
more than just touch the epiglottis, rather it will actually be laying
on the epiglottis, resulting in problems when the dog tries to eat,
breath, or swallow. It is not usually possible to see this condition in
its early stages unless the dog is anesthetized, at which time the vet
can check. Many vets routinely check brachycephalic dogs during spaying
and neutering for elongated soft palates.

Typically this
condition is not life threatening, but the dog may become stressed with
breathing problems during exercise. Owners of pug nosed breeds should
watch for signs of snoring, wheezing, snorting, and coughing when the
dog is running. As the soft palate becomes more swollen and irritated,
breathing even during relaxation and even when sleeping can become more
problematic. In addition, the dog may experience greater problems in
eating and drinking and may start to spit out food or even throw up food
or water while he or she is eating or drinking because the palate is
obstructing both the throat and the air passage.

As this
irritation increases and the dog continues to struggle trying to
breathe, eat, and drink the muscles and ligaments that control and hold
the larynx begin to stretch. As these muscles stretch the larynx begins
to collapse in on itself, eventually leading to complete obstruction of
the airway. This condition can be life threatening as the more the dog
panics and tries to breathe; the more pressure will be put on the
larynx, further hastening the collapse.

The elongated soft palate
does not always become a serious condition and can be corrected with a
surgical procedure that removes the excess tissue on the palate. Since
this condition is hereditary it is very important for any dog that has
been diagnosed or shows signs of elongated soft palate be spayed or
neutered and not used in breeding programs. Reputable breeders have
worked diligently to control their breeding stock so this condition is
far less common today than it was several years ago.
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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  KarismaGungle on 8/18/2012, 2:14 am

I'm very interested in hearing what you decide to do! My black male pug does the same thing! I got him when he was about three years old. He often does the "hair ball cough". Our vet told us he wanted to remove his nose roll and widen his nostrils for $2000. We thought he was crazy, but it makes sense after reading all of this! What have you decided to do. We are going to make an appointment to see another vet soon and see what they think.

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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  Stitch Chan on 8/18/2012, 5:18 pm

There has been some great advice in this thread! I would also have him checked for kennel cough since he just came from being at the vet for awhile. Both of my little furkids got kennel cough at the same time, they would cough 6-7 times the it sounded like they swallowed what was coming up. Just a suggestion.
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Re: Keeps coughing/gagging. Nose surgery necessary? please help!!!

Post  GingerSnap on 8/19/2012, 12:40 pm

One other thing that I noticed from the 1st post in this thread is that a vet in Boston said he needed surgery, and I'm assuming that's who gave you the estimate for the surgery. Although I would absolutely want a vet who's very familiar with brachycephalic breeds to do it if it's needed, and I wouldn't choose a vet based on price, I'd personally try to avoid a big expensive city, especially when you live away from the city. Expensive locations tend to have expensive vets. So there may be somewhere closer that could do a fantastic job more affordably. One of our members, Ayleash, used to have pugs and (I think) is also in western Mass. She may have some suggestions for you.
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