Breathing fast

Took my 10y/o maltese in today for rapid breathing. Xray showed possible allergies she was put on 5mg of prednisone with a taper down weaning schedule. Her heart is mildly enlarged at 13? it should be under 10 and she was dx with a murmur and ear infection. Has a family hx of CHF I was given lasix to try if the prednisone doesn't work. Xray did not appear to show CHF and she only has the occasional cough. I don't feel like the prednisoneis working. It was given 8 hours ago she had mild improvement then she ate and drank fm now her respiratory rate is 50 to 65.  She gets the purple/blue tounge sometimes.  At what point do I add in the lasix? Anything else I should be doing? If this doesn't resolve at what point do I euthanize her?

Hello!   It sounds as though your dog is in respiratory distress.  Purpleness (we call it cyanosis), is a quite a severe sign of not getting enough Oxygen around the body.  Rapid action is likely indicated when that happens, perhaps even Oxygen supplementation.  It is a critical sign, so if this is happening at the moment please make sure that your vet is aware.  Regarding meds, it would be unprofessional for me to make clinical decisions about someone else's case.  You may be aware of a reason for being asked to give the meds a distance apart - so that you could identify which was working, perhaps? -  This would need to be carefully balanced over the need to improve the pets' condition as quickly as possible in the case of dyspnoea and is a decision for yourself and your vet.  It is always important to give meds as prescribed on the label unless your vet tells you otherwise, but if different treatment is needed then you need to speak to them quickly - dyspnoea is a severe sign and actions at this point may prove critical. In general it is a good idea to get to the bottom of the underlying cause and to know whether this is lung disease (e.g. airway constriction due to allergy) or of cardiac (heart) origin.  Your vet can get second opinions on the radiographs or perhaps do (or refer for) a cardiac ultrasound to determine this.  Knowing the cause is important in order to establish the correct treatment. It is generally useful to know the diagnosis and therefore the best treatment before resorting to euthanasia in most situations.  Sometimes people decide to do differently for reasons of finance, for example, or because the prognosis has already been said to be poor. Best of luck.

I have given you a very direct answer there, but this this a distressing time for yourself and your Maltese so I wanted to expand a little on the questions you were asking about end of life.  In general, cost and resources are important.  I don't know how much investigation has been done here, but you suggest that the cause of your dogs' dyspnoea may be respiratory (airway disease, such as allergy), or cardiac.  The available treatments for these things are quite different and knowing the cause can be key to successful treatment.  It may be that in an ideal situation more tests could be done - an ultrasound, further radiographs or specialist opinion, for example, may answer the question of which medications will work best.  I also know that not all owners will opt for this.  Questions such as 'what is the best outcome I can hope for if I do that?' and 'what advantages will that bring?' can help owners to understand the options more clearly.  There is no 'wrong' decision unless, at any point, a pet is left in unresolvable suffering.  Vets will not judge you on what you can afford, but we rather we should do the best we can and know with the tools and knowledge available to us.  Thinking of both of you at this time.

Thank you,  her vet is aware of the cyanosis, unfortunately she(the dog)  refused oxygen.  The cyanosis has been going on for a couple of days on and off with eating/ activity.  Unfortunately  an ultrasound  is expensive  and they aren't 100% sure it would show anything so that is why we opted for the xray  that appeared to show mild inflammation and they were thinking possible allergies. I'm just unsure  of how long to allow the rapid breathing to go on if there is no improvement while on medications before we would administer euthanasia. Ideally  how long should I give the medications to work?

I would usually expect to see a difference in hours to several days with repeated doses, depending on the drug and the way it is given.  Your vets' answer should be more specific to your dog and the drug they have used.