If your dog experiences an episode of breathing difficulty, it can be very frightening and stressful as an owner. There are many potential causes, which may look and sound similar. For this reason, if your dog is having any difficulty breathing, it is important to contact your vet straight away and take them in as soon as possible to determine what might be the underlying issue. 

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Upper airway 

The upper airways comprise the nasal passages, the pharynx, larynx, sinuses and turbinates. There are a range of conditions that could affect these structures in order to cause breathing difficulties for your dog. 

Foreign object 

This is when an object from the environment gets into any part of the body and causes problems. In the upper airways, something might become lodged in a nasal passage. For example, blades of grass or seeds are quite common. These are frequently inhaled into the nose while the dog is exploring, and go on to cause inflammation, sneezing, discharge, and can disrupt breathing. 

Another type of foreign object is one that can enter through the mouth and block the airways at the very back of the mouth or throat – such as a small ball. These objects, like a small ball, can be more serious causing a blockage of the airway and need to be removed immediately as an emergency.

Laryngeal paralysis 

Largyngeal paralysis is a disease which is more likely to affect older dogs, and tends to be seen more in larger breeds. It is also known as GOLPP (geriatric onset of laryngeal paralysis and polyneuropathy) as there are other presentations which can accompany this condition. The vocal folds are flaps of tissue which move in and out as your dog breathes in and out. Over time, the nerve supply to these folds can deteriorate and gradually these flaps of tissue are less mobile, less able to open and start to obstruct the airway. This can be heard as very noisy breathing, or sometimes coughing and gagging. 

Anaphylaxis / Allergic Reaction 

Dogs can suffer from anaphylactic shock, just as humans can. This when they have a severe allergic reaction to something – such as an insect sting for example. Instead of experiencing a local reaction, the immune system has an abnormally exaggerated response and releases a tidal wave of inflammatory chemicals (such as histamine and bradykinin) which can affect multiple organs and body systems. This can present as sudden onset vomiting, diarrhoea, facial swelling, wobbliness, shaking, rashes or hives, and difficulty breathing. This is an emergency and needs veterinary attention immediately. 

Sneezing / Reverse sneezing 

Reverse sneezing is a relatively common condition that can be very alarming and often seems like your dog is choking, but fortunately isn’t as dramatic as it sounds. This tends to happen more in shorter faced breeds (such as french bulldogs, chihuahuas, or lhasa apsos). The reason for this condition is usually that the soft palate at the back of the throat becomes irritated by something (e.g. dust, pollen, other allergens). Often though, the initial cause is not known. Your dog will then repeatedly sharply suck or snort air in through his nose in an attempt to expel whatever has caused the initial irritation. This usually self resolves in under a minute and your dog will then be completely unaffected by it. 

Neoplasia 

This is another word for tumours, or cancer. Tumours can grow in any part of the body. If this happens anywhere in the upper airway, then the space the tumour occupies can cause an obstruction and result in difficulty breathing. 

Other masses 

Occasionally, a space occupying mass which isn’t a tumour may form and obstruct the upper airways (like an abscess, salivary cyst or a foreign body reaction for example). 

Lower Airway 

The lower airway on dogs is made up of the trachea (windpipe), going down into the lungs which is made up of bronchi (larger branches), bronchioles (smaller branches) and alveoli (the tiny air sacs where gases like oxygen pass in and out of the bloodstream).

Infection 

Dogs can contract infections (viral, bacteria, or fungal), which causes inflammation of the lower airways, also known as pneumonia. Signs of pneumonia in dogs include difficulty breathing, coughing, lethargy and sometimes a bluish tinge to the mucus membranes (gums). This usually requires hospitalisation, medical treatment and supportive care until the infection resolves. 

Acute Respiratory Distress Syndrome 

This is a relatively rare syndrome which can occur secondary to severe inflammation elsewhere in the body, and can happen several days after the initial event. It presents as rapid breathing, difficulty breathing, and a bluish tinge to the gums. Diagnosis is difficult and the patient needs to be hospitalised and given supportive care. 

Tracheal Collapse 

This is a condition more commonly seen in smaller breeds, or toy dogs such as Yorkshire terriers, or Chihuahuas. The trachea, or windpipe, in dogs is made up of rings of C shaped cartilage which hold the tube open. If these rings become weakened, the trachea collapses down to a more flattened shape. Initially this will result in a chronic cough but can progress to wheezing and difficulty breathing as the condition worsens. Unfortunately there is no cure for this condition but it can be managed medically in the earlier stages. 

Bronchitis 

Bronchitis is a chronic condition where the walls of the bronchi (the branches of the airway within the lungs) become inflamed, leading to narrowing of the air passage. There is production of mucus, which can trigger your dog to cough but can also lead to irritation of the lungs. This condition is irreversible once the tissues of the lung start to become damaged, and repeated episodes can predispose your dog to pneumonia. Earlier stages can be managed medically so it is important to get your dog checked by your vet if they have had a cough for longer than a month. 

Lungworm 

Lungworm can affect any dog of any age, but seems to be more prevalent in certain areas. It has been on the rise in the UK and it is now common practice to have dogs on preventative treatment from your vets to provide protection. This disease is caused by a parasite (Angiostrongylus vasorum) which is spread to your dog via an intermediate host (usually slugs and snails). The parasite travels from the intestinal tract, throughout the body to the heart and lungs. This causes coughing and difficulty breathing but can also cause other serious signs, such as uncontrolled bleeding. 

Heart disease 

Although heart disease can affect any age or breed of dog, some breeds are more pre-disposed than others (such as Boxers, Cavaliers, or giant breeds like Great Danes). There are also different types of heart disease depending on the area of the heart affected (e.g. mitral valve, tricuspid valve, dilated cardiomyopathy etc). Some patients may have a heart murmur or heart disease with no clinical signs at all, but as the disease starts to progress they will deteriorate and will then need to be on lifelong medication to manage the symptoms. Common signs include coughing, exercise intolerance, fainting/collapse, and can affect their breathing. 

Neoplasia 

Tumours or cancer, can affect the lower airways as well. In the lungs, there can be primary tumours, or secondary tumours (where the cancer has spread to the lung from elsewhere in the body). These are usually easily detected via diagnostic imaging such as X-rays. 

BOAS / Brachycephalic Obstructive Airway Syndrome 

A separate category of anatomical differences affecting short faced breeds, such as Pugs, French bulldogs, Lhasa Apsos and Boxers. Their severely flattened faces means space for the soft tissues is greatly reduced compared to longer faced breeds such as Labradors. Fitting the same amount of soft tissue into a smaller space alters the anatomy of the airways in several ways making it difficult for them to breathe properly. 

These are are a few of the conditions contributing to the overall syndrome of brachycephalic disease: 

  • Stenotic nares – the nostrils are very narrow which makes it harder to draw air in
  • Long soft palate 
  • Everted laryngeal saccules – tissues at the sides of the vocal folds which can obstruct the airway 
  • Hypoplastic trachea – a narrowed windpipe 

Some patients can experience improvement through surgical management. You can imagine just one of these problems would make it uncomfortable to breathe properly. But as these dogs often have at least one, if not all of these issues, this has a huge impact on their welfare and day to day quality of life. 

Conclusion 

There are many different underlying causes for difficulty breathing in dogs, and can present alongside a range of other symptoms. It is important to seek prompt veterinary care so they can assess and decide on the best course of investigation and treatment. Often, imaging (such as X-rays and ultrasound) will be the first step, alongside ongoing supportive care (such as oxygen therapy in severe cases). 

The prognosis depends very much on the diagnosis and how severe the condition is. But presenting your dog to the vet as quickly as possible will increase the likelihood of a good outcome.

References and Further Reading