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Thread: Coughing up phlegm?

  1. #25
    Baxter Tiberius
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    Default Re: Coughing up phlegm?

    Okay so here's the situation.

    Everywhere I read, coughing for 2-3 months after Kennel Cough is textbook "Chronic Bronchitis". The treatment for it is anti-inflammatories to calm the cough. If you don't calm the cough, it creates scar tissue. Scar tissue leads to more coughing, more scar tissue, and ultimately cardiovascular disease. The goal is to stop the cough, and creation of new scar tissue.

    But what if he has an infection still?

    Doctors unfortunately believe antibiotics are the answer for everything. So the doctor told me to put him on Doxycycline again. She even offered a second antibiotic. When I asked her why she thinks this is an infection when there are zero signs of infection, she shrugged her shoulders. Baxter has no signs of infection:

    1) White blood cell count is normal.
    2) His phlegm coming up is clear.
    3) His temperature is normal.
    4) And his behavior (until this morning) was fine.

    Yet this cough and hacking has persisted for 3 months. Again, textbook Chronic Bronchitis. But how do you tell a doctor that, when you're not a doctor?

    So we had a long, uncomfortable conversation. She politely refrained from telling me not to tell her how to do her job. I politely refrained from telling her that she needs help doing her job. But you could see it on our faces. She did offer to do the phlegm culture. Its going to cost $210, and it has to be physically extracted from his lungs, which is not going to be a pretty process at all. She also offered (after I wouldn't shut up) to prescribe him some corticosteroids. But she made it very clear (and she's correct) that if he has an infection, the steroids will cause it to get much much worse, as there will be no immune system to fight it.

    She did an X Ray of his lungs, but said something about his spine getting int he way, so no matter how she positioned him, she couldn't get a clear picture of his lungs. I have no idea how a spine can block a lung X ray. She told me the X ray showed that his trachea was expanded open at the front and back ends, but in the middle, it compresses very small. So she wants a radiologist to look at that. Waiting to hear from her on that.

    So here I am with Baxter back at home. Snot pouring out his nose as he hacks phlegm on the floor, and absolutely no idea how to proceed. If the documents I read are correct:

    1) 2-3 months of coughing *after* getting Kennel Cough
    2) normal white blood cell count
    3) no fever whatsoever
    4) clear phlegm (as opposed to green or yellow)

    Then no infection. Chronic Bronchitis.

    But if I give him steroids, and this is a virus or bacteria, it could take over and ruin him.

    I don't know how to proceed....
    Last edited by Baxter Tiberius; 11-13-2013 at 03:32 PM.

  2. #26
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    Default Re: Coughing up phlegm?

    Dude seriously, I would not put him on steroids just based off of what you've read. Why not wait until the culture's done? Meanwhile, is there anything she can recommend, or prescribe to help with the phlegm?


  3. #27
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    Default Re: Coughing up phlegm?

    Oh Kevin, this is horrible…
    You always do your homework, and then to have to argue w/the vet!!! So ridiculous… was allergies ever mentioned? I know that clear discharge from the nose is a sign…

    "What we once enjoyed and deeply loved, we can never lose, for all that we love deeply becomes a part of us." Helen Keller
    RIP Wellie, Bella, Winston & Roxie

  4. #28
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    Default Re: Coughing up phlegm?

    Oh boy, Maybe a second opinion? I'm not sure I like the sound of this vet. Why does she think a shoulder shrug is an acceptable answer to a great question??? To me she just does not seem to care about actually diagnosing and treating him. I can say that to many doctors an educated patient is not what they want to deal with. I have found with my many health issues that if I question the doctor, the relationship goes downhill. I'm sorry If we have any doctors here and I certainly don't mean to generalize but this happens all the time. I would certainly seek another opinion soon.

  5. #29
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    Default Re: Coughing up phlegm?

    Quote Originally Posted by brutus77 View Post
    Oh boy, Maybe a second opinion? I'm not sure I like the sound of this vet. Why does she think a shoulder shrug is an acceptable answer to a great question??? To me she just does not seem to care about actually diagnosing and treating him. I can say that to many doctors an educated patient is not what they want to deal with. I have found with my many health issues that if I question the doctor, the relationship goes downhill. I'm sorry If we have any doctors here and I certainly don't mean to generalize but this happens all the time. I would certainly seek another opinion soon.
    I second another opinion. I do agree with the lack of evidence that it an infection, but humans are put on steroids and antibiotics all the time when it is an infection- is this different in dogs? A short term course of steroids will not destroy his immune system. I would opt for a second opinion - just saying. Lots of prayers coming your way. Baxter just looks so sad!
    "We never really own a dog as much as they own us!"

  6. #30
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    Default Re: Coughing up phlegm?

    Here's the thing, While this vet is waiting around trying to decide what to do, Poor Baxter is suffering and Kevin is at a loss to help him. How long did she say until the culture is back? It's the in the meantime that is getting to me. I'm getting really angry and it isn't even my dog!!!

  7. #31
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    Default Re: Coughing up phlegm?

    Quote Originally Posted by brutus77 View Post
    Here's the thing, While this vet is waiting around trying to decide what to do, Poor Baxter is suffering and Kevin is at a loss to help him. How long did she say until the culture is back? It's the in the meantime that is getting to me. I'm getting really angry and it isn't even my dog!!!
    Cultures have to grow 24-48 hours before they can be read.
    "We never really own a dog as much as they own us!"

  8. #32
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    Default Re: Coughing up phlegm?

    Quote Originally Posted by mer55 View Post
    Cultures have to grow 24-48 hours before they can be read.
    UGH!

  9. #33
    Baxter Tiberius
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    Default Re: Coughing up phlegm?

    Thats kind of how I feel.

    Im not angry with the vet. I've asked 4 vets over the last 3 months about his continued coughing. If any of them were worth their degrees, someone should've suggested Chronic Bronchitis and the introduction of an inhaled coritcosteroid to calm the coughing. They *all* just shrugged off the topic.

    So I called the vet back and asked for a prescription for an inhaled cortico. She said we have to wait until the radiologist responds, which will be tonight or tomorrow. And she wants to wait for the culture to come back first as well.

    Baxter has been sleeping all day. The Doxycycline i think is kicking in again, so things are calming down a bit. He definitely gets worse when he gets excited, or stressed by something (loud noise, etc) which is also listed as one of the 5 traits of chronic bronchitis. Because its just inflammation after all. When he sleeps, he doesn't have any symptoms at all.

    There's just so much phlegm ...

    I should correct what i said above ... inhaled corticosteroids don't turn off the immune system. They mostly affect the lungs, which is where he needs it. I believe pills have a stronger systemic effect.

  10. #34
    Baxter Tiberius
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    Default Re: Coughing up phlegm?

    Here is a vid from last night. This is one of the more "dry" coughs (usually gurgling wet), with a much smaller puddle at the end (has gotten as wide as a softball).


  11. #35
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    Default Re: Coughing up phlegm?

    Kevin, I feel bad for you & Baxter as does everyone [replacer_img]

    I can suggest some herbal remedies that will help and I would be
    looking at holistic means of controlling his cough, lessening phlegm
    production and controlling the bronchitis over all. As you know, neither
    steroids or antibiotics are long term options. Can you find a holistic vet
    in your area?


    My 1st bully, Brutus
    RIP beloved boy.

  12. #36
    Baxter Tiberius
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    Default Re: Coughing up phlegm?

    Steroids do help in certain circumstances where inflammation has run a muck.

    I had a severe pneumonia once and terrible cough. The pneumonia went away, but I continued coughing for weeks and weeks afterwards. I couldn't stop. Nothing worked.

    Three other doctors theorized I might have lung cancer, or needed antibiotics because the Pneumonia never went away.

    Finally a doctor with a brain gave me Advair (steroid inhaler), and literally within 1 inhale, my coughing stopped. And it never came back.

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