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10-Year-Old Shepherd Mix Dog Coughing Blood

2010 October 7

German Shepherd Mixed Breed Dog Coughs Up Blood

dog-chest-tumor-x-ray, tumor as large as the heart in the back of the chest

oval thing on left=heart, on upper right=tumor!

Marley, a 10-year-old male, neutered black and tan German Shepherd Dog Mix, wagged his tail and smiled at Doc Truli.  Marley did not get up.

“How’s Marley’s arthritis?” asked Doc Truli.

“It’s the same, good days and bad days.  He takes the glucosamine, omega 3’s, the painkillers, and the special food you prescribed.  But, I’m worried about this new cough he has,” said Marley’s person.  “He coughs and sometimes a little blood comes up.”

“That’s very concerning,” said Doc Truli.

Top Ten Reasons for a Dog Coughing Blood: (no particular order)

  1. Rickettsial Disease, from tick bites, like Ehrlichia canis
  2. Rat poison, or other poison like bleeding side-effects from arthritis medication
  3. Sore, irritated throat
  4. Fungal Infection
  5. Foreign object, like a plant awn in the bronchial tubes
  6. Parasite infection, like lungworms from eating a snail
  7. Sore, bleeding gums or tooth
  8. Bacterial Infection
  9. Hemophilia (specific, inherited bleeding disorder)
  10. Cancer, in lungs, throat, mouth, sometimes stomach

Tests to Determine Why a Dog Coughs Blood

  1. Physical examination, especially the oral cavity (mouth), under the tongue, and the sound of the lungs
  2. Complete Blood Count
  3. Chemistries of the blood show liver, kidney function and indicators of other organ functions
  4. Tick tests, blood tests to search for traces of past or present tick diseases
  5. Imaging: radiographs (x-rays)

Marley’s X-Rays Show a Problem

Marley’s bloodwork, physical, and tick tests looked normal.  The chest x-rays showed a huge problem.

Here are images, first of a normal dog chest seen from the side and the top-to-bottom view, and then Marley’s x-rays.  Can you spot the problem?

Dog's Chest X-ray looks like two hearts, but really, the round thing on the right of the picture is a tumor that is as big as the heart

Top-to-Bottom View of Marley's Chest. What is the white round thing on the right?

Negative Contrast of a dog chest x-ray looks all blue and shaded.  A large, ominous black round area to the right on the picture represents the chest tumor

Negative Contrast of Marley's Chest. What is the Round thing on the far right?

x-ray showing the outline of a normal heart in the chest

Normal Lateral View Canine Chest

top-to-bottom (V/D) view of a normal dog's chest x-ray

Normal Dog V/D Chest X-Ray

Can you see the tumor on the x-rays? Marley had a huge, round white abnormality in his chest on the right on the x-rays. The tumor could be cancer, a granuloma – or walled-off infection, or a fungal granuloma.

Tru Tip
Doctors show radiographs (x-rays) by placing them for viewing with the right on the left and the left on the right. So, in Marley’s x-rays, the lump is on the right in the picture, which is actually Marley’s left in reality. For another clue to figure out right from left in a chest x-ray: the apex, or lowest point, of the heart in a person or a dog lies to the left of midline. Except in super-rare genetic variants where all of the internal organs are reversed.

Without a biopsy, the kind of cancer or infection cannot be determined. Marley’s person decided not to put Marley through any invasive tests, even a simple needle aspirate, because he decided he did not want surgery or heroic measures to save Marley’s life.

When is a Lump a Lump?

Doctors will often say “nodule” when they see a lumpy, smallish thing (like in the thyroid gland on ultrasound viewing.)  Nodule just means lump.  It does not mean cancer or anything else.

A doctor might say “mass,” but this sounds more like cancer.

You could also call Marley’s lump a “tumor.”  Tumor implies a growth of some sort, and would be wrong in Marley’s case if the lump was caused by a walled-off infection.  The treatment would still necessitate surgery, however, with the hope of a cure!

A “bump” is a lump on the surface of the body.  This chest mass lies inside, so a doctor would not call it a “bump.”

Dog’s Coughing Improves with Supportive Treatment

Marley received antibiotics (because masses are altered in their immune system protective functions.)  He gained 5 pounds in a week after Doc explained the importance of good nutrition, and even substituting some puppy food for dog food to give Marley extra building blocks to fight the tumor.

Marley coughs a few times a day now.  Sometimes he cannot catch his breath.  He’s slowing down, but he loves his walks (slowly), daily massages, and his food.  So far, so good.

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