My thirteen year old female pug has had bilateral nasal discharge (sometimes clear and sometimes white and yellow mucous), gag, retch, some regurgitation and unproductive cough/wheeze over a five month period. She has historically been a very healthy, active dog. She was boarded for the first time in September 2012 and very shortly thereafter presented with cough. Kennel cough was ruled out. She was treated with Zeniquin and Butorphanol with no improvement.
Chest radiographs were normal and she does not have collapsing trachea. In October she had a scope and there was adequate laryngeal function. Steroids were started to treat a possible low grade allergic pharyngitis. That didn’t help so we tried first an antihistamine and then steroid prednisone but that didn’t help either.
In October she started developing the bilateral nasal discharge and endoscopy/rhinoscopy was performed. Nothing unusual was found.
Since then there has been an increase in gag/retch/cough. Since she didn’t respond to antibiotics, steroids, antihistamines, chemotherapy Alkeran was started with the idea that if it is plasmacytoma that would be the most logical treatment option. Although she tolerated this treatment well, no improvement was noticed after three weeks.
As a final rule out, we tested her for the fungal disease blastomycosis by urine testing in January. Her test came back a low positive. To further assess that test result, we submitted the nasal tissues taken at rhinosopy for PCR testing and the results were negative.
Chest radiographs were repeated. She has a normal heart rate and rhythm, does not have a heart murmur, and has excellent exercise tolerance.
The nasal discharge is primarily during walks (when she is getting more exercise). The gag, retch, cough happens more and more and some nights she is up fifteen times and other nights not at all. The episodic nature of her symptoms is a real mystery. I understand it is difficult to diagnose without further diagnostic testing such as another endoscopy/ rhinoscopy, but I am reluctant to put her through much more at thirteen.