Why is my dog honking and gagging

When your dear old dog is coughing and gagging, it’s easy to start worrying. Could it be something serious? Or did your dog just have something that “went down the wrong tube”? To help you make sense of it all, integrative veterinarian Dr. Julie Buzby discusses seven common reasons for coughing and gagging and reviews when to call the vet. She also gives an overview of what to expect at the vet and discusses some home remedies.

If you have a furry best friend who tends to eat and drink too quickly, you might hear the occasional gag or cough immediately afterward. This can be very alarming at first. But thankfully, the average pup goes right back to normal following this display.

However, what happens when a cough seems unprovoked by the “usual” causes? And what does it mean when an older dog is coughing or gagging? To answer those questions, we first need to look at what makes a cough or gag happen.

Why do dogs cough and gag?

Like in humans, your dog’s ability to cough or gag is a normal protective mechanism. It can help expel foreign things (food, saliva, water, etc.) from the back of the throat and airways. Or it may occur in response to irritation of those areas. To better understand what is happening, it helps to have a brief anatomy lesson.

In the back of your dog’s mouth, there are openings to two tubular structures—the esophagus and the trachea. Food and water pass into the stomach through the esophagus. Air passes into the lungs through the trachea.

At the top of the trachea sits the larynx. One of the jobs of the larynx is to keep food and water from accidentally entering the trachea. The larynx has two lines of defense.

First, there is a small soft tissue flap called the epiglottis. It closes over the entrance to the larynx whenever a dog swallows and opens when the dog breathes. Additionally, there are two vocal folds in the larynx which open each time a dog inhales and close again after exhalation.

In theory, the larynx should keep all foreign material out of the airways. But in reality, that doesn’t always happen. This means the body needs a way to get food, water, or other foreign material out of the airways again.

The anatomy of a cough

If something other than air accidentally gets into the larynx or if the larynx is irritated, nerves send a signal to the brain to trigger a cough or gag. Additionally, there are nerve endings in the airways of the lungs that can also trigger a cough in response to the same stimuli.

To create a cough, the diaphragm muscle (which separate the chest from the abdomen) contracts, filling the lungs with air. In a matter of moments, as the air in the lungs gets squeezed upward and outward, the larynx closes and then opens. The force of the air trying to evacuate against a closed larynx pressurizes the lung air.

This puts a little more “oomph” behind the air trying to leave the body. In this way, things that shouldn’t be present in the airways like allergens, food or water, mucus, etc., can be removed from the body via a cough. 

Is my dog coughing and gagging? Or vomiting?

Based on the description, it would seem that coughing is a distinct act. However, where things get a bit more complicated is that dogs may also gag before or after a cough. And gagging can sometimes look a bit like attempting to vomit.

Generally speaking, a different list of things causes coughing and gagging than causes vomiting. In order to figure out what is happening with your dog, it is helpful if you use the right words when talking to the vet. So let’s take a look at how to tell the difference between coughing, gagging, and vomiting.

Signs a dog is coughing

A coughing dog is more likely to have short, hacking sounds that involve movement of the chest. He or she may occasionally have a small bit of saliva or clear fluid fly from the mouth. Sometimes coughing is dry, or nonproductive. Other times, coughing is productive. This means that the cough brings up mucus, which the dog either swallows again or spits out.

Signs a dog is gagging

When gagging, the dog will open the mouth wide and make a retching or hacking sound. The dog may not bring anything up, or he or she might expel a little saliva, mucous, or white foam. As I mentioned earlier, gagging tends to accompany coughing.

Signs a dog is nauseous

On the other hand, if a dog is nauseous, he or she may be salivating profusely or licking his or her lips. Then when vomiting, a dog usually has abdominal contractions that accompany the retching sound. Shortly after, it is common to see the production of stomach contents, which can range from food to yellow or clear fluid. Sometimes vomiting can also bring up foam, which tends to be stained yellow from bile.

7 reasons for an older dog coughing and gagging

Now that you know how to distinguish coughing and gagging from vomiting, it is time to dive into the seven most common respiratory causes of coughing and gagging. This list isn’t all-inclusive. But it does provide a good starting point for thinking through what might be going on with your dog.

1. Laryngeal paralysis

In the anatomy section, we discussed how the opening and closing of the vocal folds of the larynx can help protect the airway. Unfortunately, sometimes the nerve that triggers the muscle that pulls the vocal folds open during a breath doesn’t work right. When this happens, one or both vocal folds remain closed. This limits the flow of air into and out of the trachea.

As a result, dogs may have loud, harsh-sounding breathing from turbulent airflow through a partially obstructed trachea. Since the larynx isn’t doing a very good job of protecting the airways, affected dogs may also develop aspiration pneumonia (i.e. pneumonia that develops when a dog accidentally inhales food or water). Plus, these dogs will frequently cough and gag.

There is no known cause for laryngeal paralysis in dogs. However, genetics are thought to play a role because certain breeds like Labrador Retrievers and German Shepherds are more likely to develop the condition. In recent years, researchers have discovered that laryngeal paralysis is actually only one component of an overarching condition called geriatric onset laryngeal paralysis polyneuropathy (GOLPP). Dogs with GOLPP may also have megaesophagus in dogs and/or rear limb weakness.

The vet can attempt to manage laryngeal paralysis with medications like doxepin and environmental changes. However, many dogs need tie back surgery for dogs to help the larynx stay open. Also, regardless which other treatment options are used, weight management is an integral part in helping a dog’s coughing and breathing.

Check out my canine laryngeal paralysis FAQs to learn even more about this complex condition.

2. Chronic bronchitis (COPD)

Sometimes a dog will have a persistent cough that lasts for longer than two months but doesn’t seem to have any discernible cause. In that case, he or she may have chronic bronchitis in dogs (i.e. chronic obstructive pulmonary disease or COPD). In this condition, severe infections, trauma, allergens, or other health issues cause inflammation within the lungs.

Over time the inflammation persists and worsens, which makes it more difficult for the dog to clear mucous and foreign invaders from the airways. The lung tissue can also become scarred.

Before diagnosing a dog with chronic bronchitis, the vet will want to rule out conditions like lung cancer, infection, or heart disease. Once he or she has excluded other causes of coughing, the vet will start treatment for the COPD. This may involve medications like steroids, cough suppressants, bronchodilators, as well as weight management.

3. Tracheal collapse

The trachea (i.e. windpipe) is the biggest of the tubes that make up your dog’s airways. It carries inhaled air from the nasal cavity to the lungs, where it splits into smaller and smaller airways. As dogs age, the cartilage rings that make up the trachea become flattened. This narrows the space inside of the trachea and makes it more difficult for air to pass through. As a result, collapsed trachea in dogs may cause a goose honking cough, gagging, and sometimes even respiratory distress.

All dogs can develop tracheal collapse. The risk is even higher in older dogs and in small breed dogs. Medical therapy, similar to that for chronic bronchitis, and weight management are the key treatments for a collapsed trachea. However, in severe cases, surgical intervention is necessary.

4. Heart disease

In a healthy dog, the heart will pump blood to all parts of the body, carrying oxygen via the red blood cells. But in heart disease in dogs, insufficient pumping can lead to the accumulation of fluid in the abdomen or in the chest. When there is fluid inside of the lung tissue (i.e. pulmonary edema), it can cause coughing because the body is trying to remove the fluid. Fluid accumulation in the abdomen can make your dog look like a pot-bellied dog.

Heart problems can vary from valvular disease to dilated cardiomyopathy to heartworm disease in dogs. Many of these conditions will cause a heart murmur in dogs and also lead to overall heart enlargement. As the heart gets bigger, it can push the trachea upward and compress the bronchi that branch off from the trachea. This leads to even more coughing.

Sometimes older dogs with heart problems tend to have more coughing and gagging at night. They may also tire quickly, have difficulty breathing, or collapse. Dogs with heart disease may need medications to help the heart pump more strongly, correct arrhythmias, or remove fluid accumulation in the lungs. Sadly, heart disease may progress to the point of congestive heart failure over time.

5. Lung cancer

In the simplest terms, cancer is the abnormal and uncontrolled replication of cells. Sometimes it can show up as a single, solitary tumor. Alternatively, cancer can be widespread and affect many parts of the body. This is especially true if a cancer is malignant because these cancers can metastasize (i.e. spread to additional sites from the original site).

Dogs can develop primary lung cancer (i.e. cancer that arises from lung tissue) such as pulmonary carcinoma. However, more cases of cancer in a dog’s lungs are due to hemangiosarcoma in dogs, mammary cancer, osteosarcoma in dogs, or other tumor types metastasizing to the lungs.

Lung cancer can cause any number of clinical signs in dogs. In general, weight loss, lethargy, lack of appetite, and persistent coughing tend to be the more common symptoms. Treatment will vary depending on the type of cancer but may include chemotherapy or radiation in some cases.

6. Infections

Respiratory infections are one of the most common causes of coughing, especially in younger dogs. However, they can affect older dogs too. Foreign invaders such as bacteria, viruses, fungi, and parasites (e.g., canine lungworms) can make their way into a dog’s respiratory tract. This can lead to localized inflammation as the immune system marches into battle.

Bacteria like Bordetella bronchiseptica (one of the causes of kennel cough) can create symptoms that primarily affect the upper respiratory tract. Typically the symptoms are centered around the dog’s throat and nose. Canine influenza (or dog flu) is viral in origin, and it, too, can cause upper respiratory symptoms like coughing and gagging.

However, in some cases, bacteria, viruses, or fungi can travel to the lower airways and cause pneumonia. This is almost always the case for fungal infections with Histoplasma and Blastomyces, which can also cause severe body-wide illness. In addition to coughing and gagging, dogs with pneumonia may also run a fever, have difficulty breathing, or be a lethargic dog.

Pneumonia patients will need hospitalization and oxygen therapy if they are having trouble breathing. They might also benefit from nebulization treatment. This involves having the patient inhale a fine mist (sometimes containing medication) which can moisturize the airways to make it easier for mucus to loosen and be coughed up.

Dogs with respiratory illnesses may also need antibiotics, antifungals, and sometimes steroids. If the vet finds lungworms on a special fecal test known as a Baermann test, he or she will prescribe a dewormer as well.

7. Allergies

If you’ve ever suffered from respiratory allergies, you know that things like high pollen counts can cause terrible symptoms such as coughing and nasal congestion. Dogs, too, can be affected by indoor and outdoor allergens.

It is also possible for dogs to have acute allergic reactions to certain medications, vaccinations, insect bites, and foods. Anaphylaxis, a particularly severe allergic reaction, can cause a life-threatening inability to breathe. If your dog is in respiratory distress, collapses, or has sudden onset vomiting and/or diarrhea, contact a vet immediately as these are signs of anaphylaxis.

Mild allergies can be controlled with antihistamines and other allergy medicines for dogs. It is also good to try to avoid the allergen as best as possible. Dogs experiencing severe allergies or anaphylaxis may require steroid therapy or possibly hospitalization until symptoms resolve. Inhaled steroids may also be an option, especially if a dog has asthma-like signs and suffers from allergies often.

When do I need to call the vet if my dog is coughing and gagging?

As you can see from this list (which doesn’t even cover all possible causes), a variety of conditions can cause your old dog to be coughing and gagging. Some are more serious than others. So how do you know when you need to call your vet? And what constitutes an emergency?

Well, let’s start by addressing some reasons you may need to schedule an emergency vet visit.

Signs of respiratory distress

Sometimes a dog may go into respiratory distress. This is always an emergency. Signs of respiratory distress include:

• A dog who is breathing fast or panting hard with no good reason
• Purplish, bluish, or pale gums
• Struggling to breathe
• Abnormal sounding breathing (harsh or high-pitched noises, etc.)
• Abdomen expanding and contracting with every breath
• Short shallow breaths
• Inability to do anything other than stand still, sit, or lie down
• Outstretched neck and/or elbows winged out to the sides
• Panicked expression
• Respiratory rate greater than 40 breaths per minute while resting (To learn to count your dog’s respiratory rate, read my article about keeping a “pulse” on dog vital signs.)

Time is of the essence here. Your dog needs to get to a facility that has the ability to perform oxygen therapy and administer drugs to help him or her breathe better.

Concern that something is stuck in the throat

Another reason to seek emergency vet care would be if you think your dog has something stuck in his or her throat. Understandably, this tends to be one of the first things dog parents think about if a dog is gagging. However, most of the time this isn’t actually the case.

I still want to address it, though, because foreign bodies in the throat or esophagus can cause a lot of issues. It is important that they are removed ASAP. So this means you need to be able to recognize when your dog really might have something stuck in the throat.

Foreign bodies in the back of the throat or in the esophagus can cause sudden onset of frequent gagging. Affected dogs may also:

• Regurgitate (i.e. passively bring up undigested food or water)
• Act like it is painful to swallow
• Paw at their mouth
• Be unable to swallow food, water, or saliva
• Make exaggerated swallowing motions

Especially if you saw your dog swallow something and then start with these signs, please contact your vet immediately.

Worrisome, but non-urgent symptoms

There are other cases where you don’t need to rush your dog to the emergency room, but your dog does need to see a veterinarian. Give your vet’s office a call if:

• Coughing or gagging is worsening in frequency or severity
• Your dog is exhibiting other symptoms like eye or nose discharge, sneezing, fever, or lethargy
• Your dog has a history of respiratory or cardiac issues and the coughing or breathing seems to be worse than his or her typical baseline
• Breathing sounds or looks different but your dog seems to be getting enough oxygen and can still eat, drink, and play
• You have any other concerns or questions about how your dog is doing

What to expect at the vet visit

How things go when you arrive at the vet clinic or emergency room depends on whether your dog is stable or not. If your dog is in respiratory distress, the first priority is going to be to get him or her breathing better. The veterinary team will start oxygen therapy, either by mask or in an oxygen cage. They may also try to place an intravenous catheter in your dog’s leg. That way they can quickly administer emergency medications if needed.

Once your dog’s condition has stabilized, the veterinary team can start some diagnostics. These tend to be similar to the tests you could expect at a non-urgent vet visit for coughing and gagging.

The vet will start with a physical exam. He or she will be paying special attention to how your dog’s heart and lungs sound and your dog’s heart rate, respiratory rate, and temperature. From there, the veterinarian will decide if he or she recommends additional diagnostics. Some of these may include:

• Bloodwork to evaluate red blood cell numbers, white blood cell numbers, and basic organ parameters
• X-rays to check for abnormalities of the heart, lungs, trachea, or esophagus
• Heartworm test
• Sedated laryngeal exam to check for laryngeal paralysis
• Blood pressure measurements, ECG, and echocardiogram to assess the heart
• Bronchoscopy or fluoroscopy to evaluate the trachea and smaller airways

Once the veterinarian has made a diagnosis, he or she will discuss your dog’s specific treatment plan. The generalities of treatment were discussed under each cause of coughing and gagging so I won’t mention them again here.

At-home remedies for coughing and gagging

I do however want to give you a few at-home remedies for coughing and gagging.

Let me be clear, though, that they are not intended to take the place of a visit with your vet. These are things you might be able to do while waiting for a vet appointment, under the direction of your vet after an appointment, or if signs are very mild.

Change locations

If your dog is coughing because of an overpowering fragrance or from mild smoke due to an unforeseen kitchen fiasco, simply bring your pup to another room or bring them out of doors.

Consider allergy meds

Dogs with minor allergies may get better with an over-the-counter antihistamine such as Benadryl for dogs. But you should still call your vet for dosing information and to make sure it is safe to use with any other medications that your dog is taking.

Humidify the air

Dogs with upper respiratory infections that are stable enough to be treated at home may benefit from the use of a humidifier. Humidifiers work to moisturize the air in a room of your home. Breathing in moist air can help loosen mucus that is unable to leave a dog’s airways with coughing alone.

If you do not have a humidifier, steam from a hot shower may also serve the same purpose. Bring your dog into a small bathroom, turn the shower to “hot,” and close the door. Allow him or her to breathe the warm humidified air for up to 15 minutes at a time, provided it doesn’t get too hot in the bathroom.

Try coupage

While your furry family member breathes in the humid air, you can also employ coupage tactics. This is when you use a cupped hand to gently pat one side of the pup’s rib cage for three to five minutes. Then repeat this on the other side. By performing coupage, you can help loosen mucus in the lower airways and make it easier to cough up.

A few words of caution. Unless directed otherwise by your vet, it is safest not to put a brachycephalic dog (i.e. those with short, squished noses) in a hot, steamy bathroom. This could be dangerous because they have more difficulty cooling themselves and are prone to heat stroke in dogs.

If your dog is having trouble breathing, has a history of heart disease, or has an elevated resting respiratory rate, don’t try the steamy bathroom remedy without talking to your vet. Also, due to risk of burns, do not allow your pet to be inside the shower stall or tub while the hot water is running.

Work with your veterinarian

I know it can be easy to worry when your dear senior dog is coughing and gagging and you don’t know what’s wrong. However, you and your vet can figure it out together. If possible, review the difference between coughing, gagging and vomiting before the appointment so you can use the right terms. Or, if you aren’t sure what you are seeing, take a video to show to your vet.

Maybe your dog will end up having one of the seven conditions I listed in this article. Or maybe it will be something totally different. Either way, your vet can work with you to develop a treatment and/or management plan. With a lot of these conditions, your dog’s coughing and gagging can improve significantly. Sometimes it may even go away entirely.

Even if you get the bad news at the appointment that your beloved dog is in congestive heart failure or has cancer, all hope isn’t lost. There are still ways to help keep your dog’s quality of life as good as possible for as long as possible.

Finally, keep in mind that sometimes dogs who are coughing and gagging will end up in respiratory distress. If your dog is having trouble breathing, immediately contact your veterinarian or an emergency clinic. Being vigilant and acting quickly in those situations might just save your dog’s life.

What was the cause of your dog’s coughing and gagging?

Please comment below.