Follow up by vet - the persistent coughing shih tzu

Yesterday, Friday, Feb 10, 2012, the owner brought the Shih Tzu for review as I had phoned him to enquire about the dog's coughing of white mucus.

"Eats a lot, poop a lot. Pee a lot," the owner said to me. "Is his coughing infectious to other dogs or the children?"

"No," I said. "The blood test is normal and the dog is more active and has no fever."

No weight gain for the past 7 days. "The tongue ulcer on the tip is still there," the owner said as the dog prevented me from checking the tonsils for several trials of opening his mouth. "The dog eats dry food as he likes it," I said. "This may have caused the big tongue ulcer, 1.0 x 0.8 cm from healing, Give canned food for the next 4 weeks, if possible."

The submandibular and popliteal lymph nodes were reduced in size by around 20%. I asked the owner to feel the nodes. The axillary lymph nodes were not palpable. He would be checking the size of the nodes.

Urine test had indicated high serum urea and bacteria in the urine.

I palpated the throat. The dog retched and coughed white mucus onto the table and then the floor. The man took my tissue paper to wipe away the white mucus.

"My dog vomits when he drinks a bit of water, two teaspoonfuls per meal," the owner said and had complied with my advice to feed small amounts 5x/day. "Now, he throws up around 5X/day, but previously it was 10 times or more."

After my treatment last week, the dog threw up once per day. So, the problem has not been resolved.

A follow up is important. So, what's the problem? Pleural effusion of the lungs and enlarged heart. How about stomach gas. "We need to X-ray the stomach/gullet area if this problem persists," I said.