Species: Dog
Breed: Chesapeake Bay Retriever
Age: 9.5 years
Sex/Neuter status: Spayed female
Weight: 82 lbs (down from 91 lbs at end of February)
Location: Ohio, USA
Primary Concern
Recurrent episodes of respiratory distress with a dry, non-productive cough, which consistently improve with prednisolone. Concern for unresolved infection/inflammatory lung disease vs congestive heart failure (CHF).
History & Timeline
Mid-February 2026
- Developed a progressive dry cough
- Otherwise normal (energy, appetite, activity)
March 31
- Syncopal episode during exercise (fetch), resolved within minutes
Initial vet visit:
- Thoracic radiographs (reviewed by radiologist; images uploaded): https://imgur.com/a/CNr3Ymx
- Pneumonia
- Lung abscess
- Enlarged heart
In-clinic treatment:
- IM Baytril 100 mg/mL
- IM Depo-Medrol 20 mg/mL
- IM Lasix 150 mg
Testing:
- Heartworm/Lyme negative
Discharged with:
- Prednisolone 10 mg BID
- Cephalexin 1000 mg BID
- Lasix 50 mg BID
Response:
- Clinical improvement, cough resolved, normal behavior
April 5
- Began tapering prednisolone to 10 mg SID
April 7 (acute event)
- Severe respiratory distress:
- Cyanosis (blue tongue/gums)
- RR ~80/min
- Return of dry cough
Emergency revisit:
- Repeat radiographs (uploaded): https://imgur.com/a/XvYk08G
- Possible progression of abscesses
- Persistent cardiomegaly
- Pneumonia vs possible neoplasia
Treatment:
- Depo-Medrol IM (2 doses of 20 mg/mL)
- Baytril IM (2 doses of 100 mg/mL)
- Lasix 250 mg
Discharged with:
- Prednisolone 20 mg BID
- Simplicef 200 mg SID x7 days
- Lasix 75 mg q8h
Response:
- Rapid return to normal within 24 hrs
Follow-up diagnostics
- CBC (ProCyte Dx)
- Chem 17
- SDMA
- Total T4
- Pancreatic lipase
Interpretation per vet:
- Ongoing infection
- Low thyroid
- Possible diabetes (ruled out on repeat glucose)
New medications:
- Thyrovet 0.6 mg/day (split dosing)
- Doxycycline 200 mg BID
- Daily Baytril injections (100 mg) x1 week
Lab Summary (key abnormalities)
Inflammation / infection:
- WBC: 24.15 ↑
- Neutrophils: 18.35 ↑
- Monocytes: 3.05 ↑
Liver enzymes:
- ALT: 515 ↑
- ALKP: 1218 ↑
- GGT: 18 ↑
Pancreatic markers:
- Lipase: 5377 ↑
- Pancreatic Lipase (QPL): 1803 ↑
Renal markers:
- BUN: 51 ↑
- SDMA: 18 ↑
- Creatinine: 1.5 (normal)
Other:
- Glucose: 299 ↑ (repeat normalized)
- Total T4: 0.7 ↓
CBC notes:
- RBC/HCT/HGB within normal limits
- Mild reticulocytosis
- Eosinophils: 0
- Platelets: normal
April 20
- Repeat radiographs (uploaded): https://imgur.com/a/A9D8blE
- Improvement in lungs
- No visible abscesses
- Persistent but smaller cardiomegaly
- “Pulmonary congestion” noted
Medication changes:
- Prednisolone taper:
- 20 mg SID → then EOD starting 4/23
- Lasix reduced:
- From 75 mg TID → 75 mg BID
April 23 (relapse)
- Respiratory distress:
- Restlessness
- Orthopnea (unable to lay down)
- Return of dry cough
At-home intervention:
- Prednisolone 20 mg
- Lasix 100 mg
Response:
- Improved after ~3 hours
April 24 (vet follow-up)
- Started Vetmedin 5 mg
- Prednisolone increased to 10 mg BID
Current status:
- Respiratory status improved
- Decreased appetite and energy today
Current Medications
- Prednisolone 10 mg BID
- Lasix 75 mg BID
- Vetmedin 5 mg
- Thyrovet 0.6 mg/day (split)
- Doxycycline 200 mg BID
Key Pattern
- Each attempt to taper prednisolone results in:
- Acute respiratory distress
- Prednisolone consistently restores normal breathing and behavior
Additional Info
- Cough has always been dry and non-productive
- All radiographs referenced above have been uploaded
Questions
- Does this pattern suggest a primary inflammatory process (e.g., steroid-responsive pneumonia, eosinophilic lung disease, etc.) rather than CHF?
- Could CHF alone present as steroid-responsive like this?
- Would you prioritize:
- Echocardiogram
- CT scan
- Airway sampling (BAL)
- Any concerns with current treatment approach (steroids + antibiotics + diuretics + pimobendan simultaneously)?
I am actively working on getting a referral to a specialist for a second opinion