Panting and Excessive Panting in Dogs
Excessive
panting in Alaskan Malamute
Heavy panting and
overweight
Panting and drinking
a lot of water
also see Cushing's
also see Weight
also see Thyroid
Excessive
panting in Alaskan Malamute
Question: Dr Mike,
I'm a VetInfo subscriber who has a 140lbs, neutered male Alaskan Malamute
named Doc who's 8.5 years old. I guess my major heartfelt concern
for him is
that he is what I would call, excessively panting which seems to have
started
well over a year ago. He does also seem to salivate more than
he used to.
On average he pants about 170-230 times/minute (#pants in 6 seconds
x 10).
it's like he just finished a marathon. These are short rapid
breaths he
experiences even during bedtime. He does have difficulty going
to sleep and
it not only wakes him up several times a night but both my wife and
me as
well. Lately he seems to be having trouble controlling his bowels
and has
difficulties with his back legs (slow to sit).
I have discussed the panting at great length with my vet and have passed
Doc
through many tests. We have performed the following tests:
ECG, chest
X-rays, abdominal x-rays, cardiac ultrasound, abdominal ultrasound,
endoscopy
of his throat down most of his esophagus, basic blood chemistries,
urinalysis, thyroid enzyme test (T4), ATCH, low dose dex.
All his blood and
urinalysis readings have been pretty much within the normal ranges
except for
the following: AMYL which has gone from 1474 U/L a year ago to around
667
now, CHOL 469mg/dl to 236, ALKP 249 U/L to 429 & ALT 134U/L to
366.
The end of his tail was starting to loose hair which prompted the vet
to do
the T4 test. It did reveal he had hypothyroidism. We then
put him on
Soloxine 1.2mg BID. This got his level to the top of normal range.
Since
this was at the top of the norm, we elected to drop his dosage to 0.4mg
BID.
This only moderately helped the panting and only for a short term.
Consequently, we returned to 0.8mg BID a year later.
I don't know that he actually drinks more water than he used to but
late last
summer the vet was suspecting Cushing's disease. This prompted
the
additional blood work and the abdominal ultrasound. (by the way,
the
ultrasound was done by an Internal specialist - she was concerned about
Cushing's because she thought the adrenal glands looked too large to
her -
5cm I believe). The low dose dex test we ran twice with the second
one 9
months later. The results from the 1st test are Pre 79nmol/L,
4hr 31 & 8hr
65 while the results from the 2nd test are Pre 92, 4hr 27 & 8hr
38. The ACTH
test was done a few weeks before the first low dose dex a year ago
with its
results being: Pre 60, Post (2hr) 494.
The endocrinologist in Michigan who did the lab work on the dex tests
said
that the 8hr result was borderline and could be caused by stress and
most
likely not Cushing's. Because it was harmless (more or less)
my vet and I
tried Anipryl for two months with no improvement last August.
I think the
second test 9months later would seem to confirm that Cushing's is not
the
problem as the numbers don't indicate a progression of this condition.
I had his dental vet check his throat with a scope because 2 years earlier
he
had a non-cancerous growth in his throat and because when Doc breaths
I can
hear something rasping like someone who has a cold with flem.
The endoscopy
revealed nothing. The dental vet thinks the sound may be the
excessive
saliva draining into the back of his throat.
What do you think about canine hip dysplasia? His back end does
on occasion
go out from underneath him. Or perhaps it's just a bad case of
arthritis. I
know Northern breeds are tolerant of pain and we even tried a 2-week
regimen
of Rimadyl with no real progress (it didn't curb the panting).
I'm starting
to grab at straws here contemplating taking him to the Oklahoma State
University Veterinarian College and have a CAT scan done or at least
see an
orthopedic specialist.
Any ideas would be appreciated here, as I'm pretty lost at this point.
Thanks so much for your time and sorry for this being so long.
Sincerely, Steve
Answer: Steve-
I am a little confused by your note, but that may be because I don't
have
the normal values from Michigan State at home and have to rely on my
memory.
I thought that the normal pre-dexamethasone resting cortisol level was
usually between 15 and 115 nmol/L and that the 4 hour and 8 hour
post-dexamethasone levels should be less than 30 nmol/L in order to
assume
adequate suppression. Since you have lab values outside these
expected
ranges in both tests, even though they are way out of line, I would
have a
hard time totally ruling out hyperadrenocorticism (HAC).
I thought that the ACTH response tests were the same for resting cortisol
level and that the post ACTH response value should be less than 550
nmol/L. However, we draw the blood sample one hour after administration
of
Cortrosyn (Rx) and your vet might use ACTH gel, in which case the sample
is
supposed to be drawn at two hours.
Anyway, I would view the blood values as suspicious but not confirming
hyperadrenocorticism. I think giving Anipryl (Rx) was reasonable and
that
the lack of response does make HAC less likely but still does not rule
it
out, since it only works in about 80% of dogs with pituitary dependent
HAC.
The ultrasonagrapher's impression of the adrenal gland size is also
important and it does suggest a possibility of hyperadrenocorticism.
Since
Cushing's disease and administration of cortisones are two of the more
likely causes of panting behavior, I thought it was worth going through
that long explanation! I think it might be worth a visit to the
vet school
for another opinion on this, or possibly just asking your vet to call
and
see what their endocrinologist thinks.
A lot of pet owners with obese dogs complain about panting behavior
and
sometimes the panting is as bad as what you are seeing. It seems
likely
that 140 lbs. is at least overweight for a malamute but we have seen
some
really big malamutes in our practice, so I can't be sure of that. If
he is
overweight enough to be considered obese, though, it can cause this
degree
of panting all by itself. Weight loss would help his hips a lot, too.
This
is one of those things that people find hard to believe -- but our
practice
experience strongly indicates a high correlation between panting and
being
overweight, so please think about this possibility if Doc is overweight.
Pain can cause panting. Figuring out if there is pain and where the
pain is
can be pretty hard, but it is worth carefully looking for any other
symptoms that might indicate chronic pain, such as lameness, weakness,
tremoring, etc. If Rimadyl (Rx) didn't help, this seems somewhat
less
likely, too. The loss of control of bowel movements and weakness
in the
rear legs could indicate a problem with the caudal spine (lumbosacral
instability, cauda equina syndrome) or possible degenerative myelopathy.
I
can't recall panting with degenerative myelopathy but I have definitely
seen this sign with lumbosacral instability problems, as they can be
very
painful.
It is very hard for me to identify pulmonary diseases on X-rays, so
I
always think it is a possible problem even when I have taken X-rays.
In
addition, laryngeal paralysis sometimes causes panting, although it
more
commonly causes a roaring breathing sound, sensitivity to heat and
even
collapse on exertion.
As you can probably tell, I think you and your vets have done a good
work-up and examined the obvious possibilities pretty thoroughly. For
this
reason, I tend to think that letting someone else see the records and
the
lab tests and review them, as well as getting a fresh look at Doc,
would be
a good idea. I'd vote for the vet school since they have specialists
in
radiology, ultrasonography, internal medicine, cardiology and orthopedics,
too.
I wish I could help more with this problem.
Mike Richards, DVM
7/26/2000
Heavy panting
and overweight
Question: Hi Dr. Mike,
I have a female spayed flat coated retriever that is approximately 2
years
old. She is very large for her breed, but she is also about 10 pounds
overweight and she weighs in at 90 pounds.
The problem: She breathes hard/pants all of the time and she is an indoor
dog. The only time she doesn't pant is when she is in the middle of
a hard
sleep. We keep our house very cool and she has plenty of water available
at all times. Is there any condition that can cause this excessive
panting? We're really worried about her. Our other dogs don't do this,
but
they're not as large.
Her medical history is this:
Like all of our dogs, she was a rescued dog - we found her running
the
streets and she had mange and intestinal worms at 3 months old and
she has
since been treated and recovered from all of that.
I have had her blood tested thoroughly and the main thing they found
wrong
was hypothroidism, which I have started treating with USP Thyroid.
She
also has hip dysplasia, but we caught it early enough and are treating
it
with Glycoflex, Glucosamine and Ligaplex and it doesn't bother her.
I also
take her swimming in the pool twice a day to build up her legs.
Any ideas on conditions that can cause excessive panting? Or is it just
an
overweight thing? Or is it a "big dog" thing?
Thanks, Vanessa
Answer: Vanessa-
I would really question a diagnosis of hypothyroidism in a two year
old
patient. We have diagnosed this problem in pets this young, but I question
it every time I am suspicious of it and every time lab values are
suggestive of it. If this diagnosis was not made based on free
T4 testing
using an equilibrium dialysis technique or a combination of free T4
and
canine TSH analysis, it would be a good idea to recheck this diagnosis
at
some time. This would be especially true if the panting showed up after
the
diagnosis (which doesn't sound like the case), because too much thyroid
hormone could lead to panting. It is a good idea to check the T4 level
when
using thyroxin, just to be sure that hyperthyroidism is not occuring
and to
be sure that thyroxine supplement is adequate, as well.
Low T4 levels can be the result of any systemic illness, a condition
referred to as "euthyroid sick syndrome". It is important to try to
be sure
that there is not another disorder present when the total T4 measurement
is
below normal levels but the free T4 measurement is normal.
I think that being overweight is a cause of panting, all by itself,
though. We have several obese patients in our practice with this
symptom
and no discernible cause. I can't think of a thin patient we have had
this
complaint about except one that we were over supplementing with thyroxine,
and the behavior stopped when we readjusted the dose. In a dog
in your
dog's age range I think that her weight is likely to be the main problem.
Weight also worsens arthritic pain, so it is a good idea to work hard
to
get her to lose weight, for both the panting and the hip dysplasia.
I think
we have some dogs in our practice who pant as a symptom of pain. It
is hard
to be certain of this, but it is my impression.
There are several diseases commonly associated with panting, especially
hyperadrenocorticism (Cushing's disease) but this problem is also very
unlikely in a two year old patient.
Your vet can help you design a weight control program, if you are unable
to
cause weight loss by cutting back some on her food and trying to get
her to
exercise a little more.
Mike Richards, DVM
7/14/2000
Panting and drinking
a lot
Q: Our seven-year old Golden Retriever has started
panting quite a bit during the last couple of months. He pants when he
comes in from outdoors, but he may also start panting when he is just lying
in the middle of the living room, and has had no recent exertion. He also
drinks a lot of water. The change in the amount of water he drinks has
been gradual, but I think he drinks more than he used to. He has also been
unsually anxious to go out first thing in the morning during the past few
months. We took him to our vet once, and he treated him with antibiotics
for a hot spot. Our dog has stopped chewing the hot spot, but he is still
panting. Could this be the sign of a more serious condition? Is drinking
more water a sign of diabetes in dogs? What are the other symptoms of diabetes?
Thanks for your help.
A: Panting excessively is a sign of Cushing's disease
(hyperadrenocorticism), may show up with other hormonal diseases such as
hypothyroidism, can occur with heart disease and is seen with conditions
that result in lowering of the body's ability to carry oxygen -- but most
of these are not long term problems. One example would be hemorrhage associated
with hemangiosarcomas. We have seen a couple of these in which the owners
recognized panting as the first clinical sign. There is usually an acute
crisis shortly after that, though. Panting is commonly seen in dogs being
treated with corticosteroids such as prednisone.
Drinking more water can be seen with Cushing's disease, kidney failure,
diabetes mellitus (sugar diabetes), hypothyroidism, diabetes insipidus
and several other conditions. Dogs being treated with corticosteroids also
drink more water.
Diabetes usually results in increased hunger, at least early in the
disease, and excessive drinking of water and urinating. After a while,
there begin to be signs of poor nutrition, such as haircoat changes. Diarrhea
is not uncommon with more advanced diabetes. Early cataract formation can
occur. Increased susceptibility to disease and poor healing are additional
signs.
You should schedule an examination of your dog by your vet soon. It
is best to catch almost all the causes of increased drinking as early as
possible.
Last edited 01/08/05