It’s been almost three weeks, February 28th, since we visited the internal medicine veterinary specialist at Premier Veterinary Group. Premier is also a 24-hour emergency hospital in our neighborhood, which unfortunately the Lady I rescued visited previously with Taffy for other health issues. In our last post we told the story of our experience learning about Taffy’s diagnosis, chronic bronchitis. From the first visit to our vet for a cough then coming to terms with the fact that she has a chronic condition and will always have it.
Chronic Bronchitis in Dogs
According to petMD.com, “chronic bronchitis, or chronic obstructive pulmonary disease (COPD), occurs when the mucous membranes of the bronchi (the airways that transport oxygen from the trachea to the lungs) become inflamed.” We know that chronic is an illness that persists for a long time or it recurs constantly, which is our current situation with Taffy.
Familiar with Premier when we checked in, we were ready for the vet tech to call us and take us to an exam room. I insisted on coming along with the Lady and Taffy, but had to stay in the car, something to do about stinking. The Lady knew that the exam room windows looked out to where we parked so she is able to keep an eye on me. The vet tech had Taffy’s medical records from our vet, examined Taffy and asked the Lady some questions. She left and after a long wait the veterinary specialist, Dr. Bob came in.
Taffy is so friendly it’s embarrassing! She just wags her tail and goes right up to him, a stranger and a vet!
Treatment Options for Chronic Bronchitis
Dr. Bob obviously loved dogs and after a quick exam of Taffy started discussing treatments. He also asked about her heartworm treatments as a cough can signal heartworms. Possibilities discussed included:
- Higher dose of prednisone
- Hydrocodone instead of torbugesic for cough
- Flovent inhaler
Because of the cost involved ($2,000) and expected results of Taffy’s diagnosis, we agreed that a bronchoscopy wasn’t necessary. When the vet started talking about a higher dose of prednisone the Lady spoke up against that for other treatment options because Taffy had been taking the steroids long enough and she wanted her off of them. He suggested Hydrocodone ($14) to replace the torbugesic ($30) because it’s more effective and less expensive. But it’s an opioid and refills can only be done with a new script from the vet. The other drug suggested was theophylline, to help open her airways.
Flovent is an inhaler just like humans use for asthma. The vet gave the Lady an overview of the inhaler but by now information overload set in and she wasn’t sure what he was saying, only that it’s expensive, approximately $270. He said they have a goodrx.com drug card to lower the price or you can get if from a Canadian drug store. Then there’s the vessel, Aerodawg. Now the Lady is really confused.
The vet left to enter his notes and after a long wait the vet tech returned with our visit summary and began explaining the medications. She had three prescription scripts, one for hydrocodone 5mg 1/2 tablet every six to 12 hours, one for theophylline 200mg 1/2 tablet every 12 hours and one for Flovent 220 micrograms, two puffs twice a day. She is also to continue on the predisone 2.5mg twice a day. The Lady went over the medications at least three times with the vet tech to make sure she understood. The inhaler and the vessel started to make more sense, along with the goodrx.com discount card. After paying $139 for the specialist vet we headed home.
Using an Inhaler to Treat Chronic Bronchitis in Dogs
The Lady began price comparisons for the Flovent inhaler using goodrx.com simply by typing in the medication and our zip code. Prices all ranged in the upper $270 range but the warehouse price wasn’t listed. The Lady called Costco, where I have my own prescription card, to get their price. Costco’s price for Flovent 220 micrograms is $383! The Lady thought there was some sort of mistake. After getting off the phone she realized what it was, goodrx.com was only giving her prices for the 110 micrograms inhaler. Taffy’s prescription is for the 220 micrograms. Deciding that she would go to Target to get Taffy’s prescription the next day, she started shopping for the Aerodawg face mask, She found it easily enough on Amazon and even got same day shipping. She also relaxed some after reading the reviews about how easy it is to use and realizing a lot of other pet parents use inhalers on their pets.
The Lady returned from Target with the Flovent inhaler ($384) and the hyrdrocodene. She understood that it would take at least two weeks for the inhaler to start working and had virtually no side effects. But it’s important the face mask fits properly to insure that the dog is inhaling the drug. Taffy should breathe through the mask and spacer for 7-10 seconds. The canister should last for one mouth if given two puffs twice daily.
The Lady found it very stressful to administer the Flovent the first time but Taffy had no problem with the inhaler on first look, mostly because there were treats. The treats are a bit too much distraction to get the mask on Taffy so there was a bit of a struggle at first. Not to mention, we don’t think Taffy ever breathes through her nose, but she’s learning. In the picture you can see that her nose isn’t directly in the mask and her tongue is out. It’s getting much easier to use the inhaler, she’s breathing deeply in it and the Lady is increasing her time from 6-7 seconds to 10 seconds or breaths. There’s a flap that moves when she breathes making it easy to keep count. Taffy has no fear of it, in fact she starts wagging her tail if she sees you holding it knowing that there are treats involved. I’m always there to support Taffy when she’s using her inhaler so that I can get treats too.
Taffy’s Progress Thus Far
Over the next two weeks we saw little change in Taffy’s symptoms. The hydrocodene seemed to work really well at first but for now she’s huffing several times a day followed by hacking. We ran out of the hyrdocodene so the Lady went to get the theophylline ($16) filled at Target since she understood to start her on this later. The theophylline seemed to work right away at first too then we were back to the huffing and hacking. The Lady did email the vet with questions about the meds but not much could be done as we are still in the adjustment phase so it’s a wait-and-see.
We will have another followup for you as we continue to adjust her medications and about our two-week follow-up visit. For now Taffy is doing well, going on walks, and eating her regular diet.
Right now though, the Lady I rescued is in full Global Pet Expo preparation, so stay tuned for exciting news from the world’s largest pet industry trade show March 22 – 24 in Orlando.