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10-Year-Old Shepherd Mix Dog Coughing Blood

October 7, 2010
Negative Contrast of a dog chest x-ray looks all blue and shaded. A large, ominous black round area to the right on the picture represents the chest tumor

German Shepherd Mixed Breed Dog Coughs Up Blood

Marley, a 10-year-old male, neutered black and tan German Shepherd Dog Mix, wagged his tail and smiled at Doc Truli.  Marley did not get up.

“How’s Marley’s arthritis?” asked Doc Truli.

“It’s the same, good days and bad days.  He takes the glucosamine, omega 3’s, the painkillers, and the special food you prescribed.  But, I’m worried about this new cough he has,” said Marley’s person.  “He coughs and sometimes a little blood comes up.”

“That’s very concerning,” said Doc Truli.

Top Ten Reasons for a Dog Coughing Blood: (no particular order)

  1. Rickettsial Disease, from tick bites, like Ehrlichia canis
  2. Rat poison, or other poison like bleeding side-effects from arthritis medication
  3. Sore, irritated throat
  4. Fungal Infection
  5. Foreign object, like a plant awn in the bronchial tubes
  6. Parasite infection, like lungworms from eating a snail
  7. Sore, bleeding gums or tooth
  8. Bacterial Infection
  9. Hemophilia (specific, inherited bleeding disorder)
  10. Cancer, in lungs, throat, mouth, sometimes stomach

Tests to Determine Why a Dog Coughs Blood

  1. Physical examination, especially the oral cavity (mouth), under the tongue, and the sound of the lungs
  2. Complete Blood Count
  3. Chemistries of the blood show liver, kidney function and indicators of other organ functions
  4. Tick tests, blood tests to search for traces of past or present tick diseases
  5. Imaging: radiographs (x-rays)

Marley’s X-Rays Show a Problem

Marley’s bloodwork, physical, and tick tests looked normal.  The chest x-rays showed a huge problem.

Here are images, first of a normal dog chest seen from the side and the top-to-bottom view, and then Marley’s x-rays.  Can you spot the problem?


Dog's Chest X-ray looks like two hearts, but really, the round thing on the right of the picture is a tumor that is as big as the heart

Top-to-Bottom View of Marley's Chest. What is the white round thing on the right?



Negative Contrast of a dog chest x-ray looks all blue and shaded.  A large, ominous black round area to the right on the picture represents the chest tumor

Negative Contrast of Marley's Chest. What is the Round thing on the far right?



x-ray showing the outline of a normal heart in the chest

Normal Lateral View Canine Chest



top-to-bottom (V/D) view of a normal dog's chest x-ray

Normal Dog V/D Chest X-Ray


Can you see the tumor on the x-rays? Marley had a huge, round white abnormality in his chest on the right on the x-rays. The tumor could be cancer, a granuloma – or walled-off infection, or a fungal granuloma.

Tru Tip
Doctors show radiographs (x-rays) by placing them for viewing with the right on the left and the left on the right. So, in Marley’s x-rays, the lump is on the right in the picture, which is actually Marley’s left in reality. For another clue to figure out right from left in a chest x-ray: the apex, or lowest point, of the heart in a person or a dog lies to the left of midline. Except in super-rare genetic variants where all of the internal organs are reversed.

Without a biopsy, the kind of cancer or infection cannot be determined. Marley’s person decided not to put Marley through any invasive tests, even a simple needle aspirate, because he decided he did not want surgery or heroic measures to save Marley’s life.

When is a Lump a Lump?

Doctors will often say “nodule” when they see a lumpy, smallish thing (like in the thyroid gland on ultrasound viewing.)  Nodule just means lump.  It does not mean cancer or anything else.

A doctor might say “mass,” but this sounds more like cancer.

You could also call Marley’s lump a “tumor.”  Tumor implies a growth of some sort, and would be wrong in Marley’s case if the lump was caused by a walled-off infection.  The treatment would still necessitate surgery, however, with the hope of a cure!

A “bump” is a lump on the surface of the body.  This chest mass lies inside, so a doctor would not call it a “bump.”

Dog’s Coughing Improves with Supportive Treatment

Marley received antibiotics (because masses are altered in their immune system protective functions.)  He gained 5 pounds in a week after Doc explained the importance of good nutrition, and even substituting some puppy food for dog food to give Marley extra building blocks to fight the tumor.

Marley coughs a few times a day now.  Sometimes he cannot catch his breath.  He’s slowing down, but he loves his walks (slowly), daily massages, and his food.  So far, so good.

4 Comments leave one →
  1. September 20, 2012 9:44 pm

    Hi, I just got back from the vet with my 9 year old Shih Tzu WongWong.

    He had been coughing about a few weeks so I decided to get him x-rays tonight. The vet showed us the x-rays and they look similar to marley’s. the vet also called the white part “mass” because he doesn’t know what it is. He said he’s sending the X-rays to a radiologist tonight and will let me know tomorrow. I really hope it’s not cancer or a tumor. He said that white round “mass” is pressing down on wongwongs lungs, maybe that’s why he’s coughing. I haven’t seen him cough up blood though. Can you please tell me what happened with marley? I am so worried…I don’t wanna lose my dog. He’s only 9…so young…I’m just so sad right now…feel so helpless.

    • September 26, 2012 1:57 pm

      Marley is slowing down, but he’s hanging in there. Your vet will guide you. Perhaps a cytology or biopsy will be possible for your pup. And maybe there are treatments available. Just hang in there!

  2. Penny permalink
    September 8, 2012 9:58 pm

    I have an almost 10 year old husky/collie cross. We took him hiking and after a few kms, he drank from a lake. He started slowing down, wanting to lay down and rest. It was a bit warm that day, so we slowed down and let him rest a while. A few kms later, he started coughing, with a thick phlegm in his mouth. A few kms later, that coughing was getting worse, and then he started coughing up bloood, mostly when he layed down to rest. It took much encouragement, but we got him to walk out of the hike. We raced him to the vet, and after blood tests, and xrays, the vet said “lung cancer”. Gave him some antibiotics and some puffers to calm his breathing down. Since we have gotten home, he has no symptoms. Took him to our local vet, and she can’t see anything wrong with him.
    What caused the coughing? Why was it bloody? His xrays are showing shadowing throughout his lungs, but he has no symptoms now. I am very confused!!
    Please help

    • September 9, 2012 11:46 pm

      I could not say without examining him. Anyone else seen this? (if you are worried, get him re-evaluated all over again, maybe by a specialist)

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