When I am presented with a patient exhibiting an obvious clinical sign such as a cough I immediately conjure up in my mind a list of possible causes or differential diagnoses.

It is customary to start with what is the commonest or most likely diagnosis and then methodically and logically work down the list of problems until the correct one is confirmed.

This was my approach when faced with 2 coughing Yorkshire terriers "Sooty" and "Sweep" (Interestingly, the first dog I ever owned was a Yorkshire Terrier named Sweep!).

It soon became clear, after the initial treatment, that their problem was more complex.

After discussion with their owners Mr and Mrs Bird both dogs were admitted for further investigation.

Blood tests, radiography and tracheal washes were all incorporated into the diagnostic plan to determine the final cause.

My difficulty was not being able to find the reason for a cough but in Sweep's case I actually found 3 causes.

The cytopathologist confirmed from the samples we took during the tracheal wash that infection was playing a part in the severity of the cough.

It was also evident both in these samples and from the radiographs that Sweep was a longstanding sufferer of bronchitis.

Finally the radiograph ( above ) managed to capture a third factor which was a collapsing trachea or windpipe.

When faced with a multiple part problem the therapeutic strategy involves placing the factors in order of priority.

The infection is dealt with first followed by the bronchitis. The tracheal collapse is more problematic as neither medication nor surgery is completely successful.

Fortunately, however, after a fine cocktail of medication both "Sooty" and "Sweep" have finally allowed their owners a night of sleep without earplugs.

Yorkshire Terriers may lack size but they certainly don't lack volume!

Terry Dunne BVMS, Cert SAO, MRCVS

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