Quality ofLife
The poorly understood etiology and that CCB is probably better described as a syndrome, as opposed to a disease as a finite entity, makes prognostication difficult, because not all patients experience the same response.
In addition, long-standing cases, may have experienced damage to the respiratory tract, that may be irreversible, and therefore therapy is less likely to be successful. Owners need to understand that CCB is not normally cured but merely managed. Owners are encouraged to keep a diary of coughing, which serves to document if a change in frequency occurs. In addition, owners are asked to occasionally record sleeping respiratory rates, to track possible worsening lung function, or development of parenchymal lung lesions such as pneumonia. Documenting the incidence and severity of coughing to some extend gives an indication of how often the dog is affected by CCB. Other markers of quality of life, such as appetite, tolerance of exercise, and long periods of uninterrupted sleep usually help to decide whether CCB is progressively worsening.In refractory cases, where coughing is severe, and/or dyspnea ensues, and particularly if pulmonary hypertension is documented, euthanasia should be considered. In owners without budget constraints repeat radiographs, echocardiography, and possibly repeating endoscopy BAL may provide additional data, such as pulmonary hypertension or an infection, which may improve quality of life if managed. The most common reasons for owners to seek euthanasia are the presence of dyspnea, exercise intolerance, and bouts of severe coughing.