Allergies or something else?

[Scarlettw]

Last year, my pug spontaneous begin inverted/reverse sneezing.  I was told to not worry about it.  Shortly after, maybe a month or so, she developed a runny nose with discharge.  It's mostly always clear.  She was taken to the vet and given antihistamines, which didn't really do much.  Then a litter after the runny nose appeared, she started coughing.  It was a dry, non-productive cough, almost like a "cack" sound. She was given doxycycline (100 mg) tablets, for kennel cough.  This did nothing.  I took her back and paid a whopping $140 for "chloramphenicol ophth oint 1%" however I was given the drug in a pill form, which I was instructed to wear gloves when handling.  The bill seems like it shows it was an ointment I was given, but I'm sure it was the pill form.  This did nothing to help her either.  I took her back again, and she had 2 sets of xrays, both showing nothing of any concern at all. I was given clavamox this last time, which ACTUALLY WORKED.  Her runny nose went away, and it also helped her cough.  However, once the clavamox ended, her symptoms returned a few days after.  She was on it for a week.  It has been an ongoing issue, with her vet having ruled out a lot of very bad things, but not actually determining the cause.  

At this point we have assumed it is allergies.  But would clavamox alleviate a runny nose in relation to allergies?  I picked up some clavamox for her again last week because her coughing seemed to be especially troublesome, and like usual she was great while on the clavamox and now she's been off of it for a few days and her runny/stuffy nose has returned.  Also, it may be unrelated but she had a ear infection for months, which I misinterpreted as ear wax.  She has been on Remicin ear ointment which has pretty much cleared it up.  Her Dr. said that her ear infection probably was not related to any coughing/sneezing, however.  

I am very desperate as I've seen my baby suffer for over 8 months now. Any help is appreciated!

[Scarlettw]

Oh, I forgot to mention about a month ago she developed tear stains around her right eye, and also on the bottom part of her jaw, on the left and right.  Her Dr. contributed this to allergies as well.  Again, I'm not sure if it's related but more than enough information is better than less than enough.

[Kimberly Coyner, D.V.M., DACVD]

I certainly see alot of pugs with allergies (to food or pollen/dust), usually with symptoms such as scratching, foot licking, recurrent skin rashes and recurrent ear infections, and less commonly sneezing and reverse sneezing. It is certainly possible that your pug has an allergic cause for the ear infection and the brown stains on the jaw. Brownish staining of the fur can be due to tear or salivary staining, or to yeast skin infection, and so your veterinarian can perform microscopic analysis of the affected areas to look for yeast (malasezzia), and if yeast are identified then they can be treated with topical or oral antiyeast medications. The yeast can overgrow after antibiotic therapy, or more commonly due to underlying allergies.

Coughing is an unusual manifestation of allergy in dogs, although I have diagnosed one or two dogs with allergic bronchitis based on chest xrays and tracheal wash/cultures to evaluate the type of inflammation and bacteria present in the lungs; you are right, allergies should not get better with antibiotics, her improvement suggests that bacterial infection is a component of the problem, although infection is likely secondary to another underlying cause. You may want to talk to your veterinarian about keeping your pug on Clavamox for 3-4 weeks, and then if her symptoms recur again, about performing further diagnostics such as recheck chest xrays to see if anything has changed since 2008, a tracheal wash or even bronchoscopy/rhinoscopy, which is  where an endoscope with a camera is used to visualize the interior of the lungs and nose (they may suggest referral to an internist in that case).

Good luck,
Kimberly Coyner, DVM
Diplomate American College of Veterinary Dermatology