My Pet Is Having Trouble Breathing (Part 3): How Veterinarians Diagnose and Treat Breathing Problems

If your pet is struggling to breathe, you may be surprised that your veterinarian doesn't immediately begin running tests.

The first priority is always the same:

Help your pet breathe.

Unlike many medical problems, respiratory distress can become life-threatening within minutes. Whenever possible, veterinarians stabilize breathing before pursuing a diagnosis.

Step One: Stabilization

If your pet is in respiratory distress, the veterinary team will often minimize handling.

This may seem unusual to owners, but even small amounts of stress can worsen breathing difficulties.

Instead, your pet may immediately receive:

• Oxygen therapy
• A quiet environment
• Minimal restraint
• Continuous monitoring

Many hospitals delay blood draws or X-rays until a patient is breathing more comfortably.

Oxygen Therapy

Oxygen therapy is one of the most important treatments for pets having difficulty breathing.

Supplemental oxygen increases the amount of oxygen available to the lungs while the veterinary team works to determine the underlying cause.

Oxygen may be provided in several ways:

Oxygen Cage

An enclosed chamber that maintains a higher oxygen concentration while minimizing stress.

This is often the least stressful option for cats and small dogs.

Flow-By Oxygen

A tube delivers oxygen near the nose without touching the face.

This is commonly used during emergencies while preparing other treatments.

Nasal Oxygen Catheters

Small soft tubes placed into the nostrils provide continuous oxygen support.

These are typically used for pets requiring longer-term oxygen therapy.

Mechanical Ventilation

Rarely, pets are unable to breathe effectively on their own.

In these situations, a ventilator temporarily breathes for the patient while the underlying problem is treated.

Diagnostic Tests

Once your pet is stable, your veterinarian will begin determining why breathing has become difficult.

Several tests may be recommended.

Physical Examination

The examination provides valuable clues before any testing begins.

Your veterinarian will evaluate:

• Respiratory rate
• Respiratory effort
• Gum color
• Heart rate
• Lung sounds
• Heart murmurs
• Airway noises
• Temperature

Sometimes the examination alone strongly suggests the underlying problem.

Pulse Oximetry

A pulse oximeter measures how much oxygen is attached to your pet's red blood cells.

A small sensor is placed on an ear, tongue, lip, or toe.

This test is painless and provides real-time information about oxygen levels.

Chest Radiographs (X-rays)

Chest X-rays remain one of the most valuable diagnostic tools.

They allow veterinarians to evaluate:

• Heart size
• Lung tissue
• Fluid within the lungs
• Pneumonia
• Tumors
• Pleural effusion
• Pneumothorax
• Broken ribs
• Diaphragmatic hernia

Many breathing disorders can be diagnosed—or strongly suspected—from chest radiographs.

Thoracic Ultrasound

Ultrasound is particularly helpful for identifying:

• Fluid surrounding the lungs
• Lung masses
• Heart abnormalities
• Diaphragmatic movement

Unlike X-rays, ultrasound can often be performed while pets remain in a comfortable position.

Echocardiogram

An echocardiogram is an ultrasound of the heart.

It provides detailed information about:

• Heart valve disease
• Heart muscle function
• Congenital defects
• Pulmonary hypertension
• Congestive heart failure

If heart disease is suspected, this test often provides the most definitive diagnosis.

Blood Work

Blood tests help identify diseases that may contribute to respiratory distress.

Common tests evaluate:

• Infection
• Anemia
• Electrolytes
• Kidney function
• Liver function
• Inflammation
• Organ damage
• Blood Gas Analysis

Blood gas testing measures:

• Oxygen levels
• Carbon dioxide levels
• Blood acidity (pH)

This helps veterinarians determine how effectively the lungs are exchanging gases.

Electrocardiogram (ECG)

An ECG records the electrical activity of the heart.

It helps identify abnormal heart rhythms that may accompany respiratory disease or heart failure.

Bronchoscopy

A tiny camera is passed into the airways while your pet is under anesthesia.

Bronchoscopy may be recommended for:

• Chronic coughing
• Airway collapse
• Foreign bodies
• Airway tumors
• Persistent inflammation

Samples can often be collected during the procedure for laboratory testing.

CT Scan

Computed tomography (CT) provides highly detailed images of the chest.

It is especially useful for evaluating:

• Nasal disease
• Lung masses
• Airway abnormalities
• Surgical planning

CT scans are often recommended when X-rays cannot fully explain a pet's symptoms.

Emergency Procedures

Some pets require procedures immediately after arrival.

Thoracocentesis

If air or fluid has accumulated around the lungs, your veterinarian may perform a thoracocentesis.

A sterile needle or catheter is inserted into the chest cavity to remove the excess air or fluid.

Many pets experience immediate relief after this procedure.

Endotracheal Intubation

If a pet cannot maintain an open airway, a breathing tube may be placed through the mouth into the trachea.

This secures the airway and allows oxygen or mechanical ventilation if needed.

Common Treatments

Treatment depends entirely on the underlying diagnosis.

Your veterinarian may recommend:

• Oxygen therapy
• Intravenous fluids (when appropriate)
• Diuretics for heart failure
• Antibiotics for bacterial pneumonia
• Bronchodilators for asthma
• Corticosteroids for inflammatory airway disease
• Pain medications
• Anti-anxiety medications (when medically appropriate)
• Anti-arrhythmic medications
• Surgery
• Hospitalization for intensive monitoring

Many pets require a combination of therapies.

Monitoring Recovery at Home

Once your pet returns home, your role becomes incredibly important.

Monitor:

• Resting respiratory rate
• Appetite
• Activity level
• Coughing
• Gum color
• Sleeping position
• Energy level

Contact your veterinarian immediately if breathing worsens or your pet cannot get comfortable.

Can Breathing Problems Be Prevented?

Not every respiratory disease can be prevented, but many risks can be reduced.

Maintain a Healthy Weight

Excess weight makes breathing significantly harder.

Keep Vaccinations Current

Vaccination helps reduce the risk of several infectious respiratory diseases.

Prevent Heartworm Disease

Heartworms damage both the heart and lungs.

Year-round prevention is one of the easiest ways to protect your dog.

Avoid Smoke Exposure

Secondhand smoke and vaping aerosols can irritate the respiratory tract.

Exercise Wisely

Avoid strenuous exercise during hot or humid weather.

Flat-faced breeds require particular caution.

Schedule Regular Veterinary Exams

Early heart disease, lung disease, and airway disorders are often detected before owners notice symptoms.

Frequently Asked Questions

My dog breathes fast while sleeping. Is that normal?

A temporarily increased breathing rate can occur during dreaming, but a consistently elevated resting respiratory rate—especially above 30–35 breaths per minute—should be discussed with your veterinarian.

My cat is breathing with its mouth open.

Should I wait and see?

No.

Open-mouth breathing in a resting cat should always be considered an emergency.

My dog seems fine except they're breathing faster.

Could it still be serious?

Yes.

Rapid breathing is often one of the earliest signs of heart disease, pneumonia, pain, or other medical problems.

Can anxiety make my pet breathe fast?

Yes.

Stress and anxiety can increase breathing rate.

However, anxiety should never be assumed to be the cause until medical problems have been ruled out.

My pet seems better now.

Do they still need to be examined?

Many respiratory diseases improve temporarily before worsening again.

If your pet experienced unexplained difficulty breathing, they should still be evaluated.

Dr. Rene's Clinical Pearls

🫁 I pay close attention to owners who tell me, "Something just isn't right."

Many respiratory emergencies begin with subtle changes that owners notice before diagnostic tests reveal obvious abnormalities. Trust your instincts.

🫁 Respiratory patients often hide how sick they are.

Dogs want to please us, and cats instinctively hide illness. By the time many pets show obvious breathing difficulty, they have already been compensating for quite some time.

🫁 Oxygen is a treatment—not a diagnosis.

Owners sometimes worry when we place their pet in an oxygen cage before giving them answers. The goal is to stabilize your pet first so we can safely determine what's causing the problem.

🫁 Small changes matter.

A resting respiratory rate that gradually climbs over several days may be the first indication that a pet with heart disease needs medication adjustments. Those daily observations at home are incredibly valuable.

🫁 I'd rather evaluate ten pets that turn out to be okay than have one family wait too long.

When it comes to breathing, it's always safer to err on the side of caution.

The Bottom Line

Difficulty breathing is one of the most urgent medical problems we see in veterinary medicine. While the underlying causes range from mild to life-threatening, the first priority is always helping your pet breathe comfortably and safely.

If your pet is breathing rapidly at rest, struggling for air, open-mouth breathing (especially cats), has blue or gray gums, or seems unable to catch their breath, seek veterinary care immediately.

Early recognition, prompt treatment, and careful monitoring can save lives.

References

• Ettinger SJ, Feldman EC. Textbook of Veterinary Internal Medicine.
• Merck Veterinary Manual. Respiratory Disorders in Dogs and Cats.
• American College of Veterinary Internal Medicine (ACVIM) Consensus Statements.
• American College of Veterinary Emergency and Critical Care (ACVECC).
• Fossum TW. Small Animal Surgery.
• Nelson RW, Couto CG. Small Animal Internal Medicine.