Pneumonia in Dogs: Types and Treatment Recommendations

Although you’re likely familiar with pneumonia in people and may have experienced it yourself, many pet parents find themselves unprepared for a diagnosis of pneumonia in their canine companions. Pneumonia isn’t the most common cause of coughing in dogs, but it can be a significant illness for your pet. Awareness of pneumonia in dogs can help you act quickly to get your pet feeling better as soon as possible.

What Is Pneumonia in Dogs?

When we think of a person with pneumonia, we imagine deep coughing and difficulty breathing. While that might be what pneumonia looks like, what does the word “pneumonia” mean? The general term for inflammation of the lungs is pneumonitis. Pneumonia is a type of pneumonitis that occurs due to an infection. Although any dog can get pneumonia, it is most common in very young, old, immunosuppressed, or debilitated dogs. 

Types of Pneumonia in Dogs

There are three main types of pneumonia in dogs:

• Viral or bacterial pneumonia: Also known as infectious pneumonia, this form develops due to a virus or bacteria within the respiratory tract. 
• Aspiration pneumonia: Aspiration pneumonia refers to secondary bacterial infection after inhalation of foreign material. 
• Fungal pneumonia: Fungal pneumonia develops due to inhalation of fungal spores.

Lung inflammation without infection can occur with inhalation of smoke or chemicals, autoimmune conditions, or allergic reactions. In these situations, your pet is experiencing pneumonitis rather than true pneumonia.

Causes of Pneumonia in Dogs

In most cases of infectious pneumonia, a virus damages the respiratory tract, predisposing the dog to a secondary bacterial infection. Examples of viruses that cause pneumonia in dogs include the canine distemper, canine parainfluenza, and canine influenza viruses. The bacteria Bordetella bronchiseptica can cause infectious pneumonia in the absence of a virus. Other bacterial species involved in pneumonia typically work alongside a virus. Infectious pneumonia is contagious and affected dogs should be kept away from other dogs. Rarely, a highly fatal pneumonia caused by Streptococcus equi subspecies zooepidemicus can occur in dense housing situations, such as crowded breeding facilities or shelters. This highly contagious disease isn’t common in your typical pet but should be considered in a very sick dog with bloody nasal discharge and difficulty breathing. 

Aspiration pneumonia occurs when a dog inhales a foreign substance and develops a secondary infection. Inhalation of oral medications can cause aspiration pneumonia, so consider asking your veterinarian to demonstrate safe medication administration. Another frequent cause of aspiration pneumonia is inhalation of regurgitated or vomited material. Regurgitation sometimes occurs during surgery because the normal swallow reflex is inhibited under anesthesia. This is one of the reasons your veterinarian places a tube in your pet’s trachea (windpipe) during surgery. The tube can protect their airway if they regurgitate. Some underlying conditions can also predispose to aspiration pneumonia, such as laryngeal paralysis, megaesophagus, or seizures. Aspiration pneumonia is not contagious between dogs.

Fungal pneumonia in dogs occurs due to inhalation of fungal spores, typically from contaminated soil. Young, medium-to-large, male sporting dogs, particularly hunting dogs, may have an increased exposure risk. Fungal pneumonia is generally not considered contagious between dogs. Blastomycosis, histoplasmosis, and coccidioidomycosis are three examples of fungal pneumonias. 

• Blastomycosis, which is caused by the fungal organism Blastomyces dermatitidis, is most common across the midwestern river valleys, mid-Atlantic states, and Pacific Northwest.
• Histoplasmosis, which is caused by Histoplasma capsulatum, is most common in the midwestern river valleys.
• Coccidioidomycosis, which is caused by Coccidioides immitis, is most common in the southwestern United States.

Symptoms of Pneumonia in Dogs

Bacterial, viral, and aspiration pneumonia have a rapid onset, while fungal pneumonia usually develops slowly.

If you note the following pneumonia symptoms, contact your veterinarian:

• Coughing
• Fatigue
• Loss of appetite
• Nasal discharge

The following symptoms are more severe. If you note these symptoms, it is best to go to an emergency veterinary clinic:

• Labored or rapid breathing
• Pale or bluish gums, lips, and tongue
• Disorientation, difficulty rising, exercise intolerance

Some dogs have areas of pigment on their gums, lips, and tongue. When checking their color, you should be looking at non-pigmented areas.

Fungal infections can affect other body systems outside of the lungs. Aside from symptoms of pneumonia, other signs that your dog may have a fungal infection include:

• Weight loss
• Enlarged lymph nodes
• Changes to their eyes (cloudiness, discoloration, vision changes)
• Skin abscesses or draining tracts 
• Limping or gait changes 
• Weakness, stumbling
• Unusual behavior
• Diarrhea or poor appetite

Diagnosing Pneumonia in Dogs

Luckily, veterinarians have many tools for diagnosing pneumonia. Basic steps for diagnosis include discussion of your pet’s history, a physical examination, and chest X-rays. The veterinarian will listen to your dog’s lungs and will note if your pet is using more effort to breathe than normal.

If the veterinarian is concerned about your pet’s oxygen levels, they may use a pulse oximeter to measure blood oxygen levels. While physicians typically place the pulse oximeter on your finger, veterinarians often use the lips or ear flap in an awake dog. If your pet is hospitalized, your veterinarian may measure oxygenation levels using a blood sample. A dog with severe pneumonia will have decreased oxygen levels.

Bacterial culture determines the type of bacteria present and what antibiotics should work to treat your pet’s pneumonia. Most veterinarians will begin treatment without culture, especially if the pet parent is financially restricted. However, a sedated procedure called a bronchoalveolar lavage can be performed to “wash” the lower airways, allowing for culture of the fluid. If your veterinarian does take a culture, they may change your dog’s treatment plan once they have the results.

Diagnosis of fungal infection may require additional testing, such as cytology of lymph nodes or skin lesions. A urine test may be sent to a reference laboratory for some fungal organisms. If your veterinarian suspects that your pet has fungal pneumonia, they may start your pet on antifungal medication while awaiting results.

Pneumonia Treatment in Dogs: At-Home Care

Pneumonia can be treated at home when the case is mild, which is more likely if your pet’s illness is caught early. Almost all cases of viral or bacterial pneumonia and aspiration pneumonia will go home with prescription antibiotics to kill the bacteria. Give your pet these medications as prescribed by your veterinarian to reduce development of resistant bacteria.

Rest and recuperate! You should not vigorously exercise with your pet while they are recovering from pneumonia. Your dog can still move around, walk to their water and food bowls, and go outside to eliminate. When in doubt, follow your veterinarian’s recommendations regarding activity level. Ensure your pet has constant access to water so they’re well-hydrated.

Your veterinarian may recommend nebulization, which delivers fine mist to the lungs to loosen up secretions. Some veterinarians may send a nebulizer home. If you don’t have access to a nebulizer, you can still create steam for your pet to inhale. An easy method is to take your dog into the bathroom, close the door, turn off the fans, and run a hot shower for 10-15 minutes. Nebulization or steaming is typically followed by coupage. Coupage involves using cupped hands to pat your dog’s chest with a firm but non-painful impact, usually moving from the back of the chest to the front on both sides. If your veterinarian requests that you perform coupage at home, have them demonstrate proper technique before attempting on your own.

For fungal infections, your veterinarian will prescribe antifungal medications such as itraconazole. Fungal pneumonia requires a much longer treatment duration than bacterial pneumonia. Even if your pet starts their treatment hospitalized, you will administer antifungals at home for at least 2-6 months.

You want your pet to cough up the secretions that are building in their airways, so cough suppressants should be avoided. Never give over-the-counter human medications unless instructed to do so by your veterinarian. Some of these medications, such as ibuprofen, can be dangerous for dogs.

Pneumonia Treatment in Dogs: Hospitalization

Moderate-to-severe cases of pneumonia in dogs typically require hospitalization for several days. Common treatments administered in the hospital include:

• Oxygen supplementation: If your pet’s oxygen levels are less than 94 percent on pulse oximetry, they likely need supplemental oxygen. Oxygen can be delivered to your pet in an oxygen cage or through prongs that go in the nostrils.  
• Fluid therapy: Fluid therapy is important for preventing dehydration and is administered via intravenous catheter. 
• Antibiotics or antifungals: Your dog may receive intravenous antibiotics or antifungals through their fluid line until they can transition to oral medications.
• Nebulization with coupage: Your pet will likely get saline nebulization with coupage several times daily. 
• Nutritional support: Dogs without an appetite may receive appetite stimulants or assisted feeding.

Critical cases of pneumonia may require a ventilator, which is cost-prohibitive for most pet parents and carries a worse prognosis. Rarely, pneumonia is recurrent in a specific lung lobe, and surgical removal of the lobe (lobectomy) may be recommended. In surgical cases, there is typically an underlying cause, such as a foreign object stuck in the lung lobe. 

Recovery Time for Pneumonia in Dogs

Most dogs with infectious or aspiration pneumonia who receive appropriate treatment will show improvement within three days. Treatment lasts approximately two weeks but may be extended if needed. If there is an underlying cause for the pneumonia, such as a neurologic condition increasing risk of aspiration, your pet’s recovery will depend on management of the risk factor.

Recovery from fungal pneumonia is more uncertain. The mortality rate for blastomycosis is around 20 percent, and 20-25 percent of dogs who are treated may experience recurrence. Histoplasmosis that is restricted to the lungs has a more favorable prognosis than histoplasmosis affecting the gastrointestinal tract or other areas. Like blastomycosis, histoplasmosis has the risk of relapse. Recovery time for fungal pneumonias can last several months.

Untreated pneumonia in dogs can be fatal. If your pet is diagnosed with pneumonia, you should work with your veterinarian to find a feasible treatment plan. 

Cost to Treat Pneumonia in Dogs

The cost to treat pneumonia varies according to severity, type of pneumonia, and geographic location. Simple infectious or aspiration pneumonias that require an exam, X-rays, and antibiotics may be treatable for approximately $200-$300. Cases that require hospitalization are likely to cost $1,500 or more. In critical cases, ventilator use can add approximately $1,000 per day on top of other treatments. Initial testing for fungal pneumonias may cost several hundred dollars, with initial stabilization potentially reaching $1,500 or more. The medication and monitoring of your pet can cost approximately $300-$500 per month.  

How to Prevent Pneumonia in Dogs

To protect your dog from viruses that cause pneumonia, follow your veterinarian’s DHPP and Bordetella vaccination recommendations. Your veterinarian will determine your pet’s individual risk and develop an appropriate vaccination schedule. 

If your pet has a condition that predisposes them to aspiration, such as laryngeal paralysis or megaesophagus, lifestyle modification can decrease risk. For example, a dog with megaesophagus should be fed upright to prevent aspiration. Your veterinarian will have the best advice for your individual situation. 

Unfortunately, fungal pneumonia cannot necessarily be prevented. Awareness of fungal pneumonia can help you recognize the signs earlier, which increases your pet’s likelihood of successful treatment.