It’s 3 a.m., and you’re sound asleep. Suddenly, your dog is coughing. Or is he gagging? Wait! Is he choking?! You leap out of bed to check on him, and he’s already gone back to sleep. Dogs make all kinds of funny noises, and most don’t signal a problem. So when should you be concerned?

Choking is always an emergency, but thankfully, it’s rare. As an emergency veterinarian for 10 years, I only saw a dog choke twice — once on a racquetball and the other on a large wad of food.

Coughing or gagging is much more likely the culprit. Choking occurs when objects like balls, food, treats or bones obstruct the airway. A choking dog will be able to make very little or no noise at all. His gums will be pale or blue-tinged.

What To Do

If you suspect your dog is choking:

✔ the first step is to open his mouth and look for a foreign object that you can reach.

✔ If that’s the case, sweep quickly with your fingers to try and dislodge it. (This obviously poses a risk, as your dog can bite you due to stress and fear, so proceed with caution.)

If you cannot reach the object, you can attempt a “doggie” Heimlich maneuver:

✔ Stand your dog on his hind legs.

✔ Join hands just under his rib cage.

✔ Attempt three strong thrusts.

If this doesn’t work, do not delay seeking medical help. Head to the nearest veterinary office ASAP. The veterinarians and techs will intervene quickly with oxygen therapy and attempt to remove the object. If it cannot be quickly removed, an emergency tracheostomy may be performed.

Coughing and Gagging

Again, choking is rare. If your dog is making strange sounds, he is much more likely to be coughing or gagging.

If your dog is coughing, it doesn’t necessarily mean that a trip to the veterinarian is in order. Like humans, coughing and sneezing are protective mechanisms for the airways — preventing foreign objects, such as bacteria and dust, from entering the lungs. An occasional dry, non-productive cough that resolves is not a reason for concern. A cough that is persistent, sounds wet, leads to difficulty breathing or is productive should be evaluated by your veterinarian. Anything from allergies to kennel cough to heartworm disease can cause this.

Sometimes, a dog will cough hard enough to retch at the end, as if trying to throw up a hairball. Gagging isn’t necessarily a serious sign, unless it continues. It is fairly normal for a dog to gag at the end of a hard cough.

If your dog does need veterinary care for a cough, the diagnostics and treatment are varied depending on the underlying cause. If there are no other signs, such as fever, and your pet has been exposed to other dogs, Bordetella (kennel cough) is the likely culprit. No specific testing is usually needed for this diagnosis, just a good history and physical examination. Treatment is symptomatic and usually lasts for one to two weeks.

If there are other red flags, such as fever, nasal discharge or your veterinarian hears abnormalities when he auscults your dog’s chest, more specific tests like blood work, canine flu testing and chest X-rays will likely be recommended. If oxygen levels are affected, your dog may need hospitalization for treatment with oxygen, antibiotics and nebulization to open the airways. This happens in the cases of pneumonia or severe cardiopulmonary disease.

Gagging without coughing can be an indication of many things, including esophageal foreign bodies. This is much more common than actual choking. Common offenders include rawhide chews and bone fragments. If your dog has an object stuck in the esophagus, immediate care is needed. Other causes of gagging can be irritation of the esophagus (esophagitis) secondary to a respiratory disease or upper airway problems like laryngeal paralysis.

If your dog is exhibiting unusual symptoms, try to get a video. This can really help with a diagnosis. If you are concerned, following up with your veterinarian is never a bad idea!