Experienced and professional animal trainer provide their insights in answering this question :
A. These medications should be given for life. Your dog will get worse again if you stop them

How to Identify Common Pet Problems ?

Our sources include academic articles, blog posts, and personal essays from experienced pet care professionals :

Potential Side-Effects of Enalapril

Less-severe side effects include, but aren`t limited to diarrhea, cough, loss of appetite, vomiting, dizziness, drowsiness, itching, skin rash, dry mouth, or problems sleeping. Enalapril also can cause an allergic reaction in some dogs and cats.

Previous studies have shown that the ACE inhibitors imidapril and enalapril improve clinical symptoms, especially cough, in dogs with MVD and dilated cardiomyopathy [5, 14, 15]. Our results also showed that cough completely or partially resolved in 55.6% of dogs treated with alacepril.
In addition to its diuretic properties, furosemide can also act as a respiratory airway dilator to reduce coughing in dogs. Dogs with chronic bronchitis may benefit from furosemide, but it`s not typically used alone to treat this condition.
It is fairly common that dogs with chronic heart failure will end up on enalapril plus a diuretic (i.e. water pill) like furosemide. The combination of these two medications can decrease blood flow to the kidneys as a side effect of helping to take the burden off the heart.
In dogs that have been diagnosed with heart failure and are on furosemide (also known as Lasix or Salix), a worsening cough may indicate worsening heart failure with more fluid in the lungs.
Enalapril is an ACE inhibitor that treats heart failure and high blood pressure. It also treats chronic kidney failure, heart murmurs, and protein in the urine. Enalapril for dogs is a prescription medication available in several forms.
Cough medicines do not usually help coughs caused by enalapril. Sometimes the cough will get better on its own if you keep taking enalapril. Talk to your doctor if it carries on, bothers you or stops you from sleeping. Another medicine may suit you better.
Enalapril improves the signs and symptoms associated with congestive heart failure.
Coughing can be a telltale sign that a dog with a heart murmur is experiencing heart failure. When dogs have a heart murmur, their hearts can become enlarged and lose the ability to pump blood into their lungs and the rest of their body.
The most common clinical sign of congestive heart failure (CHF) is persistent coughing accompanied by difficulty breathing. This is due mainly to pulmonary edema or the accumulation of fluid in the lungs. The enlarged heart will also push against the trachea, causing irritation that can induce a cough.
Enalapril is commonly used in combination with diuretics, especially furosemide. In this situation, monitoring kidney parameters is especially important as both these medications serve to decrease blood supply to the kidney as they support the heart.
Although enalapril and furosemide are frequently combined together, their effects may be additive on lowering your blood pressure. You may need a dose adjustment or special tests to safely take both medications. Contact your doctor if you have a reduced heart rate, dizziness, fainting, or headaches.
The most common side effect is an increase in urination. Other possible side effects include diarrhea or constipation. Serious side effects include weakness, collapse, head tilt, balance problems, electrolyte imbalance, lack of urine production, or a racing heart rate.
The good news is that many dogs live a good, healthy life with a heart murmur, as long as they are getting the correct treatment and lifestyle changes have been made if needed. Early detection is a key success factor for a better prognosis with heart conditions.
An innocent murmur will not require any treatment, but your vet will want you to come for follow-up appointments to ensure the heart murmur resolves itself. A heart murmur caused by cardiac disease or defect may require medication, a specialized diet, or surgery.
Relative Contraindications: Clinicians should avoid using enalapril or, if necessary, use it with caution in patients with aortic stenosis, myocardial infarction, stroke, hypertrophic cardiomyopathy, collagen vascular disease (e.g., SLE), renal artery stenosis, and renal impairment.
The means by which ACE inhibitors affect the respiratory system is thought to be through an increase of substance P, which is released from the vagal and glossopharyngeal sensory nerves in the pharynx and upper airways, and is naturally degraded by ACE [7,47]. In this case, this will increase the cough reflex.
During long-term treatment, no adverse effects of enalapril occurred. Thus, enalapril improves cardiac function at rest and during exercise. Compared with placebo, maintenance therapy with enalapril results in symptomatic improvement and increased exercise capacity.
This can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.
Enalapril is a medicine used to reduce high blood pressure and to prevent or treat heart failure. If you have high blood pressure, taking enalapril will help prevent a future heart attack or stroke. Enalapril lowers your blood pressure and makes it easier for your heart to pump blood around your body.
As a result, enalapril relaxes the blood vessels. This lowers blood pressure and increases the supply of blood and oxygen to the heart. Hydrochlorothiazide is a thiazide diuretic (water pill). It reduces the amount of water in the body by increasing the flow of urine which helps lower the blood pressure.
As dogs age, the cartilage rings that make up the trachea become flattened. This narrows the space inside of the trachea and makes it more difficult for air to pass through. As a result, collapsed trachea in dogs may cause a goose honking cough, gagging, and sometimes even respiratory distress.
When your dog is in the end stages of congestive heart disease you will notice that your pup has difficulty breathing even while resting, experiences frequent bouts of coughing, develops bluish-grey color gums, possibly faints when standing and will become reluctant to walk.
If your dog has a heart murmur and you see coughing, congestion, change in breath sounds or rapid breathing, exercise intolerance, weakness or “fainting,” gray or blue gums, abdominal distention, or lethargy, you should most certainly seek medical attention.

Relevant Questions and Answers :

the most relevant questions and answers related to your specific issue

Q. My C. K. Charles has an asmathic cough. Ok most of the day, but worse in hotter rooms in the evening. What’s wrong?
ANSWER : A. Coughing in dogs can be caused by a number of things including allergies, asthma, illness such as Bordetella (kennel cough) or even lung and heart problems.

Allergies and asthma can cause a dog to have a raspy cough, and they may wheeze, sneeze or have running noses or trouble breathing when active or in an area where the allergen is present. Your vet can determine if an allergy or asthma is present and provide medication as needed to help with symptoms.

Bordetella can also cause a deep hacking cough, and is common in dogs that frequent doggy day cares, kennels or dog parks. The causes can be bacterial or viral, and treatment depends on if any secondary symptoms such as fever or dehydration is present. Treatment involves cough suppressants from your vet, or even antibiotics and fluids to treat secondary illnesses. Other illnesses such as heartworm may cause a chronic cough and exercise intolerance and should be looked for if your dog is not already on a heartworm preventive.

Small dogs are also prone to a condition called collapsing tracheas, and Cavaliers are very prone as a breed to heart and lung issues. Collapsing tracheae often cause a gasping or hacking cough when excited or active, and may require treatment if they become problematic. Heart and lung problems such as heart failure or genetic abnormalities can also cause coughing as a sign of the illness. Your vet can perform a complete exam to check the health of the lungs and heart.

Q. My dog keep hacking like a cough or something in her throat, what can I do?
ANSWER : A. Hacking and coughing can be caused by a number of things ranging from foreign bodies such as twigs stuck in the mouth or throat, to infections or illnesses such as Bordetella or Kennel cough, common in dogs that frequent kennels, dog daycare or dog parks. In older dogs, heart and lung issues can also be indicated by a cough that does not go away.

If you think there may be a foreign object stuck in your dog’s throat, you can sweep a finger gently through the back of the mouth or throat if your dog will let you. If something feels stuck and is not easily moved by the finger, it is best to contact your vet to have the object safely removed. This usually requires sedation so that your dog does not become panicked or move, causing the object to become further stuck or cut the throat.

If your dog is showing other symptoms of illness in addition to the cough such as runny nose or eyes, fever, lethargy or changes in appetite, it may indicate a viral or bacterial illness such as kennel cough. These are usually treated with a cough medication in severe cases, plus rest and treatment of any additional symptoms until the condition improves. In bacterial causes, antibiotics may also be given to help your dog feel better.

If your dog has a constant cough that does not go away, or has had changes in ability to exercise, breathing, or appears to have swelling around the chest or abdomen, in may indicate a lung or heart issue. Your vet can thoroughly examine your dog for any signs of heart or lung problems and can then offer care as needed depending on the cause.

Q. My new puppy is coughing a lot and I think it is Kennel Cough. Could it be?
ANSWER : A. Kennel Cough is similar to the human cold, and it can be caused by three categories of microorganisms.

1. Bordetella Bronchiseptica: A small bacteria which can result in bronchitis and severe cough in dogs.
2. Canine Adenovirus: A serious and contagious virus.
3. Canine Influenza Virus: An extremely contagious virus causing mild to severe respiratory symptoms in dogs.
Kennel Cough has its own course of 1 to 3 weeks and can be managed medically.

Close environments with several dogs can increase the chance of dogs catching the cough. Kennel Cough vaccination is aimed mostly at preventing the Bordetella infection through an inhalant or injection vaccination. Although not 100% effective, it should be recommended in all dogs that spend time around other dogs, even the park is considered one of these social occasions.

Kennels have their own policy with regards to Kennel Cough vaccinations and should always be contacted well ahead to understand and comply with their requirements before the stay of your dog.
If you suspect that your dog has caught Kennel Cough, you should see your veterinarian. Your dog might benefit from certain medications to speed up his recovery. These might include antibiotics, anti-inflammatory drugs, and cough suppressants at your vet’s discretion.

Q. I cannot afford vet care. Can I treat my 13 year old dog for kennel cough with OTC meds?
ANSWER : A. Not really, he/she needs antibiotics. You can try to nebulize her at home or even run the shower on hot with the door closed to create a steam room, then turn off the water and leave him/her in there for 15 minutes to help clear the mucous out and help him/her breath better. Sometimes it will help but many times it does not clear the problem. You really need antibiotics if it is indeed kennel cough. Are you sure it is not a heart issue causing the cough? Especially being he/she is a little older I would suspect a heart issue causing the cough and not kennel cough. You should really seek vet care somehow.

Q. Dog-persistent loud frequent cough 30+days; still has good appetite,doesn’t act sick. Need names of effective cough suppressant & anti-inflammatory
ANSWER : A. I would not recommend use of any cough suppressant until you have an accurate diagnosis as to why your dog is coughing as it could make the condition worse. Coughing is a natural protection to keep the airways clear and healthy. A common reason for persistent coughing are heart disease and this should be investigated as a priority. Honey can be used as a natural antiseptic and soothing barrier for the back of the throat but after more than one month your dog really does need a full health check

Q. My dog has a heart murmur, is having nose bleeds and what seems like seizures. Are the seizures and nose bleeds related to the murmur?
ANSWER : A. True epileptic seizures are not connected with heart disease. However, dogs with heart murmur and heart arrhythmia can faint and this sometimes this can be confused with epileptic seizure. Ideally, you should record one of the seizures on your camera and show it to your vet.

Q. My cat is having coughing episodes like hes trying to get up a fur ball and his chest is heaving with every breath he takes between coughing episodes
ANSWER : A. I’m pretty concerning about your cat. While coughing can be the sign of mild respiratory infection, the fact that his chest is heaving between coughing episodes suggests more serious disease. Coughing is from the respiratory tract and bringing up a hairball is a GI thing (vomiting). Sorry not trying to state the obvious but lots of people think their cat is vomiting when it’s actually trying to cough.

It sounds like from your description that your cat is in respiratory distress. This could be due to a number of problems that can be quite serious – asthma or heart disease, as a couple of examples. I think it’s important that you get him assessed by a vet ASAP in order to determine what’s going on.

Q. I am fostering a 4 yo Chihuaha and he has recently been diagnosed with a heart murmur graded 5 of 6. What treatment do you recomend? Is it fatal?
ANSWER : A. It depends if the dog is in heart failure or not. There is no clear benefit of treating dog with heart murmur which is not in heart failure yet. Pimobendan is one of the medications which may be helpful. If the dog is already in heart failure which means he has fluid build up in his lungs then there is a list of medications that should be used e.g. furusemide, ACE inhibitor, Pimobendan, Spironolactone