Veterinary Antitussive Medications: A Practical Guide to Treating Coughing in Dogs

When is the right time to use a cough suppressant drug, and how do you choose the best option for the dogs who come into your clinic sounding like a honking goose? The most effective antitussive medications used to treat coughing dogs in veterinary practice might not be your go-to choices. Here's what to know about treating dogs with respiratory disease, whether you’re managing chronic bronchitis, collapsing trachea, or the tail end of an upper respiratory infection like kennel cough.

A cough suppressant can bring veterinary patients relief, provided the cough doesn’t have a purpose. Productive coughing, especially when tied to a respiratory infection, can help remove irritants and pathogens from a dog’s lungs and airways.¹ Bronchodilators, antibiotics, or anti-inflammatories may be better first-line choices for these patients.

That said, drugs with antitussive properties can be a game-changer for dogs with a persistent, dry cough that lingers long after the initial trigger resolves or when correcting the underlying respiratory system issue is impossible.¹ In cases of chronic tracheobronchitis, airway disease, inflammatory conditions, or tracheal collapse, the cough reflex can become a quality-of-life issue.²

There are several options for cough suppressant drugs that meet your patient’s needs. Some work directly on the cough response centers in the brain, while others decrease inflammation or relieve anxiety that can help stop a cough-anxiety spiral. Here’s a quick overview.

This centrally acting opioid has been the go-to for suppressing the relentless, honking cough in dogs with chronic bronchitis or collapsing trachea. As an opioid, hydrocodone may cause significant side effects, including sedation, constipation, or respiratory depression. It’s a tightly controlled drug, so take care when prescribing. To discourage misuse, hydrocodone is often compounded to include homatropine.³

Though not quite as potent as hydrocodone, codeine is still effective for milder coughing or when hydrocodone causes serious sedation. Bioavailability can be unpredictable, and combination products with acetaminophen are not appropriate for dogs. Keep an eye out for potential side effects like gastrointestinal (GI) upset and drowsiness.³

This opioid is used as an analgesic, cough suppressant, and sedative. It works quickly, especially when delivered intravenously (IV) or subcutaneously (SQ). Because of its short duration and limited oral absorption, butorphanol is not ideal for chronic use, but is a reliable option for dogs with situational needs.³

Dextromethorphan is a safe, over-the-counter option, but its efficacy is low. It’s the cough suppressant pet owners ask about most, but the one we recommend least. However, it might be appropriate for a mild or occasional cough when better options aren’t available.³

Studies suggest maropitant, a reliable anti-emetic often used for vomiting and motion sickness, may help suppress cough by targeting neurokinin-1 receptors.¹ It’s a promising non-opioid option that’s well tolerated in most dogs because it causes fewer adverse effects, but chronic use might be cost-prohibitive for some dog owners.

Although not traditionally used as a cough suppressant, gabapentin has been investigated for chronic coughing in people and dogs that might be related to neuropathic causes in the central nervous system.⁴ Sedation is the most common trade-off, but can be a helpful side effect in some cases. Calming a dog coughing from excitement, exertion, or panic (think Frenchies with brachycephalic obstructive airway syndrome [BOAS] or a Lab with laryngeal paralysis) can break the cycle.¹

Used more in human internal medicine for refractory coughing, tricyclic antidepressants such as amitriptyline show potential for dogs with coughing that is tied to behavioral triggers or nervous system hypersensitivity.¹ Although anecdotal, these drugs might be options in cases where nothing else works. Use cautiously in patients with other health concerns and who take other medications.

First-generation antihistamines (e.g., chlorpheniramine) may help address allergic causes of coughing and dogs with non-allergic inflammation. They’re safe options that are sometimes effective, and the secondary drowsiness can help coughing dogs (and their owners) get a good night’s sleep.³

Cough suppressants work best when paired with strategies that target the underlying airway irritation. Supportive therapies to consider include:^1,3

• Corticosteroids for reducing airway inflammation

• Bronchodilators to improve respiratory tract airflow

• Nebulization or aerosol respiratory therapy treatments to target bronchi locally

• Supplements that support immune system balance

• Expectorants to clear respiratory secretions

Talk to pet owners about realistic expectations, since achieving sufficient antitussive effects and reducing cough frequency can take some trial and error.

After the appropriate diagnostic tests, antitussives can keep the cough reflex from taking comfort, sleep, and sanity from canine patients and pet owners at their wits’ end.

Looking for custom antitussive dose formulations to improve compliance and patient acceptance? Wedgewood can help. Explore our formulary or contact us for compounded medications and unique solutions for your coughing patients.