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Secondhand Smoke Kills

It’s Friday, and that means I have another case for you today. Today is a tough one. Tough in the sense that it was completely preventable. But, it is a good reminder that our actions and decisions not only affect us, but also other people, and in this case, the pets around us as well.


Meet Lizzy (name changed for privacy). Lizzy was a patient of mine for years. Cavalier King Charles Spaniels are wonderful little dogs. They have great personalities and make fantastic family pets. She was a sweet little firecracker and I always enjoyed seeing her.

Lizzy came to see me due to a cough that she had developed. She was still eating and drinking, but was more quiet and had a new cough.
Knowing what we Veterinarians know about Cavaliers, my first thought was that she may be developing heart disease. One unfortunate fact about this breed is that they are genetically predisposed to developing heart disease. Their mitral valve (valve between the ventricle and atrium on the left side of the heart) often becomes “leaky” as they age, leading to heart disease and sometimes heart failure.

So, after getting a full history from Mom regarding boarding, daycare, grooming or other places she may have visited where she could have picked up a bacterial or viral cause for this cough, I started her physical exam. She had no ocular or nasal discharge, and no fever, so my thoughts of this being infectious were decreasing. When I listened to her heart and lungs I did not hear a heart murmur as I would have expected if this was heart disease. However, I did hear wheezing on the right side of her chest as she was breathing.

Courtesy: Long Beach Animal Hospital
My next recommendation to her owner was to take a few chest x-rays. At this point in my career, I lived in an area where we had a fungal disease called Blastomycosis. This can present as a lung disease, eye disease, skin disease, GI disease, or neurological disease. I saw every form of this disease during my years practicing in the Midwest. An x-ray would tell me if this should be tested for, or if something else may be going on.  This x-ray is not Lizzy's, but is an example of what Blastomycosis in the lungs would look like.

Her owner agreed to x-rays, so off we went. After the first x-ray I knew she was in trouble. Something much bigger was going on here. Do you see how most of the front part of her chest is white in this first view? The heart (large white oval) sits in the middle of the chest. Lung tissue (gray/black) surrounds the heart on all sides, but not in her picture. The area above her heart is all white. Something was going on in her lungs. But, what side was the problem on? When we lay dogs on their side for an x-ray, the left and right sides superimpose over each other. So, that’s why a second view was so important to take.


In the second x-ray that you see below, she is laying on her back, so her right side is on your left, and her left side is on your right. Do you see the difference between the sides? They should look almost identical. Her heart is pushed way off to the left side. That large white area in the right side of her lungs is a large tumor. This is lung cancer.


I brought Mom back to look at the x-rays, as I always do. I think it’s very important for owners to see what is going on in their pet’s x-rays so that they have a full understanding of the diagnosis. I had always noticed the smell of cigarette smoke on the owner when she brought Lizzy in. That day after I explained Lizzy’s x-rays to her and the diagnosis, I gently asked Mom if she smoked in the house around the dog. She hung her head and said “yes.” She knew right away that her smoking had caused Lizzy’s lung cancer.


Lizzy declined quickly after that visit. Her cough became more severe, she ate very little, and her Mom brought her back in for euthanasia a short time later. She vowed to never smoke around another dog in the future.

If you are a smoker I encourage you to QUIT!  Do you have children or pets?  Please realize that they cannot make the decision to leave the area if you are smoking in the car or house with them.  Not only is smoking bad for your own health, but it is terrible for other people and pets around you.  Both you and they will be much healthier if you put the cigarette down!
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