Comparative Study of Inhaled Fluticasone Versus Oral Prednisone in 30 Dogs with Cough and Tracheal Collapse

SIMPLE SUMMARY: Coughing is common in dogs with tracheal collapse (TC). Inhaled corticosteroids are the standard of care in humans, but their use in dogs is less widespread than oral corticosteroids. This study compared the efficacy, adherence, and tolerance to treatment of inhaled versus oral corticosteroids in 30 dogs with cough and TC, randomized to each treatment. Responses were monitored in the hospital (enrolment and weeks 2 and 4) and at home (weeks 1 to 4) using a semiquantitative clinical scale based on four key clinical parameters (respiratory distress, cough episodes, cough frequency, tracheal sensitivity). Both treatments provided comparable clinical improvements, with significantly greater improvements at the end in the fluticasone group. Adherence and tolerance were equivalent, but thirst and the frequency of urination increased in those taking prednisone. In conclusion, inhaled fluticasone is effective in controlling cough in dogs with TC without side effects, which encourages its use to be extended compared to prednisone. ABSTRACT: Coughing is common in dogs with tracheal collapse (TC). The use of inhaled corticosteroids is less widespread than oral ones. This study aims to compare the effects of oral and inhaled corticosteroids in dogs with cough and TC. Thirty dogs were prospectively included and randomized to the prednisone oral group (OG, 14) or fluticasone inhaled group (IG, 16). A clinical score (CS) based on four clinical parameters (respiratory distress, cough episodes, cough frequency, tracheal sensitivity) was monitored at the hospital (enrolment and weeks 2 and 4). Water intake, urination habits, and adherence and tolerance to treatments were monitored weekly. Significant improvements in clinical parameters were identified in both groups throughout the study. Between-group (OG–IG) comparisons revealed no significant differences, indicating equivalent improvement. At the study’s endpoint, the IG dogs had a significantly lower CS (5.69 ± 0.79) than OG dogs (6.43 ± 1.02, p < 0.05). Adherence and tolerance were comparable. From weeks 2 to 4, OG dogs were significantly thirstier and urinated more frequently than IG dogs. In conclusion, fluticasone provided good tolerability and efficacy in controlling cough in dogs with TC, and they showed a lower incidence of signs of hypercortisolism compared to prednisone. These data encourage the use of inhaled fluticasone in dogs with cough and TC.