Case report details rare recurrent hemoptysis syndrome in a dog

A new case report in Animals describes what appears to be a rare, successfully managed presentation of recurrent nocturnal hemoptysis, transient polycythemia, and acute respiratory distress in a Shih Tzu. The authors said the dog was clinically normal between episodes, but repeatedly arrived at emergency visits overnight with severe diffuse interstitial-to-alveolar pulmonary infiltrates on thoracic radiographs and marked, reversible increases in packed cell volume. After a stepwise workup ruled out more typical causes of hemoptysis and respiratory distress, the team proposed dysregulated sympathetic activity with splenic contraction as the underlying mechanism, and reported that targeted management ultimately controlled the episodes. The paper was published April 30, 2026, in Animals. (mdpi.com)

Why it matters: For veterinary professionals, the report adds a useful differential framework for dogs with episodic hemoptysis and respiratory distress that resolve between crises. Hemoptysis in dogs is uncommon and has historically been linked more often to bacterial bronchopneumonia, respiratory neoplasia, trauma, heartworm disease, and immune-mediated thrombocytopenia than to transient erythrocytosis or suspected sympathetic dysregulation. The case also highlights how radiographic pulmonary edema patterns and reversible PCV spikes can complicate interpretation in emergency settings, especially when patients appear normal between events. (mdpi.com)

What to watch: Whether additional case reports support prazosin-responsive sympathetic dysregulation as a reproducible explanation for similar canine nighttime respiratory crises remains the key next step. (mdpi.com)