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Signs That Need Prompt Veterinary Attention If your dog is coughing and gagging as well as showing any of the following signs, contact Dundee Veterinary Clinic right away: Persistent coughing that lasts more than a few days Difficulty breathing or wheezing Loss of appetite Lethargy or weakness Blue or pale gums Coughing up blood or unusual material Diagnostic Tests Your Veterinarian May Recommend To identify the cause of your dogs coughing and gagging, your veterinarian might recommend diagnostic tests such as: Chest X-rays to examine the lungs and heart Bloodwork to check for infections or organ function concerns Heartworm testing Echocardiogram (heart ultrasound) Airway sampling to detect infections or inflammation These tests help your veterinarian form a clear diagnosis and create an appropriate treatment plan