Techniques for Nebulization and Coupage in Dogs

By Ryan Llera, BSc, DVM; Catherine Barnette, DVM

What is nebulization?

Nebulization is the delivery of a fine mist to the lungs. In some cases, this fine mist may consist of saline or water only. Saline or water adds moisture to the lungs, which can help loosen secretions. In other cases, nebulization may be used to deliver medications directly to the lung tissues. Commonly nebulized medications include anti-inflammatories (such as steroids, which are used in the treatment of allergic airway disease), bronchodilators (which increase the diameter of the airways, allowing air to be moved more easily through the lung), and antibiotics (used in cases of infection).

What is coupage?

Coupage is a technique that can be performed by veterinary staff and pet owners to help clear secretions from the lungs. Coupage is performed by striking the chest gently but firmly with cupped hands. This action helps loosen secretions trapped in the lower airways, allowing them to be more effectively cleared by coughing.

When are nebulization and coupage used?

Nebulization and coupage are used in patients with a variety of lung conditions. Nebulization may be used to deliver a variety of medications to the lungs, in cases of infection, allergic lung disease, or other lung conditions such as smoke inhalation. Coupage is often recommended for patients with pneumonia or bronchitis. Secretions produced as a result of these conditions can interfere with the ability of oxygen to reach the lower airway and enter the bloodstream. By loosening secretions and allowing them to be coughed up more effectively, coupage can help clear secretions from the lungs.

"Nebulization and coupage are used in patients with a variety of lung conditions."

How do I perform nebulization on my dog?

Nebulization may take several forms, depending on your dog’s needs.

In some cases, your veterinarian may recommend steam nebulization. This is used to increase moisture in the lungs, allowing your dog to clear secretions more effectively. Take your dog into your bathroom, close the door, close any windows, and turn off any vent fans then run a hot shower – hot enough to allow your bathroom to fill with steam. Once the bathroom is steam-filled, keep your dog in the room for 10-15 minutes to allow him to breathe the moisture-laden air. This may be performed once daily or more, depending on your veterinarian’s recommendations. Steam nebulization may also be followed by coupage if recommended by your veterinarian.

In other cases, your veterinarian may recommend the use of a nebulizer to deliver aerosolized medications to your dog’s lungs. Water and medication are added in specified quantities to a machine that is used to deliver the vaporized medication to your dog for breathing. Your dog will breathe from the nebulizer for a specified number of breaths on a specific schedule. After each use, the machine must be shut down and cleaned as directed.

How do I perform coupage on my dog?

First, you may wish to place your dog on a table or elevated surface so that you can comfortably reach his chest. Next, cup your hand and pat the side of your dog’s chest. If you have a large dog, you can use two hands (one on each side of the dog’s chest); for smaller dogs, use one hand and do one side at a time. When you pat your dog’s chest, there should be a small amount of air remaining between your palm and the side of the chest; your palm should not flatten against the body wall. This impact should make a sound similar to drumbeats. The impact should be firm enough to loosen fluid that may be trapped deep within the lungs, but not so hard as to cause pain or discomfort for your dog. Gradually work your way around your dog’s entire chest, coupaging each area of the chest on both sides of the body.

"The impact should be firm enough to loosen fluid that may be trapped deep within the lungs, but not so hard as to cause pain or discomfort for your dog."

This procedure should take only a few minutes. After coupage, encourage your dog to get up and walk around, as activity will promote coughing and help your dog to bring up the loosened secretions.

Follow your veterinarian’s recommendations regarding how frequently coupage should be performed. Additionally, coupage should not be performed immediately after eating; wait at least one to two hours after a meal before performing coupage.

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