Understanding Pulmonary Fibrosis in Dogs

Pulmonary fibrosis is a progressive lung condition where healthy tissue is gradually replaced by stiff, scar-like tissue, making it harder for your dog to breathe over time. There’s no cure, and that’s hard to hear. But understanding what’s happening, what treatment looks like, and what you can realistically expect can help you make the best decisions for your dog from here on out.

What is Pulmonary Fibrosis in Dogs?

Pulmonary fibrosis is a condition where healthy lung tissue is gradually replaced by stiff, scar-like tissue. As the scarring spreads, the lungs lose their ability to expand properly and transfer oxygen into the bloodstream, meaning your dog has to work harder and harder just to breathe. The condition is progressive, meaning it worsens over time, and there is currently no treatment that reverses or stops that progression.

The most common form is idiopathic pulmonary fibrosis. “Idiopathic” meaning the cause is unknown. The condition is most strongly associated with West Highland White Terriers, where it’s sometimes called “Westie lung disease,” and has also been documented in other terrier breeds.

Signs and Symptoms

Symptoms develop slowly, which can make them easy to overlook at first. By the time most dogs are brought to the vet, the disease is often already in an advanced stage. Here’s what to watch for:

• Persistent dry cough
• Fatigue or reluctance to exercise
• Rapid or labored breathing, even at rest
• Weight loss
• Blue-tinged gums (a sign of low oxygen levels in advanced cases)
• Crackling sounds when the vet listens to the lungs, a common finding in affected dogs

If your dog is showing any of these signs, especially an older Westie or terrier, contact your vet. The sooner you have a clear picture of what’s going on, the more options you have.

What Causes Pulmonary Fibrosis?

In most cases, the cause is unknown, which is what “idiopathic” means. There is a clear genetic component, particularly in West Highland White Terriers. Other possible contributing factors include:

• Chronic lung inflammation or infections
• Inhaled toxins or environmental pollutants
• Side effects from certain medications

Westies are at the highest risk, but Staffordshire Bull Terriers, Border Terriers, and Cairn Terriers are also more susceptible than other breeds.

Diagnosing Pulmonary Fibrosis in Dogs

Diagnosis can be challenging because pulmonary fibrosis shares symptoms with other respiratory conditions like pneumonia or heart disease. Your vet will work through several steps:

• Physical exam: Your vet will listen to your dog’s lungs for crackling or unusual sounds.
• Chest X-rays: These can show changes in the lung structure but may not provide a definitive diagnosis.
• CT scan: A high-resolution CT scan offers the most detailed view of the lungs, revealing the characteristic patterns of scarring associated with fibrosis. This is the preferred imaging method for diagnosis and staging.
• Bronchoscopy: A small camera passed into the airways to examine the lung tissue and collect samples if needed.
• Lung biopsy: Rarely done due to its invasive nature but provides a conclusive diagnosis.

Your vet will also assess for pulmonary hypertension (high blood pressure in the lungs), which develops in many dogs with pulmonary fibrosis and influences treatment decisions.

Treatment Options

It’s important to be honest here: there are currently no treatments proven to slow or reverse pulmonary fibrosis in dogs. All current approaches are focused on managing symptoms and keeping your dog as comfortable as possible.

Treatment	What it does	What to know
Cough suppressants (hydrocodone, butorphanol)	Helps manage the persistent cough and improve day-to-day comfort	One of the most straightforward ways to improve quality of life
Bronchodilators (e.g., theophylline)	May ease breathing in some dogs	No proven efficacy in treating the underlying disease, most useful in dogs who also develop pulmonary hypertension
Steroids (e.g., prednisone)	May help if chronic bronchitis or active inflammation is also present	No proven benefit for fibrosis itself, and carry significant side effects with long-term use
Sildenafil	Lowers pressure in the lungs	Only indicated for dogs who develop pulmonary hypertension as a complication, not a general treatment for all dogs with pulmonary fibrosis
Oxygen therapy	Helps maintain oxygen levels during acute episodes	Used during breathing difficulties or in advanced stages
Exercise restriction and environmental management	Reduces stress on the lungs and limits exposure to triggers	Dogs should be allowed to self-limit activity — avoid heat, humidity, smoke, and dust where possible

Your vet will tailor a plan to your dog’s specific symptoms and stage of disease. Regular check-ups every few months are important to monitor changes and adjust the approach as needed.

Prognosis and Living with Pulmonary Fibrosis

This is the hardest part of this diagnosis, and it deserves a straight answer. The average survival time following diagnosis is about a year, although some dogs live much longer, while others succumb to respiratory failure shortly after diagnosis. How quickly the disease progresses varies significantly from dog to dog, and the severity of changes visible on a CT scan at the time of diagnosis is one of the strongest indicators of how things will go.

The goal isn’t to chase a cure that doesn’t exist; it’s to keep your dog comfortable, reduce stress, manage symptoms well, and make the most of the time you have together. Many dogs with pulmonary fibrosis have a good quality of life for a meaningful period after diagnosis with the right care in place.

Does Pet Insurance Cover Pulmonary Fibrosis in Dogs?

Yes, pulmonary fibrosis is covered under Lemonade Pet’s base accident and illness policy, as long as it isn’t pre-existing. That includes eligible costs like diagnostic imaging, medications, and specialist visits that are typically part of managing the condition; things like CT scans, bronchodilators, and the regular check-ups needed to monitor how your dog is doing over time.

This is a serious diagnosis, and the ongoing cost of care is a real consideration alongside everything else you’re navigating. Having coverage in place before any symptoms appear means that side of things is one less thing to carry.

Once signs show up, the condition is typically considered pre-existing and won’t be eligible for coverage. If your dog is healthy now, getting a policy in place is one of the most meaningful steps you can take.

Before we go

A pulmonary fibrosis diagnosis is genuinely difficult news. There’s no minimizing that. But with a clear management plan, a good relationship with your vet, and the right support in place, you can focus on keeping your dog comfortable and making the most of your time together. 

Frequently Asked Questions

A few quick words, because we <3 our lawyers: This post is general in nature, and any statement in it doesn’t alter the terms, conditions, exclusions, or limitations of the policies issued, which differ according to your state of residence. You’re encouraged to discuss your specific circumstances with your own professional advisors. The purpose of this post is merely to provide you with info and insights you can use to make such discussions more productive! Naturally, all comments by, or references to, third parties represent their own views, and Lemonade assumes no responsibility for them. Coverage may not be available in all states. Please note that statements about coverages, policy management, claims processes, Giveback, and customer support apply to policies underwritten by Lemonade Insurance Company or Metromile Insurance Company, a Lemonade company, sold by Lemonade Insurance Agency, LLC.  The statements do not apply to policies underwritten by other carriers.