I was wondering when someone would ask! There is a device called Aerodawg. It fits over the dogs nose and mouth. At the other end the inhaler attaches. Inside it has a little flap that goes up and down as the dog breaths. After one pump of the inhaler we then count 7 to 10 breaths by watching the flap to make sure she is getting the full dose of the inhaler. Our dog cooperates but we have to hold her in place and make sure her nose and mouth are well covered. You get the hang of it after using it. It has made a world of difference.