The trachea is the large tube that carries air from the mouth down to the lungs. Certain breeds of dogs (typically small breeds including Yorkshire Terriers, Pomeranians and Chihuahuas) are predisposed to weakening of the cartilage with age. This results in a disease called tracheal collapse, which makes it difficult to get air down to the lungs efficiently. In other cases, dogs may be born with a malformation of the trachea. Yorkies are especially susceptible to this birth defect, which also makes it hard for air to pass to the lungs.
If a dog is experiencing tracheal collapse or malformation of the trachea, s/he will exhibit signs including:
- Chronic coughing (often described as “goose honking”)
- Difficulty breathing
- Exercise intolerance
- Cyanosis (i.e. “turning blue”)
Diagnosis of Tracheal Collapse
If your dog consistently exhibits any of these clinical signs, schedule an appointment with your veterinarian. Your vet will likely suspect tracheal collapse if your pet appears to have difficulty breathing or shows any other associated signs. S/he will also factor in breed during the evaluation. Subsequently, the vet will perform a physical examination (e.g. listen to the airway sounds and elicit a cough from light tracheal palpation). Prior to diagnosis, the vet must perform further diagnostic testing.
- Chest X-Rays (thoracic radiographs): Often, the vet will begin diagnostic testing with chest x-rays, which may be enough to not only confirm suspicions but also determine the severity of the condition.
- Fluoroscopy: While thoracic radiographs may suffice, it is important to understand that dogs with tracheal collapse often have a dynamic form of the disease. This means that the trachea is not always completely collapsed (especially when the patient is not coughing). Therefore, if your dog’s signs are consistent with tracheal collapse but the chest x-rays appear normal, the vet will not stop the evaluation. Fluoroscopy utilizes x-rays and obtains a video. Accordingly, this allows the veterinarian to observe the pet during all phases of breathing as well as during coughing episodes to obtain the most information possible. Additionally, a vet can take a scope and pass it through the pet’s trachea (under general anesthesia). From there, the vet can view the degree of collapse from the inside.
- Tracheoscopy: Additionally, a vet can take a scope and pass it through the pet’s trachea (under general anesthesia). Afterward, the vet can view the degree of collapse from the inside.
Unfortunately, there is no cure for tracheal collapse. Treatment focuses primarily on limiting the clinical signs that the pet is experiencing. That being said, while there is no complete cure, most dogs respond well to treatment and may go years without major complication.
Your veterinarian may recommend a variety of anti-coughing and anti-inflammatory medications to make your pet as comfortable as possible. Additionally, it is extremely important to ensure that overweight pets overweight lose weight as obesity can worsen the signs associated with tracheal collapse. Also, dogs with this disease should not be walked with a neck leash/collar; instead, consider a harness that does not put pressure on the trachea.
Though most pets never need more than daily medications, there are others that need more interventions to save their lives or to improve their quality of life. Consequently, dogs that present with more severe signs (such as passing out or turning blue) or that are no longer responding to medical therapy may be candidates for tracheal stenting.
Tracheal stents are a mesh metallic material and are sized specifically for each patient. The stent is placed in the trachea with assistance with fluoroscopy and endoscopy. This procedure can often be lifesaving or at least provide dramatic improvement in quality of life for the pet as well as the owner. These pets can often live a few more good quality years with the implant in place! While this procedure sounds excellent (and it often is!), it is important to understand the downsides. These include:
- Stent migration
- Stent fracture
- Stent infection
- Persistent coughing
When a dog is being managed medically, s/he will likely need recheck appointments with a veterinarian at least every 6 to 12 months for a routine evaluation and medication adjustments. Those with a tracheal stent need periodic follow up appointments with their internist or surgeon. These appointments help to ensure the stent is still in the correct place and is maintaining its integrity. Unfortunately, since tracheal collapse is a progressive disease, there are some pets that will need an additional stent placement in the future as the trachea continues to collapse further.
Complications of Untreated Tracheal Collapse
If you suspect that your dog has tracheal collapse, we recommend scheduling an appointment with your vet. In time, if untreated, tracheal collapse will likely worsen and the dog may experience:
- Excessive coughing (which can induce inflammation and increase coughing even further)
- Death in severe cases
Treating Tracheal Collapse at CARE
CARE’s internal medicine team has the ability (and passion) to perform fluoroscopy and endoscopy as well as the ability to place tracheal stents. So, if you or your primary veterinarian are concerned that your pet has tracheal collapse, has uncontrolled coughing or have questions about whether your pet is a candidate for a stent, contact us to schedule an appointment with our internal medicine service.