Tracheal Collapse in Dogs

By Malcolm Weir, DVM, MSc, MPH; Krista Williams, BSc, DVM; Ernest Ward, DVM

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What is the trachea?

The trachea, or windpipe, is the tube connecting the throat to the lungs. Small cartilage rings along the tracheal wall maintain the tube shape of the trachea. In dogs, these rings do not completely encircle the windpipe but only cover about 5/6 (83%) of the circumference. A thin membrane of tissue completes the circle.

What is a collapsing trachea?

If the cartilage rings lose strength and rigidity, or the membrane becomes slack and sags, the tracheal rings will flatten when air is drawn into the airway during inspiration. This is called tracheal collapse. Tracheal collapse makes it difficult for air to get to the lungs.

Tracheal collapse occurs most frequently in middle-aged to senior dogs (4-14 years), but some younger dogs can also be affected.

Are certain breeds more often affected?

Yes, tracheal collapse often affects Chihuahuas, Pomeranians, Shih Tzus, Lhasa Apsos, Toy Poodles, and Yorkshire Terriers. Because some breeds are more predisposed to tracheal collapse, it is suspected that a genetic factor is involved. It is important to note that while tracheal collapse is seen more often in these breeds, it can occur in all dogs, regardless of size or breed.

"...it can occur in all dogs, regardless of size or breed."

What are the clinical signs?

The most common clinical sign is a persistent, dry, harsh cough. It is sometimes described as a ‘goose honk’ cough. The cough may worsen at night, with excitement, with pressure on the trachea, such as from a collar, during hot or humid weather, or immediately after eating or drinking.

How is a collapsing trachea diagnosed?

During a physical exam, very light pressure on the trachea that causes coughing or breathing difficulty may raise suspicion of tracheal collapse. Tests such as radiographs (X-rays), fluoroscopy (dynamic x-ray), or the use of an endoscope or bronchoscope are needed to confirm the diagnosis.

Are there other conditions that can be similar to collapsing trachea?

Other causes of coughing, including congestive heart failure, must be ruled out. Sometimes heart disease and collapsed trachea are present at the same time.

How is collapsing trachea treated?

Collapsing trachea can be treated medically, surgically, or by combining the two. Your veterinarian will discuss the various treatment options. Even with good control, most dogs will continue to experience at least some coughing throughout their lives. Surgical correction is complex, and the procedure is typically performed only by an experienced board-certified surgeon. Newer implant materials and techniques promise hope for dogs affected by the condition.

"Collapsing trachea can be treated medically, surgically, or by combining the two."

Antibiotics and anti-inflammatory drugs, such as prednisone, may be intermittently needed. Cough suppressants such as Hydrocodone bitartrate, tramadol, or butorphanol, and sometimes, sedatives may be needed daily to minimize irritation from coughing. Maropitant citrate (Cerenia®) has also been used to help decrease inflammation in the airways. Bronchodilators such as theophylline may be helpful if the collapse occurs in the lower trachea.

A study indicated that many dogs with collapsing trachea also have concurrent liver disease. Therefore, all dogs with collapsing trachea should have their liver function monitored closely. Your veterinarian will provide specific treatment advice to help your dog's condition.

Weight management is important to reduce the severity of symptoms caused by a collapsing trachea. Preventing overexcitement and using a harness rather than a collar is also advised. Avoid exposure to irritants, such as tobacco smoke.

What is the prognosis for my dog?

Collapsing trachea is a progressive disease, as the tracheal cartilage can continue to deteriorate over time despite treatment. Even pets who have surgery for the condition often need medications for life. The prognosis will depend on how well your dog responds to treatment.

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