Tracheal Collapse in Dogs

Tracheal collapse is a chronic disease involving the trachea (also called the windpipe) and the lower airway. This disease is progressive, meaning it gets worse over time. Although tracheal collapse is irreversible, there are treatments available to improve symptoms.

What Is Tracheal Collapse?

The trachea is a major part of the upper airway. It is a flexible tube-shaped structure that is surrounded by u-shaped rings of cartilage, making it appear somewhat accordion-like. The rings are attached to a membrane and help keep the trachea open, allowing the dog to breathe normally. If these cartilage rings become weak or worn, they may no longer be able to hold the trachea open. They flatten and collapse, shrinking the space through which air can pass. The condition may or may not also involve collapse of the lower airways, where smaller tubes branch off to carry air to the lungs.

Tracheal Collapse Risk Factors

Small dog breeds are most commonly affected by collapsing trachea, especially Pomeranians, Poodles, Yorkshire Terriers, and Chihuahuas. Tracheal collapse may or may not be hereditary. It may be congenital (present at birth) or acquired (developed later, sometimes secondary to other diseases). Overweight or obese dogs have a higher risk of developing tracheal collapse. Exposure to cigarette smoke or other air pollution may worsen a collapsing trachea by irritating the throat and inciting coughing.

Signs of Collapsing Trachea in Dogs

Coughing is by far the most common sign of tracheal collapse in dogs. Dogs with tracheal collapse often experience the following signs:

• A cough that is harsh, dry, and unproductive (often sounds like goose honking)
• Coughing when pressure is put on the neck (especially by a collar or hands)
• Coughing and/or wheezing when excited
• Coughing when picked up
• Retching (looks like trying to vomit, but produces nothing)
• Noise when breathing (wheezing, etc.)
• Trouble breathing (increased effort)
• Exercise intolerance
• Blue-colored gums (often in conjunction with exercise or excitement)
• Episodes of fainting/loss of consciousness

Be sure to report these and any other signs of illness to your veterinarian as some of these signs can also be seen with other conditions and you should have your veterinarian make the diagnosis. It's better to act early so you can give your dog some relief.

How Vets Diagnose Tracheal Collapse in Dogs

If you suspect your dog has a collapsing trachea, be sure to visit a veterinarian for an evaluation. Your vet will begin by asking several questions in order to get a history of your dog and the signs you have noticed.

Next, your vet will perform a physical examination on your dog. Your vet may try to elicit a cough by putting a bit of pressure on the trachea. This is not an actual determination of the disease, but it can give your vet an idea of the type of cough your dog is experiencing. In addition, it may be helpful to show your vet a video of your dog coughing, wheezing, or exhibiting other signs.

Your vet will most likely recommend radiographs (x-rays) of the chest to determine a diagnosis. This will provide a radiographic view of your dog's airway, heart, and lungs. Be aware that tracheal collapse may not show up on the x-rays, especially in mild cases since the airway is only collapsed some of the time and the X-ray may capture it when it is open. The x-rays may even reveal a completely different cause for your dog's symptoms. This is why it's an important first step to take radiographs.

There is a good chance your vet will want to run some lab work to get a better idea of your dog's overall health. Lab tests like blood chemistry, complete blood count, and a urinalysis may reveal underlying conditions. These conditions may contribute to the tracheal collapse or can be unrelated. The lab results may point to another condition that is causing your dog's signs.

If your pet needs advanced diagnostic tests, your local vet may not have the necessary equipment and may refer you to a specialist (typically a veterinary internist or interventional radiologist). The veterinary specialist may recommend one or more advanced tests.

• Bronchoscopy, during which a tube-like fiber-optic camera is inserted into the trachea, allowing the veterinarian to see the inside of the trachea and take fluid samples for culture and analysis (all with your dog under anesthesia).
• Echocardiogram, which is an ultrasound of the heart that evaluates cardiac function.
• Fluoroscopy, which is a moving x-ray that shows what occurs as your dog breathes in and out.

Based on the outcome of the testing, your vet will hopefully be able to make a diagnosis. The next step is to begin treatment.

Medical Treatments for Collapsing Trachea

Tracheal collapse cannot be cured, but there are several ways to help your dog.

First, be sure to stop using neck collars on your dog, Switch to a harness that does not put any pressure on your dog's neck area. Weight loss is important if your dog is overweight. Excess weight adversely affects the airway.

There are several medications that can help alleviate the symptoms of tracheal collapse. Cough suppressants are most commonly prescribed, such as hydrocodone. Sedatives may also be prescribed to reduce anxiety and keep your dog calm and relaxed. This will make your dog less likely to cough or have tracheal spasms.

Dogs with tracheal collapse can have a crisis where their symptoms become severe. This can be brought on by many things including episodes of major stress or excitement, respiratory infections or other illnesses—especially in the heat. If your dog is having difficulty breathing, has a blue tint to its gums, or is coughing excessively, see your vet right away. They often need additional care to get them through these episodes and get back to a more stable condition.

Be sure not to use any over-the-counter medications unless specifically recommended by your vet. Use all medications according to your vet's instructions and do not change doses without consulting with your vet. Avoid so-called "home remedies or "natural remedies" unless your vet says they are safe to try. Unfortunately, some of these can actually make things worse.

Surgery for Collapsing Trachea

Medical management is effective in the majority of dogs. However, in severe cases, surgery might be an option to consider. Surgical treatment of tracheal collapse is a major procedure that must be performed by a veterinary surgeon, ideally one who is ACVS board-certified.

Surgery may involve the placement of special plastic rings around the trachea to hold it open. Or, the surgeon may need to place a stent inside the trachea or lower airway. The stent is a mesh device that holds open the airway. In some cases, the stent can be placed by a veterinary internist (ideally ACVIM board-certified internist) via tracheobronchosopy.

There are several serious risks associated with both of these procedures. In some cases, the stent or plastic rings may break or become displaced. There are also potential complications that can damage the trachea, and surrounding structures. A post-operative hospital stay is required. Medical management is usually continued during the recovery period to decrease pain, swelling, coughing, and excitement. Many of these patients will still require medications to control their signs to some degree even if surgery is successful.

As with most surgical procedures, the dog's activity must be restricted during the recovery period and follow-up visits to your vet or specialist will be necessary. After recovery, many dogs will continue to exhibit signs, especially coughing. Fortunately, these signs are usually much milder, but may still require medication.

The good news is, with proper care and monitoring, most dogs can live relatively normal lives despite tracheal collapse. As always, be sure to communicate with your vet, asking questions and provide updates on your dog's condition.