Tracheal Collapse in Dogs

What is the trachea?

The trachea, or windpipe, is the tube that connects the throat to the lungs. Small cartilage rings along the tracheal wall maintain the trachea’s tube shape. In dogs, these rings do not completely encircle the windpipe, but cover about 83% of the circumference. A thin membrane of tissue completes the circle.

What is tracheal collapse?

If the cartilage rings lose strength and rigidity, or if the membrane becomes slack and sags into the airway, the tracheal rings flatten when the dog breathes in (inhales). This is called tracheal collapse. The narrowed airway makes it difficult for air to get to the lungs. Tracheal collapse occurs most frequently in middle-aged to senior dogs (4 to 14 years of age), 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 dogs of any 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, during hot or humid weather, immediately after eating or drinking, or when there is pressure on the trachea, such as from a collar.

How is tracheal collapse diagnosed?

During a physical exam, your veterinarian may suspect tracheal collapse if light pressure on the trachea causes coughing or breathing difficulty. Tests such as radiographs (X-rays), fluoroscopy (a dynamic X-ray), or endoscopy using an endoscope or bronchoscope are needed to confirm the diagnosis.

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 tracheal collapse treated?

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

Medications that may be used include:

• Antibiotics and anti-inflammatory drugs, such as prednisone, may be intermittently needed.
• Cough suppressants (e.g., hydrocodone bitartrate, butorphanol) and sometimes sedatives may be needed daily to minimize irritation from coughing.
• Maropitant citrate (Cerenia®) has been used to help decrease inflammation in the airways.
• Bronchodilators (airway-expanding medications) such as theophylline may be helpful if the collapse occurs in the lower trachea.
• Stanozolol (an anabolic steroid) is sometimes used.

Many dogs with tracheal collapse also have concurrent liver disease. For that reason, any dog with tracheal collapse should have their liver function monitored closely. Your veterinarian will provide specific treatment advice based on your dog's condition.

Weight management is important to reduce the severity of symptoms caused by a tracheal collapse. It is also advisable to prevent overexcitement and use a harness rather than a collar. Avoid exposure to irritants, such as tobacco smoke.

What is the prognosis for my dog?

Tracheal collapse is a progressive disease, which means the tracheal cartilage can continue to deteriorate over time despite treatment. Even dogs that undergo surgery often need medication for life. The prognosis depends on how well your dog responds to treatment.