Tracheal Collapse in Dogs: a Complete Guide
Coughing is a common problem in older, small breed dogs. Tracheal collapse is one possible cause.
Find out the causes, signs, management options and home treatment steps you can take to make sure your dog has the best prognosis possible.
Please what’s the treatment for trachea collapse . My Yorkie cannot be operated since she’s almost 13 years old. - Lydia
Before I can answer how to treat tracheal collapse in dogs without surgery I need to start off by explaining what tracheal collapse is. Once we understand why it happens (and what else might be causing similar signs and symptoms), we can better understand the best options for each individual dog.
If you are not sure why your dog is coughing, then this post will run you through the most likely causes of coughing in dogs.
Tracheal Collapse in Dogs
Tracheal collapse is a progressive condition where the trachea, the main airway that you can feel in the neck, goes from being a round cylinder to becoming compressed and flattened. The collapse can progress so much that in fact the tube effectively becomes completely blocked. It is squashed so flat that the airway becomes completely obstructed.
Tracheal collapse is most common in older small breed dogs. A 13-year-old Yorkie certainly fits the bill here!
Also Toy Poodles, Pomeranians, Chihuahuas and Pugs are commonly affected by this condition.
Signs of tracheal collapse
Coughing (goose honk)
Heavy, labored breathing
The result of this narrow airway won’t surprise you. An affected dog will have noisy breathing and coughing that often sounds like a goose honk. Tracheal collapse can also cause heavy breathing and difficulty breathing, which can eventually lead to collapse and even hyperthermia.
On hot days, a dog will really struggle to pant, not only can they not loose heat effectively, their muscles are also having to work really hard and as a result will be generating even more heat.
Hyperthermia kills just as effectively as asphyxiation.
What are the causes of tracheal collapse in dogs then?
Unfortunately, we don't really know exactly.
There is likely a genetic component, with specific breeds as well as individuals within a breed being more at risk. The environment though plays a huge role as well.
Obesity plays a massive role, having a big impact on disease progression. Something I'll discuss later when it comes to treatment.
Pollutants can also be a cause. If there is lots of smoke, environmental allergens (like pollen), or a dog’s environment is really dusty then tracheal collapse can be stimulated or made worse. This is especially the case in those dogs which also suffer from chronic bronchitis, which will be a high proportion.
Finally, infection with kennel cough (or canine cough) can cause a deterioration in tracheal collapse in small dogs.
Diagnosing Tracheal Collapse
Of course, not all small coughing dogs are suffering from tracheal collapse. It is vitally important that your dog gets a proper diagnosis made, especially if any initial treatment fails to control the signs and symptoms.
We get this diagnosis through imaging. Imaging is not always straightforward however.
X-rays are generally the first step. They are easiest and cheapest method, but they are not very accurate at picking up this problem.
1-in-4 dogs that have tracheal collapse diagnosed with x-rays will actually be wrong. X-rays are also not particularly sensitive. There will be a proportion of dogs which are diagnosed as negative for tracheal collapse which actually do have the condition.
Despite all this, x-rays are still an appropriate first step as they can be used to rule out other causes of coughing in small breed dogs, as well as being relatively cheap (compared to the other imaging options at least). Having x-rays taken under anesthesia can also allow your vet to perform other test, such as bronchoalveolar lavage (BAL), which are important steps in the diagnostic process.
The best way to diagnose tracheal collapse it is to use something called fluoroscopy. Think of this as real time x-ray on a TV screen. It is an x-ray video, rather than regular x-rays which as just take a single picture.
This is important because tracheal collapse is dynamic. The collapse is only going to be present when a dog is breathing in, or out, or with a certain amount of effort. All this depends on the individual dog’s disease and which section of the trachea is collapsing.
Unfortunately, flouroscopy is not available except in the most advanced veterinary centers, and carries a higher cost as a result.
Bronchoscopy is another valuable technique, and one that may be more readily available to your dog.
Bronchoscopy involves passing a tube with a camera on the end down into the airways to have a look at how they are shaped.
This will again be much more sensitive than x-ray, although it is also going to be significantly more expensive because of the equipment and expertise needed. This means it is not readily available in every clinic and certainly in every part of the world.
Treating Tracheal Collapse
The good news for Lydia and her Yorkie is that most cases of tracheal collapse in small dogs are managed medically, with about a 70% success rate. The chances are that this dog will be successfully managed with medical treatment compared rather than not recover at all.
The mainstays of treatment is anti-coughing medication.
This includes drugs like codeine or hydrocodone.
Steroids are the other key drug used to control tracheal collapse in dogs. Corticosteroids, like prednisone, reduce the inflammation in the airway. This can reduce coughing, reduce excessive mucus production and so reduce the severity of the disease.
Dogs are typically given a higher steroid dose to start with, before gradually tapering down this dose to try and reduce it to the lowest level that works.
Steroids get a bit of bad press online, but used appropriately they are an incredible important drug. You can read more about the action, benefits and side effects in my complete guide to steroids in dogs.
Inflammation results in more mucus being produced, and this increases the risk of infection. Something that is especially true in the early stages of disease, before any treatment has taken effect.
As a result, antibiotics are often administered, especially at the start of treatment although they may be needed intermittently afterwards as well.
Bronchodilators are another medication that may help.
Bronchodilators are drugs that open up the smaller airways. While they have very little effect on the trachea itself, bronchodilators play a role in dogs suffering from chronic bronchitis in addition to tracheal collapse.
This will again reduce coughing and have an overall beneficial effect in these dogs.
Antihistamines may also make a small difference in some dogs.
This can be very variable, working well in some dogs but making no difference in others. You can read more about antihistamine use in my article about giving Benadryl to dogs.
Home Treatment Options
While drugs are vital, taking these steps at home can make all the difference in ensuring that your dog’s tracheal collapse is managed as effectively as possible.
Weight loss is essential if your dog is overweight. We are in the middle of an obesity epidemic in our pets. Over 60% of dogs are overweight or obese, so the chances are good that your dog will also be affected.
Getting your dog to lose weight can make a huge difference to the severity of tracheal collapse. It could make the difference between your dog being treated successfully or not. Find out more here about weight loss and dieting for dogs.
Pollutants and dirty air can be triggers for tracheal collapse.
Don’t smoke around your dog (or even better, try and quit smoking completely). Keep your dog’s environment as dust-free as possible. Reduce the use of aerosols or diffusers in the house, including products like air fresheners and bug sprays.
Harness Instead of Collar
The final home treatment option is to use a harness when walking your dog, rather than a collar. A harness is going to reduce any pressure around your dog’s throat, reduce coughing and reduce inflammation.
Medical treatment helps the majority of dogs with tracheal collapse. Despite this, 3-in-10 will still not be managed acceptably and it is in these cases that surgery plays an important role.
A stent is a titanium alloy mesh tube that is placed inside the trachea. After it is placed, the stent expands and holds the trachea open, preventing collapse.
Cost may be a major consideration with this technique. Not only are the stents relatively expensive, their placement is not a common procedure. They are not something that is place by your average general practitioner, with stent placement typically taking place in specialist referral hospitals. The expertise needed further adds to the cost.
In addition to this, there is about a 10% mortality rate within 60 days of stent placement. It is not risk free.
Those dogs that do well post implantation and survive, really do go on to do very well in general. Their disease is typically very well controlled.
There are other complications like the stent breaking or migrating, the trachea can rupture, and a dog can also develop collapse of the non-stented tracheal areas.
Despite these risks and complications, stenting is a good fallback position if medical management fails, is otherwise appropriate for your dog and is available in your area.
The above is a transcript taken from “The Dr Alex Answers Show”.
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