Key Points
Tracheal collapse is commonly seen in small breed dogs such as Yorkshire terriers, Poodles, and Pomeranians to name a few Tracheal collapse is caused by a progressive weakening of the the tracheal rings When medical treatment is not effective surgery is a good option Prognosis is good following surgery.
Anatomy
- The trachea, commonly known as the windpipe, is a tube that allows passage of air from the back of the throat to the lungs
- There are two regions of the trachea: cervical which is located in the neck and the thoracic trachea which is located in the chest
- The trachea is made of many "C"-shaped cartilage rings and a dorsal tracheal ligament which connects the "C" to form a complete tube
- Each of the cartilages is connected together by fibrous tissue
- The voice box or larynx is the gateway of the trachea and prevents food and water from getting into the trachea Two delicate nerves located on each side of the trachea, called the recurrent laryngeal nerves, control the muscles that open the doors of the voice box; damage to these nerves causes laryngeal paralysis
- Below is a section of a normal trachea illustrating the dorsal tracheal ligament that is on the top side of the trachea and the cartilage rings that maintain the structure of the trachea
Cause of tracheal collapse
- Tracheal collapse is commonly seen in small breed dogs such as Yorkshire terriers, Poodles, and Pomeranians to name a few
- Tracheal collapse is caused by a progressive weakening of the the tracheal rings. One study showed that dogs with tracheal collapse have less chondroitin sulfate in their tracheal rings
- Cushing's disease (adrenal gland produces too much steroid) can weaken the cartilages
- Below is an illustration showing about 50% collapse of the trachea, as the cartilage rings become progressively weaker, the trachea continues to collapse
Clinical signs- Goose honking cough is the classic sign of this disease
- Coughing frequently is worsened by hot weather, exercise and excitement
- Fainting spells due to lack of oxygen
- Exercise intolerance
Diagnostic testing
- Complete blood cell count
- Chemistry profile
- Testing for Cushing's disease if clinical signs are present
- Urinalysis
- Fluoroscopy - movie type of x-ray (real time) that allows evaluation of the airway during inspiration and expiration
- Scoping the airways
- Chest radiographs below demonstrates a severely collapsed trachea (dark grey thin stripe labeled as trachea) in a dog; both the trachea in the neck and in the chest are collapsed
Treatment
- Medical therapy
Cough suppressants
Antibiotics if indicated
Short course of steroids
Bronchodilators
Weight loss
Use harness instead of neck collar
Limit excitement
Keep out of hot environment - Surgery
Indicated if collapse is advanced
Indicated if collapse is not responsive to medical therapy
Surgery involves suturing the collapsed trachea to plastic rings which are placed around the trachea (see illustration); in the photo below, two clear plastic rings have been sutured to the trachea; an instrument has been passed beneath the trachea in order to pass the third plastic ring.
Aftercare
- Cough suppressants are needed while the trachea is healing - excessive cough can break the repair down
- Pain medication
- Antibiotics
- Exercise restriction for 4 month
- Use harness instead of neck collars
- Weight reduction
Potential complications
- Laryngeal paralysis
- Swelling of the airway
- Necrosis of the trachea
- Recurrence
- Anesthetic death
- Pneumonia
- Infection of surgical site
If you are concerned about the health of your pet you should contact your veterinary surgeon at all times.
My thanks to Dr. Daniel A. Degner for allowing me to use his material, original can be viewed at the Vet Surgery Central website.
