Many small-breed dogs suffer from collapsing trachea. This is a condition in which the supporting cartilage rings for the windpipe are unable to maintain their shape, resulting in narrowing of the airway. This typically leads to chronic coughing, which is often characterized as having a honking sound (goose-honking). Severely affected patients may have marked difficulty breathing and even life-threatening airway obstruction. The most commonly affected breeds include the Yorkshire terrier and Pomeranian, though any small-breed dog may be affected. Large-breed dogs rarely have this problem.
Diagnosis of tracheal collapse is made using the history, physical examination, and chest x-rays (thoracic radiographs). Occasionally, direct visualization using tracheoscopy or fluoroscopy is necessary for diagnosis of dynamic airway collapse.
Patients with tracheal collapse rarely quit coughing altogether. Typically, we can medically manage patients to reduce the frequency of coughing. If the coughing suddenly worsens, sounds “wet” or rattles, then we may consider a transtracheal wash to collect samples from the airways for culture and sensitivity and cytology. Patients should be off antibiotics for at least 48 hours before having this procedure done. Regular administration of a cough suppressant is critical to medical management. Patients may require tapering courses of corticosteroids to help reduce inflammation that is associated with airway collapse. Patients that develop secondary airway infections require antibiotics. Periodic reevaluation with chest x-rays is advised to monitor for complications such as lower airway collapse and concurrent heart or lung disease.
Patients that have severe airway obstruction (difficulty getting air in, turning blue in the tongue, etc.) or patients with symptoms that are refractory to medical management are potential candidates for tracheal stent implantation. This is a last-ditch effort to save a patient’s life. Expected complications associated with tracheal stent implantation include fracture, chronic airway infection and granuloma formation.
Patients that are overweight benefit greatly from weight loss. Such patient may experience complete resolution of symptoms and even come off of medications with a return to a normal body weight. Your veterinarian can work with you to devise a weight loss plan. Neck leads should be avoided. Use a harness when walking to avoid undue pressure across the neck.
Owners should monitor affected pets for excessive coughing, difficult or labored breathing, and should bring them in immediately on emergency for oxygen therapy if they are having marked labored breathing and a bluish color to the tongue. Severely affected patients in a crisis may require oxygen therapy, injectable corticosteroids and sedatives.
Minimizing excitement and activity helps when patients are having excessive coughing. Sometimes isolating patients in a dimly lit room by themselves is enough to do the trick. Other patients become quite agitated if left alone and need to be picked up. Distracting others with mild activity such as a short walk may be helpful.