This month’s pet of the month is Ruby, who has been suffering from tracheal collapse for the last nine years. She has been fortunate in that her symptoms have been limited to a chronic cough and have not progressed to more serious respiratory difficulty or distress.

Tracheal collapse is a progressive weakening of the tracheal cartilage, or “windpipe”, seen most commonly in middle-aged small breed dogs. As the trachea collapses it results in an obstruction to the passage of air. Certain breeds including Yorkshire Terriers, Bichon Frise and Pomeranians are more prone to this condition

How can I tell if my dog has tracheal collapse?

Tracheal collapse is characterised by a harsh “goose honking “cough that is often worsened by excitement. The disease is often worse in the summer months due to the heat. While the disease typically progresses over months or years, some dogs can present with a sudden onset difficulty breathing and require emergency therapy.  Dogs with tracheal collapse can often have other conditions including heart murmurs, pneumonia or problems with their larynx/palate.

How is tracheal collapse diagnosed?

Tracheal collapse is a dynamic process meaning that it can often be missed on normal chest radiograph (x-ray). Ideally, it is diagnosed using a combination of fluoroscopy – a video x-ray that allows visualisation of the trachea as the dog inhales and exhales – and bronchoscopy, where a camera is passed down the trachea to assess the degree of collapse and assess for other conditions, such as pneumonia.

How is tracheal collapse treated?

Medical management

The vast majority of dogs will respond to lifestyle changes (weight loss, being walked with a harness rather than a neck lead, avoidance of cigarette smoke or aerosols in the house) in combination with medications (corticosteroids, cough suppressants and antibiotics). Almost all dogs will have some improvement with the introduction of medication and up to 90% will be well controlled for 12-18 months.

Tracheal stenting

Tracheal stenting involves placing a metal (nitinol) mesh within the trachea under anaesthesia. The stent holds the trachea open and stops the airway obstruction. 90% of cases show a rapid improvement in clinical signs. It is important to know that dogs that have a tracheal stent placed will likely still require lifelong medications as outlined above.

What are the potential complications with tracheal stenting?

Tracheal stenting should only be performed by veterinary surgeons who have been properly trained in the technique. As the procedure requires fluoroscopy it is normally only performed at a referral practice. Many of the complications associated with stenting such as stent movement or fracture are more likely to occur if an incorrect size of stent has been placed. However, even when performed by appropriately trained personnel the complications seen with the technique can include inflammatory tissue growing through the stent and chronic infections. Up to 40% of cases that have a tracheal stent placed may require a second procedure at some point in their life. Following stent placement, most animals will be discharged within 24-28 hours.