Collapsed Trachea in Dogs

The trachea, also known as the windpipe, is an important structure that connects the throat to the lungs. It serves the purpose of directing air into the respiratory tract.

The normal trachea is tubular. It maintains its shape because of a series of rings made of cartilage. These rings do not completely encircle the trachea. Instead, they go from the 2 o'clock to 10 o'clock positions. The remainder of the trachea composed of a flexible membrane that joins the ends of the cartilage rings.

When the cartilage rings are flattened from the top to the bottom, the trachea is said to be collapsed. Rapid inhalation of air can cause the trachea to flatten and make it difficult for air to enter the lungs.

Cause

We do not completely understand how this condition develops. However, we know that these dogs have an abnormality in the chemical makeup of their tracheal rings. The rings lose their stiffness so they are not able to retain their circular shape. We also know that it occurs in certain breeds of dogs, notably Chihuahuas, Pomeranians, Shih Tzus, Lhasa Apsos, Toy Poodles, and Yorkshire Terriers. Because of that, we suspect that there is a genetic factor involved.

Clinical Signs

The most common clinical sign is a chronic intermittent cough. It is often described as dry and harsh and can become quite pronounced. The term "goose honk" is often used to describe it. Coughing is often worse in the daytime and much less at night. The cough may also begin due to excitement, pressure on the trachea (from a leash), or from drinking water or eating.

Diagnosis

A dog of the breeds listed above with a chronic cough, especially a “goose honk,” should be suspected as having collapsed trachea. Many times, very light pressure placed on the trachea during the physical examination can raise a suspicion of collapsed trachea in a small dog with a persistent dry cough. While the information gained from the physical examination is helpful, other tests are needed to confirm this condition.

Radiographs (x-rays) of the chest can identify the trachea and its shape. However, a collapsed trachea changes its diameter during the respiratory cycle. It is usually collapsed during inhalation and normal during exhalation. Therefore, we attempt to make radiographs during both phases of respiration. This is easy in some dogs and rather difficult in others since dogs are not likely to understand the command, “Take a deep breath and hold it.”

Endoscopy is another way to visualize the trachea. An endoscope is a tube that is small enough to insert into the trachea; the operator can see through it and visualize the inside of the trachea. By watching the trachea during inspiration and expiration, abnormal collapsing can be seen. Unfortunately, tracheal endoscopes are expensive and not available at every veterinary hospital.

Coughing and Heart Failure

Coughing is a common sign of heart failure, and many dogs with collapsed trachea will also have heart disease. Testing that occurs when diagnosing this disease should include chest radiographs (x-rays) so the heart can be evaluated. Treatment for heart disease is not indicated unless it can be demonstrated with some form of testing.

Treatment

Collapsed trachea can be treated medically or surgically. Most dogs respond well to cough suppressants. Brochodilators and various types of anti-inflammatory drugs may also be used. The trachea of these dogs is easily infected, so antibiotics are sometimes part of the treatment. If obesity is present, weight loss is often beneficial. Excitement and vigorous exercise are likely to cause a relapse, so they should be avoided as much as possible.

Some dogs respond well to the medical approach, and others do not. Because medical therapy only treats the symptoms and does not correct the problem, these dogs are always subject to recurrences of coughing and breathing difficulty.

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