Section: Veterinary Care In-depth
Diagnosis In-depth
Palpation of the trachea. On physical examination, if gentle pressure on the trachea elicits the characteristic "goose honk" cough, this is supportive of a diagnosis of collapsing trachea.
X-rays. X-rays taken during both inhalation and exhalation are often needed to demonstrate tracheal collapse as well as to identify any concurrent heart or lung problems. During inspiration, the trachea in the neck tends to collapse. During expiration, a portion of the trachea that is found in the chest tends to collapse.
Fluoroscopy. X-rays are not always diagnostic. Fluoroscopy is a continuous x-ray that allows the observation of the trachea while the dog is actually breathing or coughing. This procedure is typically available only at universities or referral centers.
Tracheobronchoscopy. If surgery is being considered, or if X-rays or fluoroscopy still haven't yielded a definite diagnosis, tracheobronchoscopy can be used to confirm the diagnosis. This procedure involves the insertion of a bronchoscope into the trachea. The bronchoscope has a light and a camera on the end of it. The entire trachea may then be visualized, from the inside. This procedure may need to be performed at a university or referral center.
Treament In-depth
Treatment for tracheal collapse will not cure the condition. Treatment consists of medical management and/or surgical intervention. Approximately 71 percent of dogs undergoing medical management of tracheal collapse show long-term resolution of clinical signs. As a result, medical management should be attempted first.
Medical Management
If tracheal collapse presents as a respiratory emergency, patients must be stabilized immediately. Dogs are put into an oxygen cage. Administration of a rapidly acting steroid to reduce inflammation of the trachea and larynx is often necessary. Cough suppression and sedation may be necessary to stabilize the dog.
Chronic management of a collapsing trachea is based on the severity of clinical signs. Mild cases may need only a cough suppressant. More severe cases may require a combination of cough suppressants, airway dilators, steroids, and/or antibiotics Weight loss helps decrease the required respiratory effort in overweight dogs with collapsing tracheas.
If two weeks of medical treatment hasn't helped, or if clinical signs are very severe, surgery may be attempted. Many procedures have been tried, but the one that is currently in favor is the application of prosthetic polypropylene rings around the trachea. The overall success rate in significantly reducing clinical signs is 75 to 85 percent. Prognosis is better for dogs younger than six years of age. This procedure should be done by an experienced surgeon.
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