Collapsing Trachea

Collapsing trachea occurs most often in middle-aged to older
dogs. The diagnosis is suggested by a honking cough precipitated
by activity, excitement, or water drinking. Non-productive
coughing may occur without a stimulus.

Signs vary and include mild to severe panting, respiratory
distress, and bluish discoloration of the mucous membranes
(cyanosis). Abdominal breathing efforts result in tense
abdominal muscles. Dogs are frequently overweight but may be
thin. A heart murmur associated with valvular heart disease is
often encountered because both problems occur in aging dogs.

Collapsing trachea results when the windpipe (tracheal)
cartilages soften. The trachea (windpipe) should resemble a
relatively firm garden hose. Viewed on end, the windpipe is a
U-shaped structure with a tight membrane covering the top. Where
cartilage softens, it collapses and widens at the top. The
membrane then drapes (collapses) loosely, blocking the inside of
the “hose.” This results in an inability to bring air into or
out of the trachea and lungs during breathing.

Complications of this disease include lung problems, heart
disease and/or failure, enlarged liver, and chronic kidney
insufficiency. Dental infections, other infections, and obesity
aggravate the disease.

The diagnosis of collapsing trachea, initially historical, is
substantiated when a veterinarian can cause your pet to cough by
digital manipulation of the neck. Radiographs (x-rays) identify
changes in the trachea during both inspiration and expiration.

The diagnostic evaluation includes laboratory sampling of the
blood to identify causal or complicating medical problems,
motion studies of the trachea and lung during respiration,
endoscopic examination of the windpipe and throat, and
evaluation of abdominal organ enlargement.

There are four components of treating collapsing trachea. During
the acute phase, respiratory distress and severe bouts of
coughing are ameliorated with drugs that relax the trachea and
lung and sedate the pet. Fluid congestion is relieved with
diuretic drugs, and short-term anti-inflammatory agents minimize
swelling and tissue irritation. Antibiotics are utilized if
there is an infection. Cough suppressants temporarily relieve
discomfort. Cough suppressants (narcotic derivatives) may be
used in a lifelong schedule for some pets with collapsing
trachea.

Later, drugs that relieve bronchial constriction and spasm are
utilized along with products to reduce anxiety and
over-stimulation. Anticough medications are used orally as
necessary. Corticosteroid anti-inflammatory drugs may be helpful
during episodes of acute exacerbation of the coughing.

Problems requiring simultaneous medical care that compromise the
tracheal syndrome include recurrent pulmonary or pharyngeal
infections, dental disease, and swelling of lymph tissue in the
pharynx and tracheal region. Weight control is important.

Evaluation of thyroid function may be indicated. Liver
enlargement, secondary to fatty infiltration or other disease,
adversely affects the outcome of this disease. Many smaller dogs
are simultaneously affected with heart disease. You veterinarian
understands how these conditions interact. Diagnosing and
treating both may significantly improve the long-term prognosis.

Surgical correction of a collapsing trachea may be considered in
young dogs when the trachea is collapsed in the neck region.
Older dogs, those with complicating medical problems, and those
with most of the trachea affected are not candidates for surgery.

The prognosis remains good for many pets with early-developing
collapsing trachea, but the condition can be a serious,
life-threatening problem when severe coughing and respiratory
distress negatively affect a good prognosis. The client should
be made aware of the frustrating nature of therapy for these
pets. Unless properly informed that coughing is likely to
continue to occur to some degree, on and off, the client may
become frustrated and seek additional care.

The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.