Collapsed Trachea
Overview
The (trachea) is surrounded by c-shaped rings of cartilage that allow the neck to be flexible. As the name implies, collapsed trachea is a condition in which one or more rings collapse inward. This obstructs the breathing passage to varying degrees, interfering with breathing and causing internal swelling and pain.
Weakened tracheal rings can be genetic or acquired. With the genetic form, collapse may occur at any rate but can be triggered by pressure and stress placed on the neck. The acquired form is linked to certain health issues including chronic respiratory disease, Cushing’s disease, and heart disease.
Occurrence Rate
Though not seen as often as hypoplastic trachea, collapsed trachea is an issue to be aware of.
Age of Onset
The acquired type can develop or occur at any age and the genetic type generally is apparent by the age of 6.
Symptoms
- A distinctive honking-type cough is the #1 sign and can be one of the most troubling symptoms. When coughing, the neck may be extended and a dog may take a stance with elbows spread as if struggling to cough something up. Generally, coughing progressively
- worsens.
- Trouble eating (gagging on or regurgitating food)
- Noisy breathing (gasping, rattling, or wheezing noises)
- Coughing, sometimes with mucus
- Gasping for breath
- Symptoms may be more apparent during/after exercise, when excited, or when breathing in cold air
- Cyanosis (gums turn blue; seen in severe cases)
- Collapse, fainting (seen in very severe cases)
- Aspiration pneumonia, as a secondary issue (regurgitated mucus is inhaled back into the lungs)
How This is Diagnosed
Most experienced veterinarians will recognize the honking-type cough and immediately suspect collapsed trachea. X-rays generally confirm this. In some cases, x-rays will be inconclusive; in these instances, if the clinical symptoms are there, a dog can still be treated for this. If you desire confirmation, you can ask for a fluoroscopy which allows real-time visualization of the trachea as a dog inhales and exhales.
With a diagnosis, the degree of collapse will be graded:
Grade I: The tracheal membrane hangs slightly, cartilage maintains normal shape, the tracheal opening (lumen) is reduced by approximately 25%.
Grade II: The tracheal membrane is widened and hanging, cartilage is partially flattened, the tracheal opening (lumen) is reduced by approximately 50%.
Grade III: The tracheal membrane is almost in contact with dorsal trachea (the opposite side of the windpipe), cartilage is nearly flat, the tracheal opening (lumen) is reduced by approximately 75%.
Grade IV: The tracheal membrane is lying on dorsal cartilage (is completely touching the opposite side of the windpipe), cartilage is flattened and may invert, the tracheal opening (lumen) is essentially closed.
Treatment; Non-Surgical
Ongoing studies show that improvement is seen with approximately 70% of dogs managed with a non-surgical treatment plan.
This includes:
1. Excess weight gain prevention/weight loss since obesity puts a strain on the respiratory system. With puppies, a plan will be put in place to prevent future issues of possible excess weight gain which includes careful monitoring of food intake and meeting exercise requirement. With older dogs, the veterinarian will speak to you about any excess weight that your Pug may be carrying and devise a weight loss plan if needed.
Helping a Pug lose weight
will involve a low-calorie diet. Depending on a Pug's capacity for physical activity, this may also involve low-cardio exercise such as slow walks several times per day.
2. Immediate discontinuation of a collar. Because collars sit right on the trachea, putting direct stress onto the area, these will never be worn again, either on or off leash. When a Pug is on a leash, a harness will be used instead. These leave the neck free and instead distribute pressure over the much stronger and more muscles chest, shoulders, and back. Details about harnesses are coming up under '
How to Help Prevent Tracheal Issues'.
3. Limiting over-excitement. This involves keeping stimuli that would normally get a Pug excited to a minimum to help prevent heavy breathing. Introductions to other dogs or people may need to be done in a calm, gradual way and such things as offering new toys, etc., should be done in a relaxed manner. Households should be kept peaceful (no yelling, no commotion, no chronic loud noises, etc.).
4. Avoidance of exercise during hot, humid weather; maintain exercise restrictions year-round. During the summer, activity may need to be limited or adjusted. Year-round, careful monitoring must be done to ensure that a dog is not overexerting himself.
5. A smoke-free, irritant-free household environment. There should be no smoking and no use of airborne cleansers or deodorizers. If pollen is a known issue running central air systems with a HEPA filter or using standalone air purifiers can help keep the air clean.
6. Bronchodilator, as needed.
7. NSAIDs (nonsteroidal anti-inflammatory drugs) such as Rimadyl or Etogesic can help with pain and inflammation.
8. Corticosteroids such as prednisone may be given, which works to reduce pain and inflammation. This may be given orally or via an inhaler. This is given short-term and with careful monitoring due to possible severe side effects. Even with short-term use, there can increased thirst or appetite and risk of susceptibility to infections.
9. Antibiotics, to treat or prevent aspiration pneumonia.
10. With severe cases in which breathing distress greatly interferes with quality of life, treatment does not offer relief, and surgery is not deemed viable, the veterinarian may recommend euthanasia.
Overview:
Surgery is an extraordinarily invasive and extensive procedure; all possible non-surgical treatments should first be implemented. Surgery involves using a mesh-type sleeve to reinforce the trachea, sometimes along with prosthetic polypropylene rings.
Prognosis:
The success rate of this surgery can be as high as 75%, though recovery is quite lengthy and there are serious risks including bleeding, laryngeal paralysis, and/or severe internal swelling that can be fatal. Dogs under the age of 6 are more likely to have a good prognosis.