Canine Collapsing Trachea

Can happen secondary to what two conditions

-chronic bronchitis

-heart failure

Key physical exam finding

-palpation on trachea may elicit a honk cough

Typical signalment

-small breeds: yorkie, pomeranians, chihs, pugs, etc

-older animals around 7 yrs

Typical clinical signs

-respiratory distress

-early signs: mild productive cough and exercise intolerance

-advanced signs: development of a honking cough, substantial exercise intolerance, and possible cyanosis

-dyspnea triggered by excitement or anxiety

-typically obese patients

Pathophysiology - causes

-can be a result of weak or redundant dorsal tracheal membrane

-cartilaginous rings become hypoplastic or fibrodystrophic

-if involving extrathoracic trachea (neck), trachea will collapse on inspiration

-if intrathoracic, will collapse on expiration

Diagnostic tools

-palpation of trachea incites severe coughing spasms → honking cough

-flattened trachea on radiographs

-fluoroscopy on awake patient in lateral recumbency is helpful

-endoscopy allows evaluation and visualization of bronchi which may be collapsing

Treatment steps

-id and treat any other primary condition affecting upper resp system

-conditions associated: stenotic nares, elongated soft palate, everted laryngeal saccules, laryngeal paralysis

-rule out concurrent cardiac disease

-if bronchial collapse is present, surgical treatment for tracheal collapse is less likely to be successful

-medical management can be the be best option for: weight loss, anxiolytics as necessary, bronchodilators if indicated

Surgical options (3 types)

1. dorsal tracheal membrane plication: if cartilage is normal can plicate the redundant tracheal membrane, only use for mild cases of collapse, not done commonly since mild cases are mostly medically managed.

2. intratracheal stenting: stent can fracture, collapse can occur proximal and distal to placement, can induce severe mucous and granulation tissue production, 80% success rate is used right

3. external support: surgeons have attempted to use long solid objects to externally support trachea: plastic rings partially around trachea, polypropylene syringe cases, teflon tubing, non consistent results