Diagnosis and Treatment for Collapsing Trachea in Pets

What is Collapsing Trachea in Pets?

Collapsing trachea is a condition where the collagen rings that support the trachea are weakened, leading to the flattening or complete collapse of the trachea. The trachea allows air to pass from the lungs outwards, and where new air is brought into the lungs, so any restriction of the trachea can cause breathing difficulties. There is no known cause of tracheal collapse, but it is thought that many small dogs are genetically predisposed to it. Almost 65% of Yorkshire terriers will be diagnosed with the disease.

Symptoms and Signs of Collapsing Trachea in Your Pet

Common symptoms of collapsing trachea include:

• Coughing (dry or “honking”)
• Difficulties breathing
• Vomiting
• Gagging
• Retching
• Cyanotic episodes (when the pet’s gums or tongue turn blue or purple)
• Wheezing

Activities like drinking water, exercise, excitement, barking, very cold or hot temperatures, obesity, pressure on the throat, pollutants in the air, and humidity can all play a factor in how serious the symptoms become.

Diagnosing Collapsing Trachea In Pets

Veterinarians must take into account many factors when diagnosing tracheal collapse, including the common symptoms. A variety of diagnostics are required - such as taking x-rays for the most accurate diagnosis; performing a tracheoscopy or bronchoscopy, which involves passing an endoscope through the throat and breathing passages respectively to view them; and doing a fluoroscopy - during which an injection may be given so that doctors may look at it on video. 

Performing bloodwork, a urinalysis and testing for heartworm will help to determine a diagnosis, as tracheal collapse can also be concurrent with other conditions, such as heart disease, obesity, liver enlargement, dental problems, an elongated soft palate, and conditions of the larynx (voice box).

There Are Four Levels of Severity in Collapsing Tracheas

Treatment for collapsing trachea varies depending on the severity of the collapse. For mild cases (grades 1 or 2) treatments aim to preserve the airway and keep the patients calm, so that episodes are mild and rare.

Common Treatment Options for Collapsing Trachea

There are a number of medications and treatment options that are commonly prescribed by veterinarians for mild to moderate collapsing trachea. Which medications and treatments will be prescribed are based on your pet’s symptoms and the severity of the condition.

Some common medications that are prescribed for collapsing trachea are:

• Antibiotics (e.g., doxycycline, azithromycin)
• Cough suppressants (e.g., Hydrocodone bitartrate)
• Steroids (e.g., prednisone)
• Bronchodilators (e.g., theophylline)
• Sedatives (e.g., acepromazine)
• Supplemental oxygen (e.g., Pawprint Oxygen)

Prognosis of Collapsing Trachea

Tracheal collapse is a progressive disease - this means that, over time, the cartilage will continue to break down, causing patient's symptoms to worsen over time. Severe cases may require surgery for the insertion of a stent which keeps the airway open or to keep it from closing off entirely. Thankfully, there are some steps that can be taken in order to slow this disease's progression and maintain a good quality of life for your pet.

Preventing Collapsing Trachea in Your Pet

While there is no way to completely prevent or cure collapsing trachea in your pet, certain breeds are genetically predisposed to the disease. Knowing if your pet’s breed is susceptible to collapsing trachea may allow you to diagnose the disease earlier, take the appropriate measures to extend the life of your pet, and access medication from your veterinarian sooner, rather than waiting.

Collapsing trachea has a higher prevalence in small-breed and toy-breed dogs, including:

• Yorkshire terriers
• Pugs
• Shih tzu
• Chihuahuas
• Toy Poodles
• Pomeranians

Cats and large dogs can also suffer from collapsing trachea, but it is a more rare diagnosis in these groups.

Tracheal Collapse and the Importance of Supplemental Oxygen

Tracheal collapse episodes are commonly described as a "vicious cycle". Once a pet starts to bark or cough or breath heavier than normal, their already narrowed tracheal opening can become irritated and swollen, making breathing even more difficult. As the pet starts having trouble breathing, panic causes them to try to breath harder, which also causes irritation, and the lumen starts to become narrower due to swelling. If the episode continues, there is a chance that the trachea can collapse completely, creating an emergency situation.

During an episode of a dynamic obstruction (collapsing trachea), depending on the specific condition, medications such as sedatives or bronchodilators coupled with oxygen can break this vicious cycle, returning the pet to their normal breathing.

If medications and oxygen therapy do not resolve the episode then portable rescue oxygen can be continued during transport to a veterinary hospital where additional treatment can be provided for the collapsing trachea episode.