Tracheal Collapse in Dogs - Causes, Treatment and Associated Conditions

Key takeaways

Tracheal collapse (TC) in dogs is a progressive condition affecting the trachea (windpipe).

The trachea is held open by cartilage rings and TC describes weakening of the cartilage which results in narrowing of the windpipe, leading to obstruction of the upper airway
Symptoms include chronic, ‘honking’ cough, often brought on by pulling on the lead or excitement and sometimes sudden difficulty breathing
Investigation involves physical examination and diagnostic imaging including X-rays, fluoroscopy, or endoscopy
Treatment depends on severity, which is is graded from 1 to 4 depending on the percentage of collapse
Low grade TC often responds to weight and exercise management; moderate TC benefits from medication; severe TC sometimes requires surgery
Prognosis depends on the grade of TC, but is usually good with ongoing monitoring and management

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A closer look: Tracheal Collapse in Dogs

TC varies significantly in severity. Most cases are inherited and are usually diagnosed in young animals. While TC is a progressive condition, many cases cope well for many years with lifestyle and medical management.

TC is graded from 1 to 4 depending on severity of the decrease in diameter:

Grade 1 = 25% reduction
Grade 2 = 50% reduction
Grade 3 = 75% reduction
Grade 4 = 100% reduction

Dogs with high grade TC progress to sudden onset fainting, difficulty breathing, or airway obstruction. Dogs with symptoms of TC benefit from prompt veterinary attention. Dogs with breathing difficulties or airway obstruction require emergency treatment.

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Risk factors

Symptoms of tracheal collapse vary depending on the grade of severity.

-Grade 1 TC presents with coughing fits and exercise intolerance. -Grades 2 and 3 progress to severe coughing and increasing obstruction of the airway resulting in fainting episodes. -Grade 4 TC can quickly become fatal without veterinary intervention.

TC is an inherited condition seen primarily in toy and small breed dogs. TC is occasionally seen in large breed dogs.

Additionally, certain risk factors can exacerbate the condition by putting additional strain on the respiratory system, or irritating the airways. These include:

Overweight/obesity
Exposure to respiratory irritants (cigarette smoke, aerosols)
Walking or tied on leash by a neck collar/lead

Possible causes

The underlying disease mechanism behind TC involves an inherited weakness of the cartilage rings that maintain the tracheal diameter. Weakening of the rings results in flattening of the cartilage and reduction in the diameter of the trachea.

Main symptoms

The cough in cases of TC has a characteristic ‘honking’ sound, often induced by excitement or pulling on the lead.

Testing and diagnosis

Investigation of TC involves:

Physical examination
Blood work
X-rays
Fluoroscopy (dynamic x ray)
Endoscopy - visualization of the trachea with a camera

Steps to Recovery

Treatment varies depending on severity. Options may include a combination of:

Lifestyle factors:

Weight management
Exercise management
Use of a harness rather than a collar
Avoiding irritants such as cigarette smoke, aerosols, humidity

Medications:

Cough suppressants
Anti inflammatories
Antibiotics
Airway dilators
Sedatives
Anti anxiety medication

Surgery: Placement of implants to maintain tracheal diameter. Medication to control coughing is usually still necessary in cases of surgical correction.

Prognosis varies significantly depending on grade. TC progresses throughout life and often requires lifestyle and medical management. Most dogs maintain a good quality of life with appropriate treatment.

Dogs with higher grade TC often require surgical treatment. Surgery aims to improve airflow and prevent airway obstruction. Most dogs improve with surgery in terms of airflow but the complication rate is high. TC is fatal in a minority of dogs.

Regular monitoring of clinical signs and follow-up veterinary visits including diagnostic imaging is usually required for ongoing management of dogs with TC.

Prevention

Since the condition is genetic, prevention of the condition is not possible. Prevention of symptoms in diagnosed cases involves lifestyle changes such as: