Tracheal collapse is most common in toy and miniature breeds of dogs and rare in cats. The aetiology is unknown. Affected animals have a non-productive, honking, chronic cough, and inspiratory or expiratory dyspnea. Frequently they are obese and may have concurrent cardiovascular or other pulmonary disease (especially chronic bronchitis). Weight loss (if obese) is critical in management. Other measures include exercise restriction, reduction of excitement and stress, and medical therapy, eg, antitussives, antibiotics, bronchodilators, and corticosteroids. 

What is tracheal collapse?
Tracheal collapse is a common cause of airway obstruction in dogs. The trachea, or “windpipe,” is a tube made up of sturdy rings of cartilage through which air is transported to and from the lungs. Sometimes, however, the tracheal rings begin to collapse, and as air is squeezed through, a characteristic honking cough results.

Why tracheal collapse occurs is unknown, although a congenital abnormality, in which the cartilage of the tracheal rings is less cellular and therefore weaker than normal, is suspected.

What are the signs of tracheal collapse?

In addition to a honking cough, other signs that may be seen include exercise intolerance, laboured breathing and a bluish tinge to the gums. The cough and other signs may be provoked by excitement, eating, drinking, tracheal irritants (smoke or dust), obesity, exercise and hot and humid weather.

What breeds/ages are prone to tracheal collapse?
The condition, which is genetic, primarily affects toy breeds of both sexes, with Yorkies by far the most commonly affected. Collapsing trachea can manifest at any age, though the average age when clinical signs begin to appear is six to seven years.

How is tracheal collapse diagnosed?
A honking cough in a toy-breed dog is highly suggestive of collapsing trachea, but a definitive diagnosis may require additional tests. Radiographs may reveal an obviously collapsed trachea, although not always. Fluoroscopy, which allows visualization of the trachea as the dog inhales and exhales, may be necessary to confirm the diagnosis. Fluoroscopy is available only at universities and referral centres.

How is tracheal collapse treated?
Most cases of tracheal collapse are treated with cough suppressants, bronchodilators, corticosteroids (to control inflammation), and/or antibiotics. In obese patients, weight loss helps decrease respiratory effort. Although treatment is not curative, a study released in 1994 showed that 71 percent of dogs treated medically showed a good long-term response.

If medical management produces no response in two weeks, or if severe signs compromise the pet’s functionality, surgery is recommended. Various surgical techniques have been described, but the application of prosthetic polypropylene rings to the outside of the trachea is the current treatment of choice, with an overall success rate reported to be in the 75- to 85-percent range. In general, the outcome of surgery is poorer for dogs older than six years. It is a tricky, specialized surgery that is best performed by a skilled surgeon, usually at a referral centre.

What else can pet guardians do if their dog has a collapsed trachea?
Whether medical or surgical treatment is chosen, pet owners can help relieve signs by keeping their pet’s weight down (even slightly under is ideal), switching from a collar to a chest harness, and avoiding respiratory irritants.

Key Points

  • Collapsing trachea results when the tracheal (windpipe) cartilages soften.

  • A diagnosis of the tracheal collapse is based on history, physical examination and x-rays

  • Treatment may include medical therapy in the early phases and surgery in the more advanced stages of the disease.

  • Prognosis can be favourable with therapy.

What is it? 
Collapsing trachea occurs most often in middle-aged to older dogs. The diagnosis is suggested by a honking cough that starts from excitement, activity or water drinking. This is usually a non-productive cough, and can occur without any stimulus. 
Collapsing trachea results when the tracheal (windpipe) cartilages soften. 
The trachea should resemble a relatively firm garden hose. Viewed on end, the trachea is a U-shaped structure with a tight membrane covering the top. Where cartilage softens, it collapses and widens at the top. The membranes then drapes (collapses) loosely blocking the inside of the “hose”. This results in an inability to bring air into o rout of the trachea and lungs during breathing. 

Clinical Signs
Signs vary with the severity of the collapse and may include mild to severe panting, respiratory distress and cyanosis (a bluish colour to the gums). 
The dog may also “belly breath” (abdominal breathing) which can cause tense abdominal muscles. These dogs are frequently overweight, but may thin. 

The diagnosis of collapsing trachea, initially historical, is substantiated when your veterinarian can cause your pet to cough by digital manipulation of the neck area. 
Radiographs (x-rays) identify changes in the trachea during both breathing in and breathing out. 
Scoping of the trachea may be indicated in some cases to help identify the extent of the tracheal collapse 

When treating the effects of collapsing trachea, multiple medications may be used. Medications can not reverse the changes that have occurred to the trachea, but can help make your pet more comfortable. During the acute phase, respiratory distress and severe bouts of coughing are treated with medication that relax the trachea and lung and sedate your dog.

  • Short-term anti-inflammatory medications help decrease the swelling and irritation in the trachea and airways. 

  • Antibiotics are given if there is an infection. 

  • Cough suppressants are usually derived from narcotics and help suppress the cough, but can also sedate your pet significantly. 

  • Surgical correction of a collapsing trachea may be considered when medical therapy is not effective. Surgery involves suturing plastic rings around the trachea, which then keep the airway open. 

  • Obesity can complicate collapsing trachea by increasing the effort that your pet exerts to breath. The additional weight adds to the work you pet must do to move as well as increasing the amount of fat in the abdominal cavity pressing on the lungs. Weight control is very important and without weight loss in an obese animal, the medications can not work as well as they would otherwise. 

  • A harness should be used instead of a collar. 

The prognosis remains good for many pets with early developing tracheal collapse, but the condition can be a serious, life-threatening problem when severe respiratory distress occurs. Repeated bouts of severe coughing and respiratory distress would give a poorer prognosis. 


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