Overview 

Tracheal collapse is a progressive disease of the trachea (windpipe) that causes chronic coughing. This is common in toy and small breed dogs such as Yorkshire Terriers, Pomeranians and Toy Poodles that are middle-aged or older. 

There is no cure for tracheal collapse, but ongoing medical management can improve clinical signs and quality of life. This condition can worsen over time, and in severe cases, may become a respiratory emergency requiring surgical intervention.  

Cause 

The trachea is a flexible tube supported by rings of C-shaped cartilage that hold the airway open during breathing and other movements. Tracheal collapse is caused when the cartilage rings weaken — flattening them and narrowing the airway. The underlying cause is suspected to be due to multiple unspecified factors, but a genetic component may be involved since small-breed dogs are most commonly affected.  

The collapse can occur in one or more sections along the length of the trachea. In severe cases, the collapse can extend into the bronchi (the lower airway leading into the lungs). Stress, excitement, physical activity, heat and humidity, inhaled irritants (such as smoke) or pressure on the neck can exacerbate coughing. Chronic airway inflammation may occur from ongoing coughing and predispose affected dogs to lung infections.  

Clinical signs 

The most common sign of tracheal collapse is a persistent, harsh and dry cough, sometimes described as a “goose-honking” cough.  

The signs may progress to a wheezing noise when breathing in, or in severe cases, difficulty breathing, gums or tongue turning blue, or fainting. These more severe signs would indicate a respiratory emergency, and you should seek veterinary care for your dog immediately.

Coinciding medical conditions such as obesity, heart disease and other airway diseases can also contribute to these more severe signs.  

Diagnosis 

Your veterinarian will perform a physical exam and likely recommend blood work to assess your dog’s overall health.  

Often, a cough can be easily elicited from gently palpating the throat of dogs with tracheal collapse, but confirming a diagnosis may require one or more of the following tests: 

• X-rays: These images are often taken to help diagnose tracheal collapse or other causes of coughing, but they might not always detect tracheal collapse. This is because X-rays are a snapshot in time, and the trachea can collapse during inhalation or exhalation.  

• Fluoroscopy: Also known as moving X-rays, this is a type of specialized imaging that can show the trachea during inhalation and exhalation to diagnose where collapse is occurring and its severity.  

• Bronchoscopy: While the dog is under general anesthesia, this test uses a fiber optic camera to go inside the trachea and airway, allowing the clinician to directly visualize the dog’s airway as they’re breathing. This test can also collect fluid samples to check for infection.  

Treatment 

Many patients respond well to medical management, which may include any of the following: 

• Cough suppressants  

• Sedatives or anti-anxiety medications 

• Corticosteroids  

• Bronchodilators 

• Antibiotics, if infections occur 

In a respiratory emergency, dogs with tracheal collapse require immediate attention by a veterinarian, oxygen therapy, as well as the medications listed above.  

Any underlying health conditions contributing to worsening clinical signs, such as obesity and heart disease, must also be addressed.  

Lifestyle adjustments include switching from neck collars to harnesses, avoiding respiratory irritants like cigarette smoke, and avoiding hot and humid environments.  

A surgical procedure may be considered when dogs do not respond to medical management or when they experience respiratory emergencies. The procedure involves placing a stent within the trachea to help prevent collapse, and this operation is performed by a board-certified veterinary surgeon. A tracheal stent is not without potential risks, and often medical management needs to continue after surgery.  

Outcome 

Most dogs with tracheal collapse will continue to have progressive signs throughout their life. The prognosis for tracheal collapse depends on the severity of the disease and the dog’s response to medical management. While there is no cure for tracheal collapse, many dogs, especially those with mild disease, will respond well to medical management.  

Some individuals may eventually stop responding to medical treatment and require surgery or other interventions. Surgery is not a substitute for ongoing medical management, but it can help prevent respiratory emergencies. Dogs with additional underlying medical conditions, such as heart disease, may have a poorer long-term outcome.