Tracheal (windpipe) collapse is characterised by the dorsoventral (top to bottom) flattening of the tracheal rings with a laxity of the dorsal tracheal membrane. It is thought there is an intrinsic weakness of the tracheal rings, resulting from a reduction in glycoprotein and glycosaminoglycan content of the hyaline cartilage of the tracheal rings. There is a reduced capacity of the cartilage to retain water and this consequently diminishes the rigidity of the rings. The syndrome causes dogs to cough with varying degrees of breathing difficulty. Clinical signs of this condition can be seen in young adults through to older toy or miniature breeds, with the Yorkshire Terrier the commonest breed seen with this problem. Any section of the trachea can collapse, a common region being the thoracic inlet, where the neck meets the thorax (chest). Once signs of coughing have developed, the syndrome of tracheal collapse is perpetuated by the cycle of chronic inflammation of the tracheal mucosa (lining).
Treatment should always start with medical therapies used singularly or in combination, such as the use of anti-inflammatories, anti-tussive (cough suppressants), short courses of antibiotics or bronchodilators. Patients should always be exercised using a harness and dogs carrying excess weight should be encouraged to reduce their body condition. For the majority of dogs the medical management alone is enough to control their clinical signs. However, tracheal collapse is a progressive condition and for some dogs their breathing difficulty is severe and quality of life poor even with all the medical treatments on board.
Is there any other option of management?
YES – for those dogs that have exhausted medical managements, at Northwest Surgeons we have the ‘know-how’ and technology to place self expanding tracheal stents. The stents are made of nickel and titanium and are delivered by a thin catheter system directly into the trachea using fluoroscopy (real-time x-ray imaging). Measurements are taken prior to stent placement to determine the tracheal lumen size and length of collapse. The stents are made by Infinti Medical in the US and are shipped to Northwest Surgeons within a week. So, no surgery required, very short anaesthesia time and often home the same day.
A stent immediately restores an open lumen to the collapsed section of the trachea. The patient can breath easily. Some patients will still have a cough as there are irreversible changes within the tracheal lining and some do require more long term medications to reduce inflammation. However, most patients with stents placed can partake again in the day to day activities they have not be able to do for years and can cope with situations that stimulate excitement without the constant worry to owners of a life threatening respiratory crisis.Feature, General