Collapsing Trachea

Question 1

What is a common secondary cause of a collapsing trachea?

Answer 1

cardiopulmonary disorders - heart failure, chronic bronchitis

Question 2

What signalment is predisposed to developing a collapsing trachea?

Answer 2

small breeds around 7 y/o +/- obese

• Yorkies
• Pomeranians
• Chihuahuas
• Pugs

Question 3

What are early and advanced signs of a collapsing trachea?

Answer 3

EARLY - mild productive cough, exercise intolerance, dyspnea caused by excitement

ADVANCED - honking cough, substantial exercise intolerance, cyanosis

Question 4

What is the pathogenesis behind primary tracheal collapse?

Answer 4

weak or redundant dorsal tracheal membrane causes the cartilaginous rings to become hypoplastic or fibrodystrophic

Question 5

How does the location of the tracheal collapse affect the collapse?

Answer 5

EXTRATHORACIC - collapses on inspiration

INTRATHORACIC - collapses on expiration

Question 6

What are 4 options for diagnosing tracheal collapse?

Answer 6

1. palpation of trachea incites a severe coughing spasm –> HONKING
2. flattened trachea on radiographs
3. fluoroscopy on an awake patient
4. endoscopy allows visualization of bronchi

Question 7

What is the first major step to possibly treating tracheal collapse?

Answer 7

• identify and treat other primary conditions of the upper respiratory system, like stenotic nares, elongates soft palate, everted laryngeal saccules, laryngeal paralysis
• rule out concurrent cardiac disease

Question 8

What medical management is recommended for tracheal collapse? When is this preferred?

Answer 8

• weight loss
• anxiolytics
• bronchodilators

bronchial collapse –> when surgery is less likely to be successful

Question 9

What are 3 surgical options for treating tracheal collapse? When are the performed?

Answer 9

1. dorsal tracheal membrane plication - normal cartilage, mild cases
2. intratracheal stenting (80% success!)
3. external stenting with plastic rings, polypropylene syringe cases, or teflon tubing

Question 10

What are 3 complications associated with intratracheal stenting?

Answer 10

1. stent fracture
2. tracheal collapse proximal or distal to stent placement
3. severe mucous and granulation tissue production

Question 11

What treatment is commonly preferred overall for tracheal collapse?

Answer 11

medical management initially due to overall low success rates associated with surgery