Respiratory - Tracheal Collapse

Question 1

What is the definition of tracheal collapse

Answer 1

dorsoventral flattening of the tracheal rings

Question 2

2 etiologies of tracheal collapse

Answer 2

Primary - cartilage rings deficient in glycosaminoglycan, chondroitin and Ca
Secondary - increased pressure/mechanical forces on trachea in association with other chronic resp diseases

Question 3

T/F: tracheal collapse most common in cats

Answer 3

False, primarily affects dogs and is rare in cats

Question 4

Signalment of tracheal collapse

Answer 4

small breeds, middle aged to older

yorkies, Pomeranians, poodle, maltese, chihuahua, pug

Question 5

Which is FALSE regarding tracheal collapse?
A) collapse of cervical trachea occurs during expiration, collapse of thoracic trachea occurs during inspiration
B) overstretching of the dorsal tracheal membrane causes inflammation
C) Severe collapse can cause dyspnea and is life threatening
D) coughing exacerbates collapse and leads to more inflammation

Answer 5

A - collapse of cervical trachea occurs during inspiration, collapse of thoracic trachea occurs during expiration

Question 6

Clinical signs of tracheal collapse

Answer 6

chronic honking cough is most common
often precipitated by pressure over trachea, excitement/activity, or drinkingwater
coughing episodes/paroxysms often terminate with a retch or ‘gag”
exercise intolerance, dyspnea, excessive panting, cyanosis, syncpe

Question 7

PE findings of tracheal collapse

Answer 7

cough easily elicited with tracheal palpation
honking or rattling sounds during panting
auscultation over trachea may reveal stridorous sounds
snapping or crackles noted if concurrent small airway or parenchymal disease present
dogs with moderate-severe PH may have right apical systolic murmur
DMVD is common so a left apical systolic murmur may be present
may be hyperthermic

Question 8

Which of the following is FALSE regarding diagnosis of tracheal collapse?
A) a lateral view rad should be taken during inspiration, expiration and coughing
B) a normal trachea on rads rules out tracheal collapse
C) bronchoscopy can help investigate for concurrent lower airway disease
D) The only abnormality may be presence of a redundant dorsal trachea membrane

Answer 8

B - it is a dynamic condition so a normal appearing trachea on still radiographs doesn’t rule out TC

Question 9

Medical therapy of tracheal collapse

Answer 9

cough suppressant, life long - goal is to prevent as much coughing as possible, medication given regularly
corticosteroids
antibiotics if secondary bacterial infection suspected
sedation for events known to cause excitement or stress
bronchodilator may be helpful

Question 10

Intraluminal stenting/surgical prostheses

Answer 10

reserved for patients with life threatening dyspnea or patients that fail medical therapy
are not curative and are not risk free
many patients will still require lifelong daily meds

Question 11

Prognosis of tracheal collapse

Answer 11

patients whose clinical signs are well controlled can survive for years
moderate-severe CS can not be well controlled, may be euthanized