Tracheal Collapse in Dogs

Tracheal collapse is a relatively common cause of coughing in small breed dogs. Affected dogs may begin to show signs of coughing and respiratory difficulties as early as 6 to 12 months old. In most cases, however, tracheal collapse does not become apparent until the dog is middle-aged or older. 

Read on to learn more about tracheal collapse in dogs, including why it occurs and how it can be diagnosed and managed.  

What is Tracheal Collapse in Dogs?

Tracheal collapse refers to a narrowing of the trachea (windpipe). This is a relatively common condition in small-breed dogs, and it is most commonly reported in Yorkshire Terriers, Pomeranians, Shih Tzus, Chihuahuas, Lhasa Apsos, and Toy Poodles.

The trachea is a hollow tube that carries air from your dog’s mouth and nose to the lungs. In a normal, healthy dog, the trachea is held open by round cartilage rings. These rings go approximately three-fourths of the way around the trachea, and support the trachea much like tent poles support a tent. The remaining one-fourth of the trachea is covered by a thin membrane, which stretches between the two ends of the cartilage rings. This tubular structure allows the trachea to remain open, directing air to the lungs without any obstructions. 

In a dog with tracheal collapse, however, the trachea becomes narrowed. This narrowing is caused by two factors. First, the rings of cartilage are too weak to maintain their normal, round shape. Weakened tracheal rings can be compressed by external pressure or by sucking forces within the trachea, flattening the trachea and making it harder for a dog to breathe. Additionally, the membrane that stretches between the tracheal rings can also become weakened, causing it to sag or bulge into the trachea. This further interferes with the flow of air, worsening a dog’s respiratory difficulties. 

Dog Tracheal Collapse Symptoms

The most common sign of tracheal collapse is intermittent coughing. You might notice this coughing when your dog is excited, barking, exercising, or panting. Some dogs with tracheal collapse cough when eating or drinking, while others cough when pressure is placed on the throat (such as when the dog pulls against its collar). Many veterinarians and pet owners describe the cough associated with tracheal collapse as a “goose honk” cough, because of its characteristic honking sound. The cough may also be mistaken for vomiting, because it sometimes ends in a gag or retch. 

You may see other signs of respiratory issues. These may include increased respiratory rate, increased respiratory effort (struggling to breathe), increased breathing sounds, and an inability to exercise for long periods of time. In severe cases, tracheal collapse can cause life-threatening respiratory distress when a dog becomes excessively excited, anxious, or overheated. 

Signs of tracheal collapse in dogs may include: 

• Cough brought on by exercise or excitement
• Cough associated with eating or drinking
• Coughing when pressure is placed on the throat
• Shortness of breath
• Increased respiratory effort 
• Noisy breathing sounds
• Exercise intolerance
• Acute episodes of respiratory distress

Stages of Tracheal Collapse in Dogs

Tracheal collapse can be divided into four separate grades or stages: 

• Grade I: The tracheal membrane sags but the cartilage maintains its normal shape. The trachea is narrowed by approximately 25%. Most dogs with Grade I collapse have few, if any, respiratory symptoms at home or on a veterinary exam. 
• Grade II: The tracheal membrane sags and the cartilage is partially flattened. The trachea is narrowed by approximately 50%. Dogs with Grade II tracheal collapse often show symptoms, such as coughing and wheezing. 
• Grade III: The tracheal cartilage is nearly flattened and the tracheal membrane sags so dramatically that it periodically touches the opposite side of the trachea. The trachea is narrowed by 75%. These dogs experience severe symptoms and require urgent treatment. 
• Grade IV: Cartilage is flattened or inverted, with the tracheal membrane almost completely obstructing the trachea. Grade IV tracheal collapse is untreatable and often fatal. If your dog has Grade IV tracheal collapse, your veterinarian may talk to you about when to euthanize a dog with tracheal collapse.

Tracheal collapse is a progressive disease. Dogs that start with Grade I tracheal collapse may progress to Grade II or Grade III over time. Fortunately, Grade IV tracheal collapse is uncommon. 

What Causes Tracheal Collapse in Dogs?

We don’t know exactly what causes tracheal collapse in dogs.

Most cases of tracheal collapse are suspected to have an underlying genetic component. While we haven’t yet identified the exact genes that are responsible for this condition, tracheal collapse appears to be a hereditary condition in predisposed small breed dogs. 

However, tracheal collapse does occasionally occur in unexpected breeds. In these cases, the condition may be caused by the environment, underlying health conditions, and other factors. 

Diagnosing Tracheal Collapse in Dogs

A thorough physical exam is the first step in diagnosing tracheal collapse. Your veterinarian will listen closely to your dog’s heart and lungs and press gently on your dog’s trachea to elicit a cough. Your veterinarian may also recommend screening laboratory tests, to look for heartworm disease and other potential causes of illnesses. 

Next, your veterinarian will likely recommend X-rays. Images taken at specific points during your dog’s breathing cycle may clearly show the tracheal narrowing that accompanies tracheal collapse. Additionally, X-rays allow your veterinarian to rule out other heart and lung diseases that may cause coughing. 

If your dog’s X-rays do not provide clear evidence of tracheal collapse, your veterinarian may refer you to a specialist for more advanced testing. Fluoroscopy and/or endoscopy can be more accurate in diagnosing some cases of tracheal collapse, although these tests are more expensive and not always necessary for every patient. 

Tracheal Collapse in Dogs Treatment

Treatment for tracheal collapse in dogs typically involves using medication to manage (not cure) the condition. Your veterinarian may prescribe cough suppressants, corticosteroids (such as prednisone), bronchodilators, and even sedatives in an attempt to reduce your dog’s signs of tracheal collapse. 

If your dog is experiencing an acute episode of respiratory distress due to tracheal collapse, hospitalization may be required. An emergency veterinarian will administer oxygen therapy, along with injectable medications to aid your dog’s breathing. 

In severe cases, surgical treatment may be needed. This surgery is only performed by specialists, so your veterinarian will refer you to a veterinary surgeon at a specialty practice or veterinary teaching hospital. Surgical treatment of tracheal collapse requires placing a stent that will help hold the trachea open and allow smooth airflow. 

Managing Tracheal Collapse in Dogs

While medication is a mainstay of treatment for most cases of tracheal collapse, there are also lifestyle changes that you can make at home to help minimize your dog’s symptoms. 

Keep your dog at a healthy weight. Overweight and obese dogs have more fat surrounding their trachea. This can increase pressure on the trachea, worsening symptoms of tracheal collapse. 

Use a harness when walking your dog, instead of a collar. Neck collars place pressure on the trachea, which often triggers coughing in dogs with tracheal collapse. A harness distributes pressure across your dog’s chest, limiting pressure on the trachea. 

Avoid smoke and other airborne irritants, such as scented candles and strong cleaners. Many dogs with tracheal collapse are sensitive to these irritants, and they may trigger coughing episodes that can worsen signs of tracheal collapse. 

How long can a dog live with tracheal collapse? It depends on the severity of the dog’s tracheal collapse and your ability to manage their condition. Many dogs with mild tracheal collapse go on to live long, relatively normal lives. 

How to Prevent Tracheal Collapse in Dogs

There is no guaranteed way to prevent tracheal collapse in dogs. However, if you have a small-breed dog that is predisposed to tracheal collapse, keeping them at a lean weight and limiting your use of neck collars may help reduce the risk of this condition.