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COLLAPSING TRACHEA

The trachea, also known as the windpipe, is an important structure which connects the throat to the lungs. It is composed of 35- 45 C-shaped rings of cartilage that are joined by muscle and ligaments to create a tube-like structure. It serves the purpose of directing air into the respiratory tract.

When the cartilage rings are flattened from the top to the bottom, the trachea is said to be collapsed. Rapid inhalation of air can cause the trachea to flatten and make it difficult for air to enter the lungs, much like a soda straw being drawn on too vigorously.

Why does it happen?

We do not completely understand how this condition develops. However, we know that these dogs have an abnormality in the chemical makeup of their tracheal rings. The rings loose their stiffness so they are not able to retain their circular shape. We also know that it occurs in certain breeds of dogs, notably Chihuahuas, Pomeranians, Shih Tzus, Lhasa Apsos, Toy Poodles, and Yorkshire Terriers. Because of that, it is suspected that there is a genetic factor involved.

What are the signs?
Collapsing trachea or Reverse sneezing

With reverse sneezing the pharynx (back of the throat) goes into spasms. The dog finds it difficult to draw in air through the spasms, so it stands still, stretches out her neck, and thrusts its elbows out (like a bowlegged bulldog) as it honks, wheezes, or snorts. Often eyes open wide. The spasms will stop if she swallows a couple of times.

•Close off her nostrils with your fingers so it has to breathe through its mouth for a few seconds.
•Gently rub its throat. This works for some.
•Distract it by carrying the dog outside into the fresh air.

Young puppies can reverse sneeze, but the first episode typically occurs in late adolescence. Stay calm and get it to swallow with one of the methods described above. In a few seconds to a minute, it will run off to play. Reverse sneezing is a harmless phenomenon which needs no vet consultation and no medical treatment whatsoever. It is very common in toy breeds.

Other signs, however, will help you distinguish the two conditions:
If it makes these sounds when excited or after eating or drinking, or turns her elbows outward and extends its neck and gasps inward with a rhythmic snork! snork! snork!, this is reverse sneezing.
If it breathes through the mouth sometimes, or breathes with a raspy sound, or coughs reflexively when you simply rub its throat, it could have a collapsing trachea. If the cough is one or two expulsive outward bursts (forcing air through the trachea to open it), typically with a gag or empty retch at the end, she could have a collapsing trachea.

The most common clinical sign of collapsing trachea is a chronic cough. It is often described as dry and harsh and can become quite pronounced. The term "goose honk" is often used to describe it. Coughing is often worse in the daytime and much less at night. The cough may also begin due to excitement, pressure on the trachea (from a leash), or from drinking water or eating.

How is collapsed trachea diagnosed?

Many times, very light pressure placed on the trachea during the physical examination can raise a suspicion of collapsed trachea in a small dog with a persistent dry cough. While the information gained from the physical examination is helpful, other tests are needed to confirm this condition.
X-rays of the chest can identify the trachea and its shape. However, a collapsed trachea changes its diameter during the respiratory cycle. It is usually collapsed during inhalation and normal during exhalation. Therefore, attempts to make radiographs during both phases of respiration should be made.
Endoscopy is another way to see the trachea. An endoscope is a tube that is small enough to be inserted into the trachea. By watching the trachea during inspiration and expiration, abnormal collapsing can be seen. Unfortunately, tracheal endoscopes are expensive and not available at every veterinary hospital.

How is it treated?

Collapsed trachea can be treated medically or surgically. Some dogs respond well to:

• bronchodilators and various types of anti-inflammatory drugs.
•chemical cough suppressants
•a bronchodilator (typically the drug aminophylline) to keep the bronchial tubes open in extreme cases that are affecting the lungs
•The trachea of these dogs is easily infected, so antibiotics are usually part of the treatment.
•If obesity is present, weight loss is often beneficial.
•Excitement and vigorous exercise are likely to cause a relapse, so they should be avoided as much as possible.

Because medical therapy only treats the symptoms and not the problem, these dogs are always subject to recurrences of coughing and breathing difficulty.

•surgery. The above tests are used to determine how much of the trachea is collapsed. If the only abnormal part is that segment between the throat and the point where the trachea enters the chest (the thoracic inlet), surgery may be curative. However, if the segment of the trachea that is within the chest cavity is abnormal, surgery is not likely to be helpful because that part is not accessible to the surgeon. There are several surgical approaches that have been used. Each approach implants an artificial support device that is secured around or within the trachea. The purpose of the support device is to hold the tracheal rings in their normal, open position. Although some dogs have excellent results and are truly cured of the disease, the outcome is not uniformly successful.

Natural ways to treat your Yorkie:

•Fresh foods, keeping the amounts low for weight reduction. Fat dogs have a much harder time breathing.
•Vitamin C
•Vitamin E
•Exercise reduction. Don't stop exercise completely -- just don't let get to the point where the dog is panting heavily, especially when older. Remove all pressure from the throat. No collars, and use a harness that wraps around the chest and stomach, never around the throat. Tell visitors not to rub the throat.
•A cool-mist humidifer to keep the air moist and easy to breathe.
•Glyco-flex and Glucosamine are nutritional products packed with minerals, amino acids, enzymes, and lubricating agents. They build cartilege and help heal damaged connective tissue. These are natural products with no side effects. They are inexpensive and last a very long time, so you have absolutely nothing to lose by trying them.
•Herbal cough remedies, if coughing is really bad.

For more information visit Mary Kay Keppler's article on collapsing trachea

Sources
•Aminal Clinic Collapsing trachea in the dog Retrieved February 1998 from the WWW http://www.animalclinic.com/colltrac.htm
•Potter, Clayton Dr. Heartland Veterinary Hospital Retrieved February 1998 from the WWW http://www.hcis.net/heartlandvet/trachcol.htm
•Chihuahua Kingdom Retrieved February 1998 from the WWW http://3lbdogs.com/wellness/
•Richard, Michael, DVM Q&A-Dr Mike Retrieved February 1998 from the WWW http://www.vetinfo.com/Q&A.html
•Seranne, Ann (1980) The Joy of Breeding Your Own Show Dog New York Macmillian Publishing Company.