Tracheal Collapse in dogs: Treatment Options and when Euthanasia might be the kindest choice

Tracheal collapse is a progressive condition that affects a dog’s trachea (windpipe), leading to coughing, difficulty breathing, and distress. Tracheal collapse most commonly affects small breed dogs such as Yorkies, Pomeranians, and Chihuahuas. Normally, the trachea is held open by rings of cartilage. In dogs with tracheal collapse, the rings are soft and flatten over time, causing obstruction of the trachea. In some dogs, the condition is mild, leading to an occasional cough when excited, but in other dogs, the condition can progress to a nearly constant cough and severe difficulties breathing.

There are medical and surgical options for dogs with tracheal collapse. We’ll discuss the pros and cons of each option. Every case is different and what might be right for one dog, might not be right for every dog.

As a hospice and palliative care doctor, my goal is always this: regardless of the path you choose, to make sure your dog’s time here on this Earth is full of love and happiness. If your options are confusing, or you aren’t sure how to know when it’s time for euthanasia, don’t hesitate to schedule a comprehensive teleconsult with one of our doctors.

Treatment Options for Tracheal Collapse

Below we will discuss the various treatments used in tracheal collapse. Which treatment is best depends on many factors, which we’ll discuss below.

Medical management

1.Cough suppressants:

• • • Cough suppressants like hydrocodone and butorphanol help control the cough and reduce irritation of the trachea. Sometimes they are used temporarily to control a flare-up, and sometimes they used long-term.
    • Cough suppressants are relatively safe and effective, but they can be mildly sedating and in some cases they eventually become ineffective.

2. Bronchodilators:

• • • Bronchodilators like theophyilline can help open the airways, helping air to move freely with less turbulence.
    • Bronchodilators generally need to be combined with other therapies.
    • In some dogs they can occasionally cause increased heart rate, agitation, tremors, or gastrointestinal upset.
    • They may not be safe to use in dogs with heart disease or hypertension.

3. Steroids:

• • • Steroids are potent anti-inflammtories that can reduce swelling and inflammation of the trachea and bronchi.
    • They can be given orally, but some dogs can have side effects when oral steroids are given long term
    • There are inhaled steroids (for example, fluticasone) that may be effective in some dogs while minimizing side-effects associated with oral steroids.

4. Sedatives:

• • • Sedatives such as trazodone are occasionally used in tracheal collapse to help dogs whose flare-ups are related to anxiety.

5. Oxygen therapy:

• • • If your dog is having difficulty breathing, we recommend taking them to the hospital immediately where they can be stabilized. However, if your dog has advanced tracheal collapse, it can be a good idea to have an oxygen canister on hand like ones made by Pawprint oxygen so that you can start giving them oxygen right away. But if it’s this severe, don’t wait to go to the hospital.

Environmental management for tracheal collapse

1.Weight management:

• • • Maintainning your dog at a healthy weight can help improve breathing and comfort in mild to moderate cases

2. Use a harness, not a collar:

• • • Use a harness instead of a collar to avoid putting pressure on the trachea.

3. Environmental management:

• • • Keeping the home free of dust, smoke, and strong fragrances can help reduce airway irritation in dogs with tracheal collapse.

Surgery (stent placement) for tracheal collapse

For severe cases, placing a stent in the trachea to help hold it open may be an option. This procedure is reserved for dogs in whom medical and environmental management have failed and the dog is still having significant quality of life issues.

Pros:

• • • In some dogs, may provide dramatic improvement and long term relief
    • May be the only alternative to euthanasia

Cons:

• • • Complications including breakage and migration of stent are common, which can worsen the situation
    • Regular follow up is required to monitor for complications
    • Some dogs may not be good candidates for surgery due to other health issues
    • Can be expensive

How to Know When to consider Euthanasia

One of the hardest decisions you may have to face is deciding when it’s time for euthanasia. Because tracheal collapse is progressive in many cases, it’s important to monitor quality of life and plan ahead for when the condition becomes too severe to manage.

I highly recommend making a comprehensive end of life care plan for your dog before the disease becomes too advanced. Similar to an advanced directive in a human, you want to address important care questions like:

• If it comes down to it, would you pursue surgery?
• Do you have a plan in case of a respiratory emergency?
• Would you hospitalize your dog in oxygen in case of a respiratory emergency, or would you choose euthanasia if that happened?
• What are the objective set of criteria you will chose for when to elect euthanasia so your dog does not suffer at the end?
• Do you want to ensure your dog has a home euthanasia and does not pass in an emergency situation?
• Is everyone in your family comfortable with this plan?

It is much easier to make these decisions when you are in a relatively calm frame of mind. When we are facing an immediate crisis of possibly losing our pets, it’s easy to make the wrong decisions in a panic. I’ve made this mistake myself.

I also recommend keeping a daily journal of your dog’s quality of life in a journal. I recommend simply putting a smile for a good day and a frown for a bad day. The journal can also be a place where you write new memories you made with your cat each day. It is important when facing the end of life to live in the moment and cherish every single day.

Our comprehensive quality of life scale can help you assess your dog’s quality of life. This quiz can be taken once to give you a snapshot of your dog’s quality of life, or taken multiple times to assess trends over time.

Finally, for most owners, I recommend making the decision before there is a respiratory emergency that requires them to be rushed to the hospital. No one wants to see their beloved dog struggle to breathe and passing away from suffocation. If you can do this, you can ensure your dog has a peaceful and happy last day without knowing the severe suffering that can come at the end-stage of tracheal collapse.

When you are starting to see more bad days than good days, it’s a good time to give them a beautiful send-off. When clients wait too long, they often end up having to rush their beloved dog to the emergency room for euthanasia.

Signs That Euthanasia May Be the Kindest Option in dogs with tracheal collapse:

• Constant or near-constant coughing despite medications: When you feel like your dog is coughing constantly, or even the slightest bit of stimulation sets off a coughing fit, it may be time to consider euthanasia.
• Recurrent respiratory distress: If your dog is starting to struggle to catch their breath and treatments are no longer working, it may be time to choose euthanasia rather than risk your beloved dog dying from being unable to breathe.
• Panic or anxiety related to difficulty breathing: If your dog is getting to the point where they are constantly anxious because they are worried about their breathing, their mental health may be suffering and it may be time to consider euthanasia.
• Inability to enjoy normal activities such as walking, playing, or eating comfortably.

Conclusion

I hope this guide has helped you make the best decisions for your dog diagnosed with tracheal collapse. Regardless of what treatments you pursue, the most important goal is ensuring your dog remains as comfortable and happy as possible.

If you are not sure what to do and would like more guidance and support, we offer comprehensive teleconsults with compassionate veterinarians. We will review all your dog’s medical records and history, discuss all your options, and help you formulate the most compassionate and loving plan for your family.

And when it does come time, Paws at Peace offers in-home euthanasia to help your dog pass peacefully at home, surrounded by family. Home euthanasia can provide your dog with a gentle and dignified transition without the stress of a veterinary visit.