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RESPIRATORY -

TRACHEAL COLLAPSE

INTRALUMINAL TRACHEAL STENT

Tracheal collapse refers to narrowing and collapse of the cartilages of the wind pipe (trachea) which occurs with long term degenerative changes.  Patients with tracheal collapse are graded 1-4 based on the degree of narrowing.  Grade 1 patients are 25% narrowed, and Grade 4 patients are 100% narrowed.  The collapse occurs when the patients attempt to breath inwards, and is similar to sucking a thickshake through a straw. 

Tracheal collapse occurs in middle-aged, toy and small breed dogs, with Yorkshire Terriers, minature Poodles, Pomeranians and Chihuahuas being commonly reported.  Clinical signs may be apparent in young patients, but as the condition progresses the patients breathing becomes more affected and may lead to an increase in coughing, difficulty breathing, turning blue (cyanosis) and collapse.  The cough reported with tracheal collapse is classical for the condition and is a dry "goose-honking" cough, which occurs in episodes, and is worse during activity or excitement.  Early presentation and treatment will minimise the secondary degenerative changes and maxmise the long-term outcome.

Medical management of tracheal collpase may be trialled initially with anti-cough medication, bronchodilators and anti-inflammatories, but should the response be poor then intervention may be required.  Management of tracheal collapse has improved with the advent of intra-luminal stents which hold the trachea open.  The length of the trachea which is able to be stented is limited, and collapse of the trachea at either end of the stent and brochi is irreversible. 

Complications are uncommon but may be severe, with collapse beyond the edges of the stented area being a significant cause of major complications causing intractable coughing and ongoing respiratory difficulty.  Stent movement, stent breakage, or infection are also reported but infrequent.  Some of these complications are able to be managed with medication, but some can be fatal.