by Andrew Linklater, DVM, DACVECC
Tracheal collapse remains a challenging respiratory condition in small and toy‑breed dogs, presenting with a characteristic honking cough and progressive airway obstruction. As clinicians we are all too familiar with this condition’s impact on patient quality of life and the limitations of traditional medical management. While weight control, cough suppressants, bronchodilators, and anti‑inflammatory therapies continue to be first‑line for many patients, more severe disease often requires advanced intervention. One such intervention that has gained traction in recent years is intraluminal tracheal stenting—a minimally invasive, yet powerful tool in the right patient.
Veterinary Specialists of the Rockies is the only veterinary hospital in the southern Denver front range that has a Critical Care Specialist trained in tracheal stent placement with a supply of tracheal stents on hand. This means that nearly 80% of patients require only one anesthetic episode, and we can act quickly in emergency situations, minimizing complications and anesthesia time.
Tracheal collapse is caused by weakening of the tracheal cartilaginous rings and redundancy of the dorsal membrane, leading to dynamic airway narrowing during respiration. The condition is most prevalent in small breeds such as Yorkshire Terriers, Pomeranians, and Chihuahuas, and may occur across a range of ages. Diagnosis typically begins with thoracic radiographs, but dynamic imaging modalities such as fluoroscopy, computed tomography, or direct visualization with tracheobronchoscopy can be invaluable in defining the extent and location of collapse and in guiding therapeutic decisions.
When medical management fails to adequately control clinical signs, particularly in cases of intrathoracic collapse, intraluminal stent placement offers a rapid method to restore airway patency without surgery. Placement involves fluoroscopic or endoscopic guidance to deploy a self‑expanding metallic stent sized appropriately to the patient’s airway. This technique effectively splints the compromised tracheal lumen, often leading to immediate improvement in breathing effort and reduction of cough in many patients.
In some published reports, up to 95% of dogs exhibit immediate or marked improvement following stent placement. When patients do well within the first 2 weeks after intraluminal tracheal stent placement, the prognosis is quite impressive. The most recent reports on long term outcome have shown survival times of 2.7-5.2 years.
While outcomes can be favorable, its critical to recognize that intraluminal stenting is not without risks, underscoring the need for thorough client education and diligent follow‑up. Complications may include persistent or late‑onset cough, stent migration or fracture, granuloma formation, tracheobronchial infections, and inflammation of the trachea. Importantly, stenting does not negate the need for ongoing medical therapy and regular monitoring; rather, it complements existing strategies in appropriate cases.
Given this complexity, careful case selection and thorough pre‑procedure workups are critical. Concurrent disease—such as bronchial collapse, cardiac conditions, or inflammatory airway disease—should be identified and managed concurrently, as these can affect both prognosis and post‑stent quality of life. Multimodal management, including aggressive control of cough and airway inflammation, remains a cornerstone both pre‑ and post‑stent.
It’s valuable for general practitioners and referral partners to understand both the benefits and limitations of this intervention. Through collaborative care, we can better identify candidates who may benefit most from stenting and ensure seamless peri‑procedural and long‑term management. Ongoing research and shared clinical experience will continue to refine patient selection, procedural technique, and post‑placement care—ultimately improving outcomes for dogs suffering from this condition.
This is a sponsored content article from Veterinary Specialists of the Rockies. The views and opinions expressed are those of the sponsor and do not necessarily reflect those of CVMA.
