Tracheal Collapse in the dog: step by step from pathophysiology to management


Опубликован: Nov 17, 2017
D. PARDALI (Δ. ΠΑΡΔΑΛΗ)
A. K. ADAMAMA-MORAITOU (Α.Κ. ΑΔΑΜΑΜΑ-ΜΩΡΑΪΤΟΥ)
Аннотация

Tracheal collapse (TC) is one of the most common causes of cough in small and toy breed dogs. Collapse typically occurs in a dorsoventral direction with prolapse of the flaccid dorsal tracheal membrane into the lumen. TC may affect just a part of the trachea or its entire length. Collapse of the cervical trachea occurs on inspiration, while thoracic part collapses on expiration. Tracheal collapse is a chronic multifactorial disease. It has been suggested that genetic, nutritional, neurologic and inflammatory factors contribute to its pathophysiology. Cartilage rings appear hypocellular, while the dorsal tracheal membrane becomes thicker. The disease is most commonly recognized in middle-aged small and toy breed dogs. No sex predilection has been established. 

Dogs can be obese or not. Tracheal collapse has been rarely reported in large breed dogs, cats, horses and goats. Tracheomalaciarepresents the analogous disease in humans. In 81% of cases the presenting complaint is a dry, high pitched, goose honking, paroxysmal cough that worsens over time (chronic form), which may be accompanied by exercise intolerance and cyanosis. Various factors could exacerbate clinical signs, such as barking, excitement, drinking or eating. Few cases are presented with the acute form of the disease. Concurrent diseases may worsen or exacerbate clinical signs. The most common finding upon physical examination is the goose honking dry cough that is elucidated on tracheal palpation; flattened and collapsible tracheal rings may be also detected. A concurrent disorder may contribute to physical examination findings. Plain lateral radiographs of the neck and thorax contribute to the diagnostic evaluation of TC in dogs. Their sensitivity varies from 42,8% to 82%. Tangenital radiographs of the neck, as well as tracheal fluoroscopy and ultrasound, may be helpful in the diagnosis of TC. The gold standard method for the diagnosis and staging of TC is tracheoscopy. According to an established grading system it is divided into four stages, which are characterized by the degree of reduction (25%, 50%, 75% and 90%) of the dorsoventral diameter of the tracheal lumen. The major advantage of tracheoscopy is that it can also evaluate the morphology and function of other organs of the respiratory system and it can contribute to the diagnosis of a concurrent disease. Tidal breathing Flow - Volume loop acquisition is a recently standardized diagnostic method that seems to be a quick and reliable diagnostic tool for the diagnosis and staging of TC in dogs. One of its major advantages is that it is performed in alert and untrained dogs. Dogs that are presented with the acute form of the disease must be handled with caution and clinical evaluation should be postponed until their stabilization. Dogs with TC may respond to medical management, surgical correction or to the use of intraluminal stents. Physical examination findings, history and the general condition of the dog will all contribute to the decision of the appropriate therapeutic modality.

Article Details
  • Раздел
  • Review Articles
Скачивания
Данные скачивания пока недоступны.
Библиографические ссылки
Adamama-Moraitou ΚΚ, Pardali D, Athanasiou LV, Prasinos NN, Kritsepi M, Rallis Τ (2010) Conservative management of canine tracheal collapse with stanozolol: a double blinded, placebo control clinical trial. Int J Immunopathol Pharmacol: "in press"
Amis TC, Kurpershoek C (1986a) Tidal breathing flow-volume loop analysis for clinical assessment of airway obstruction in conscious dogs. Am J Vet Res 47:1002-1006.
Amis TC, Kurpershoek C (1986b) Pattern of breathing in brachycephalic dogs. Am J Vet Res 10:2200-2204.
Amis TC, Smith MM, Gaber CE, Kurpershoek C (1986) Upper airway obstruction in canine laryngeal paralysis. Am J Vet Res 47:1007-1010.
Bauer NB, Schneider MA, Neiger R, Moritz A (2006) Liver disease in dogs with tracheal collapse. J Vet Intern Med 20:845-849.
Baumann R (1941) Veber die Dorso-Ventrale Abplastung der Luftrohre. Beri Munch Tierartztl 37:445-447 (cited by Mason & Johnson 2004).
Bell R, Philbey AW, Martineau H, Nielsen L, Pawson P, Dukes-McEwan J (2006) Dynamic tracheal collapse associated with disseminated histiocytic sarcoma in a cat. J Small Anim Pract
:461-464.
Belli CB, Benesi FJ, Leal MLR, Nichi M (2003) Tracheal collapse in an adult goat. Can Vet J 44:835-836.
Buback JL, Boothe HW, Hobson PH (1996) Surgical treatment of tracheal collapse in dogs: 90 cases (1983-1993). J Am Vet Med Assoc 3:380-384.
Burton C (2003) Surgical diseases of the trachea in the dog and cat. In Pract (October):514-527.
Carden KA, Boiselle PM, Waltz DA, Ernst A (2005) Tracheomalacia and tracheobronchomalacia in children and adults: An in-depth review. Chest 127:984-1005.
Dallman MJ, McClure RC, Brown EM (1985) Normal and collapsed trachea in the dog: Scanning electron microscopy study. Am J Vet Res 10:2110-2115.
Done SH, Drew RA (1976) Observations on the pathology of tracheal collapse in dogs. J Small Anim Pract 17:783-791.
Ettinger S J, Kantrowitz B, Brayley Κ (2000) Diseases of the trachea. In: Ettinger S J, Feldman EC, eds. Textbook of Veterinary Internal Medicine. WB Saunders, Philadelphia: pp 1040-1055.
Fenger CK, Kohn CW (1992) Tracheal obstruction from tracheal collapse associated with pneumonia in a horse. J Am Vet Med Assoc 11:1698-1700.
Fujita M, Miura H, Yasuda D, Hasegawa D, Orima H (2004) Tracheal narrowing secondary to airway obstruction in two cats. J Small Anim Pract 45:29-31.
Gellasch KL, Da Costa Domez T, McAnulty JF, Bjorling DE (2002) Use of intraluminal nitinol stents in the treatment of tracheal collapse in a dog. J Am Vet Med Assoc 221:1719-1723.
Harvey CE, Fink EA (1982) Tracheal diameter: Analysis of radiographic measurements in brachycephalic and non-brachycephalic dogs. J Am Anim Hosp Assoc 18:570-576.
Hawkins EC (2003) Disorders of the trachea and bronchi. In: Nelson RW, Couto CG, eds. Small Animal Internal Medicine. 3rd ed. Mosby, St. Louis: pp 287-298.
Hedlund CS (1991) Tracheal collapse. Prob Vet Med 3(2): 229-238.
Hendricks JC, O'Brien JA (1985) Tracheal collapse in two cats. J Am Vet Med Assoc 4:418-419.
Hennet Ρ (1995) Periodontal disease and oral microbiology. In: Crossley DA, Penman S, eds. BSAVA Manual of Small Animal Dentistry. BSAVA, Gloucester: pp 105-113.
Herrtage ME, White RAS (2000) Management of tracheal collapse. In: Bonagura JD, ed. Kirk's Current Veterinary Therapy XIII: Small Animal Practice. WB Saunders Com, Philadelphia: pp 796-801.
Holt DA, Brockman D (2004) Laryngeal paralysis. In: King LG, ed. Textbook of Respiratory Diseases in Dogs and Cats. Saunders, St. Louis: pp 319-328.
Jerram RM, Fossum TW (1997) Tracheal collapse in dogs. Compend Contin Educ Pract Vet 9:1049-1060.
Johnson LR (2000) Tracheal collapse. Vet Clin Small Anim Pract 6:1253-1266.
Johnson LR (2001) Diagnosis and management of tracheal collapse in dogs. Waltham Focus 2:3-8.
Johnson LR, Fales WH (2001) Clinical and microbiologic findings in dogs with bronchoscopically diagnosed tracheal collapse: 37 cases (1990-1995). J Am Vet Med Assoc 9:1247-1250.
Johnson LR, Krähwinkel DJ, Mckiernan BC (1993) Surgical management of atypical lateral tracheal collapse in a dog. J Am Vet Med Assoc 203:1693-1696.
Johnson LR, McKiernan BC (1995) Diagnosis and medical management of tracheal collapse. Sem Vet Med Surg 2:101-108.
Kerr LY (1989) Pulmonary edema secondary to upper airway obstruction in the dog: A review of nine cases. J Am Anim Hosp Assoc 25:207-212.
Kim JY, Han HJ, Yun HY, Lee B, Jang HY, Eom KD, Park HM, Jeong SW (2008) The safety and efficacy of a new self-expandable intratracheal nitinol stent for the tracheal collapse in dogs. J Vet Sci 9:91-93.
Koch DA, Arnold S, Hubler M, Montavon PM (2003) Brachycephalic syndrome in dogs. Compend Contin Educ Pract Vet 25:48-54.
Macready DM, Johnson LR, Pollard RE (2007) Fluoroscopic and radiographic evaluation of tracheal collapse in dogs: 62 cases (2001-2006). J Am Vet Med Assoc 230:1870-1876.
Mason RA, Johnson LR (2004) Tracheal collapse. In: King LG, ed. Textbook of Respiratory Diseases in Dogs and Cats. Saunders, St. Louis: pp 346-355.
McCullough S, Brinson J (1999) Collection and interpretation of respiratory cytology. Clin Tech Small Anim Pract 4:220-226.
McKiernan BC, Dye JA, Rozanski EA (1993) Tidal breathing flowvolume loops in healthy and bronchitic cats. J Vet Intern Med 7:388-393.
McKiernan BC, Smith AR (1982) Bacterial isolates from the lower trachea of clinically healthy dogs. J Am Anim Hosp Assoc 20:139-142.
Moritz A, Schneider M, Bauer Ν (2004) Management of advanced tracheal collapse in dogs using intraluminal self-expanding biliary wallstents. J Vet Intern Med 18:31-42.
Murgu SD, Colt HG (2006) Tracheobronchomalacia and excessive dynamic airway collapse. Respirology 11:388-406.
Padrid PA, Amis TC (1992) Chronic tracheobronchial disease in the dog. Vet Clin Small Anim Pract 5:1203-1229.
Padrid PA, McKiernan BC (1999a) Endoscopy of the upper respiratory tract of the dog and cat. In: Tarns TR, ed. Small animal endoscopy. 2nd ed. Mosby Ine, St. Louis: pp 357-376.
Padrid PA, McKiernan BC (1999b) Tracheobronchoscopy of the dog and cat. In: Tarns TR, ed. Small animal endoscopy. 2nd edn. Mosby Ine, St. Louis: pp 377-396.
Pardali D (2008) Tidal breathing flow volume loop assessment for the diagnosis and staging of tracheal collapse in dogs. Doctoral Thesis. Aristotle University of Thessaloniki.
Pardali D, Adamama-Moraitou KK, Rallis TS, Raptopoulos D, Gioulekas D (2010) Tidal breathing flow-volume loop analysis for the diagnosis and staging of tracheal collapse in dogs. J Vet Int Med: (In press).
Payne JD, Mehler SJ, Weisse C (2006) Tracheal Collapse. Compend Contin Educ Pract Vet (May):373-382.
Radinsky MA, Fossum TW (2000) Tracheal collapse in a young boxer. J Am Anim Hosp Assoc 4:313-316.
Rha JY, Mahony Ο (1999) Bronchoscopy in small animal medicine: Indications, instrumentation and techniques. Clin Tech Small Anim Pract 4:207-212.
Rozanski EA, Hoffman AM (1999) Pulmonary function testing in small animals. Clin Tech Small Anim Pract, 14: 237-241.
Rudorf H, Hentage ME, White RA (1997) Use of ultrasonography in the diagnosis of tracheal collapse. J Small Anim Pract 11:513-518.
Rush B, Mair Τ (2004) The trachea. In: Rush B, Mair T, eds. Equine respiratory diseases. Blackwell Science Ltd, Oxford: pp 145-155.
Rush JE (1999) Syncope and episodic weakness. In: Fox PR, Sisson D, Moïse NS, eds. Textbook of Canine and Feline Cardiology. WB Saunders Comp, Philadelphia: pp 446-454.
Salisbury SK, Forbes S, Blevins WE (1990) Peritracheal abscess associated with tracheal collapse and bilateral laryngeal paralysis in a dog. J Am Vet Med Assoc 8:1273-1275.
Siger L, Hawkins JF, Andrews FM, Henry RW (1998) Tracheal stenosis and collapse in horses. Compend Contin Educ Pract Vet 5:628-635.
Sisson D, Kvart C, Darke PGG (1999) Acquired valvular heart disease in dogs and cats. In: Fox PR, Sisson D, Moïse NS, eds. Textbook of Canine and Feline Cardiology. WB Saunders Comp, Philadelphia: pp 536-565.
Smith MM, Gourley IM, Amis TC, Kurpershoek C (1990) Management of tracheal stenosis in a dog. J Am Vet Med Assoc 196:931-934.
Spodnick GJ, Nwadike BS (1997) Surgical management of extrathoracic tracheal collapse in two large-breed dogs. J Am Vet Med Assoc 211:1545-1548.
Tangner CH, Hobson HP (1982) A retrospective study of 20 surgically managed cases of collapsed tracheas in dogs. Vet Surg 11:146-149.
White RAS, Williams JM (1994) Tracheal collapse in the dog: Is there really a role for surgery? A survey of 100 cases. J Small Anim Pract 35:191-196.
Yamamoto Y, Ootsuka Τ, Atoji Y, Suzuki Y (1998) Morphological and quantitative study of the intrinsic nerve plexuses of the canine trachea as revealed by immunohistochemical staining of protein gene product 9.5. Anat Ree 250:438-447.
Наиболее читаемые статьи этого автора (авторов)