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Collapsed Trachea

Maltese Collapsed Trachea

Overview

Collapsed trachea is a condition of weakened and damaged tracheal rings. Unfortunately, this is a common issue with many toy breed dogs, including the Maltese. 

Dogs of all ages may be affected; however, the average age of onset is 6 years old. While this is considered a generic condition, acute injury or long-term wear on the neck can trigger this or lead to tracheal damage. 

In this section, we will cover:
  • What this is
  • Symptoms
  • Diagnosing
  • Treatment options
  • Prevention

What This Is

To understand what collapsed trachea does to a Maltese, first let's go over the anatomy of the dog's neck. 

The trachea, also called the windpipe, is a flexible tube that runs down the dog's throat. It is surrounded by rings of cartilage. This is the means by which air travels to the lungs.

The esophagus runs parallel to the tracheal tube and this is how food travels to the stomach. 
maltese-windpipe-anatomy
With collapsed trachea, the cartilage rings are damaged. For some dogs, this congenital disorder is so severe that tracheal collapse may occur without any triggers. 

In other cases, the inherent weakness leaves a dog vulnerable to certain triggers. Being overweight is one, though very rarely seen with the Maltese breed. Other triggers include nutritional deficiencies, chronic disease, and injury. 

With injury, pressure (either acute severe pressure or minor but long-term pressure) can cause damage to weakened rings. One of the top causes is stress placed on the neck when a Maltese is on leash and collar.
maltese-drawing-tension-on-neck
When the ring(s) collapse, this is quite literal. One or more will crush inward. 
normal-tracheal-ring-is-round
damaged-tracheal-ring-is-crushed
Normally, the tracheal rings are round; this allows for proper air flow to the lungs. 
With collapsed trachea, the ring(s) are crushed and flattened. Depending on the extent, this causes minor to very severe breathing issues. 

Symptoms

The most common signs are:
  • Coughing - This is often referred to as a goose-like honking noise. 
  • Noisy breathing - There may be raspy sounds or wheezing
  • Trouble breathing - A Maltese may gasp and have trouble catching his breath
Symptoms may worsen during exercise, during hot weather, and/or when the dog is excited.

In severe cases there may be:
  • Cyanosis - gums turn blue due to lack of air
  • Fainting

Diagnosis

In many cases, an experienced veterinarian will immediately suspect collapsed trachea based on the dog's particular cough. However, in any event, diagnostic tests will be run. This includes:
  • X-rays - This can be a helpful diagnostic tool; however, in some cases it is inconclusive.
  • Fluoroscopy - This is a continuous series of very low dose x-ray images that allow veterinarians to see real-time moving images of a dog’s internal breathing structures. Note that this is currently only available at some universities and specialized animal clinics. 
  • Endoscopy - A small fiber optic camera is inserted into the trachea. 
The extent of the collapse will be determined. If your Maltese is diagnosed with collapsed trachea, be sure to ask the veterinarian what grade has been given, since this will come into play if surgery is recommended. 

Grade 1: Minimal, 25% of the airway is obstructed
Grade 2: Moderate, 50 % of the airway is obstructed
Grade 3: Severe, 75% of the airway is obstructed
Grade 4: 100% complete collapse

Treatment

Symptomatic, non-surgical treatment:

This is the first treatment option, applicable to most grade 1 and 2 cases and has shown to be effective up to 70% of the time. This includes:
  • Eliminating a collar. This is to avoid any stress on the neck. A Maltese will wear a harness from this point on (which is recommended as a preventative measure, more ahead)
  • Avoiding triggers. Both temperature extremes, hot and cold, can worsen coughing and breathing issues, and should be avoided. Heavy extended exercise is avoided as well. 
Once a Maltese recovers, he can still be taken for walks and enjoy being outside. However, exercise times may need to be adjusted to avoid the hottest parts of summer days, the coldest parts of winter days, and pace may need to be slowed down. 
  • Medications. There are several types of medications that may be prescribed. This includes cough suppressants, anti-inflamatories, pain medication, and antibiotics. 
  • Only with overweight dogs, which rarely applies to the Maltese breed, weight loss is recommended. 
Surgical treatment:

Typically, if a Maltese has grade 3 and certainly for grade 4 collapsed trachea, surgery is recommended. In addition, if a dog has not responded to non-surgical treatment after a 4 to 8 week week time frame or if the dog's condition has worsened, this may also be recommended. 

The procedure involves placing prosthetic polypropylene rings to support the trachea. This has been shown to be successful 75 to 85% of the time, with the best prognosis for dogs under the age of 6 years old. 

Since this is such a major surgery and is not always effective, this is not something to be rushed into and time should be given for non-surgical treatment options to work. 

Prevention

1. This is a genetic disorder; therefore, any dogs found to have collapsed trachea should not be bred. 

2. To help prevent the trigger of stress on the trachea, do not place your Maltese on leash and collar. With a collar, any and all tension and pressure is placed directly on the puppy or dog's neck. This includes any time he pulls ahead on the leash, jumps up, or lunges to the side.

Even a heavy metal connector or heavy leash can be pulling on the neck. 

If, however, you use a leash and harness, this eliminates this concern. 
prevent-maltese-collapsed-trachea
A good fitting harness will displace any pressure to the shoulders, back, and chest, which are much stronger and able to handle leash pressure. The neck is free from potential injury with this option. 

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