Collapsing Trachea in Dogs: Honking Cough, Causes, and Treatment

What happens in a collapsing trachea

The trachea, or windpipe, carries air from the throat to the lungs. It is held open by C-shaped rings of cartilage. The rings do not form full circles, and the gap at the top is closed by a thin membrane.

In a collapsing trachea, the cartilage rings soften and flatten, and the membrane at the top can sag into the airway. The windpipe narrows, so less air gets through, especially during breathing in or out. Collapse can affect the part of the trachea in the neck, the part inside the chest, or both. In severe cases, it extends into the smaller airways of the lungs, called the bronchi.

Coughing makes the problem worse. Each cough knocks the weakened airway walls together, which irritates them and causes more coughing. If this cycle is not broken, the airway can become blocked for a time and the dog can struggle to breathe.

Which dogs are affected

Collapsing trachea is most common in toy and small breeds, such as Yorkshire Terriers, Pomeranians, Chihuahuas, toy Poodles, Maltese, Shih Tzus and Lhasa Apsos. It can occasionally affect larger dogs. Most affected dogs are middle-aged or older, although young dogs can be affected too.

The exact cause is unknown, and genes may play a part. Several things make signs more likely or more severe.

• Being overweight
• Heart disease
• Other airway or lung disease, especially chronic bronchitis
• Living with tobacco smoke or other airborne irritants

If you have a small breed, our guide to the Chihuahua covers other health problems common in toy dogs.

Signs to watch for

The main sign is a persistent, dry, harsh cough, often described as a goose honk. Other signs include the following.

• Coughing when the dog is picked up, or when it pulls on its collar
• Coughing when excited, or right after eating or drinking
• Coughing that is worse at night or in hot, humid weather
• A wheezy noise when breathing in
• Tiring quickly on walks or during play
• Labored breathing

Not every cough in a small dog is a collapsing trachea. Kennel cough, heart disease and other airway problems can sound similar, and some dogs have more than one problem at once. Reverse sneezing is also often mistaken for coughing, and our guide to reverse sneezing in dogs explains the difference.

Common triggers

Many dogs with a collapsing trachea have a pattern to their coughing. Knowing your dog's triggers helps you avoid them.

• Pressure on the neck from a collar and leash
• Excitement, stress and barking
• Exercise, especially in heat
• Hot, humid weather
• Smoke, dust, strong sprays and other airway irritants
• Eating or drinking

When it is an emergency

A bad coughing spell can turn into a breathing emergency. Take your dog to a vet or an emergency clinic immediately if you notice any of these signs.

• Struggling to breathe, or breathing with obvious effort from the belly
• Blue or purple gums or tongue
• Fainting or collapse
• A coughing fit that will not stop
• Noisy breathing that keeps getting worse

On the way, keep your dog as calm and cool as you can. Heat makes breathing problems worse, and our guide to heatstroke in dogs explains how to keep dogs safe in warm weather. At the clinic, a dog in breathing distress is stabilized first, often with oxygen and medication, before tests are done.

How vets diagnose it

Your vet will ask about the cough and examine your dog. Gentle pressure on the windpipe often triggers the typical honking cough. Your vet will also listen carefully to the heart and lungs, because heart disease can cause a similar cough and can occur alongside a collapsing trachea.

Tests confirm the diagnosis and look for other problems.

• Blood tests to check general health
• Chest and neck X-rays, which rule out other conditions but can miss the collapse because they capture only a single moment
• Fluoroscopy, a moving X-ray that shows the airway changing shape as the dog breathes
• Airway endoscopy, also called bronchoscopy, done under general anesthesia, which gives the best view and allows samples to be taken to check for infection
• A heart ultrasound if heart disease is suspected

If your vet hears a heart murmur, our guide to mitral valve disease in dogs explains a common heart problem in small breeds.

Medical treatment

Most dogs start with medical management, and it may help up to 70 percent of dogs, especially those with mild collapse. Your vet will choose treatment based on your dog's signs. It may include the following.

• Cough suppressants to break the cough cycle
• Sedatives or calming medication for dogs whose coughing is triggered by excitement or anxiety
• Anti-inflammatory medicines, such as corticosteroids, when needed
• Bronchodilators, which open the smaller airways
• Antibiotics if there is an infection

Treatment is usually lifelong. Signs often come and go, and doses may need adjusting over time. Many dogs with a collapsing trachea also have liver problems, so your vet may check liver values from time to time. Never give human cough medicines without your vet's advice.

Daily care at home

What you do at home matters as much as medication.

• Use a harness instead of a collar. Attach the leash to the harness so that walks put no pressure on the throat. A collar can still carry ID tags.
• Help your dog reach a healthy weight. Weight loss is one of the most important parts of treatment. In a small dog such as a Yorkshire Terrier, losing a quarter to half a pound can make a noticeable difference.
• Avoid smoke. Do not smoke around your dog, and keep it away from fireplaces, strong sprays and dusty places.
• Plan walks for the cool early morning or evening in summer, and keep your dog in a cool room on hot, humid days.
• Run a humidifier in winter, when heating dries the air.
• Keep greetings and play calm, and avoid situations that make your dog bark for long periods.
• Keep a simple diary of coughing spells and their triggers to share with your vet.

Our guide to overweight dogs and cats explains how to check your dog's body condition and plan safe weight loss with your vet.

Surgery and stents

When medication no longer controls the signs, or a dog has breathing emergencies, a procedure to hold the airway open may be recommended. These procedures are done by specialist surgeons or interventional teams.

• Extraluminal rings. Supports are placed around the outside of the trachea and stitched to it. They are mainly used for collapse in the neck.
• Intraluminal stents. A spring-like mesh tube is placed inside the trachea without a skin incision. Stents can treat collapse in the neck or the chest.

Both options help many dogs. According to the American College of Veterinary Surgeons, about 75 percent of dogs improve after rings, and about 90 percent are clearly better at follow-up after a stent. Both also carry risks. Rings can damage the nerves of the voice box, which may need emergency surgery. Stents can irritate the airway, cause scar-like tissue to grow, break or move. Most dogs still cough to some extent after either procedure and need medication for life. Dogs older than six years, or with disease of the voice box or smaller airways, tend to have more complications.

Outlook

A collapsing trachea is progressive, so signs usually change over a dog's lifetime. Many dogs with mild collapse do well for years with weight control, a harness, a calm routine and medication when needed. Dogs that also have heart disease or other airway problems tend to have a harder time. Regular checkups help your vet adjust treatment before a crisis.

Small rescue dogs with a cough

Small breeds and senior dogs often come into rescue, and some of them already have a honking cough. At Paw Squadron, every dog we rescue goes to the vet for a checkup and deworming before adoption. A collapsing trachea does not have to stand in the way of a happy home. With a harness, a healthy weight and a quiet routine, many of these dogs live comfortably. If your newly adopted dog coughs, ask your vet to check whether it is kennel cough, which is common after time in kennels and shelters, or a long-term airway problem. Our guide to kennel cough in dogs explains the signs.

For more health guides, browse PawPedia. If you adopted a dog from us and have questions, write to us from the Contact page.