DIAGNOSIS:
Collapsing trachea - mild
HISTORY:
Mia, a 5 year old female, spayed papillon, presented to OSU-VTH as a referral for collapsing trachea. In April, Mia was seen by _____________who performed thoracic radiographs and diagnosed collapsing trachea. She has been having increased respiratory sounds (raspy exhalation) and she also had some exercise intolerance. The loud, raspy breathing occurs after Mia has been playing or walking; no coughing was noted. She vomits foam once in a while. She is otherwise eating, drinking, and defecating fine. She is on heartworm prevention and current on vaccinations. Mia lives with another dog, apparently healthy.
Wt: 3.9 kg T: 102.1 F HR: 88/min RR: 40/min MM: pink, moist CRT: < 2 sec
Mia was bright, alert, and responsive on presentation. Her eyes and ears were clear. Her heart asculted with no arrhythmias or murmurs and her femoral pulses were strong and synchronous. Her lungs ausculted with normal bronchovesicular sounds, with no crackles or wheezes. On palpation of the trachea, a cough could be repeatedly and consistently elicited. No abnormalities were found on abdominal palpation. Mia's submandibular, prescapular, and popliteal lymph nodes palpated of normal size and consistency. Upon abdominal palpation, no pain was elicited and no masses or organomegaly were noted. While in the exam room, she became excited and her raspy, increased respiratory sounds were noted.
DIAGNOSTICS:
1. Chemistries: AST 92 (15-66), Potassium 3.4 (3.6-5.5), Na/K ratio 43 (27-38), CPK 2,347 (59-895) - not clinically significant
2. CBC/Differential: Platelets 507 10^3/mL (170-400) - not clinically significant
3. Urinalysis: all within normal range
4. CO2: within normal range
5. Thoracic Radiographs: final report pending. On preliminary examination, there are no evidence of bronchitis, pneumonia or severe tracheal collapse.
6. Thoracic Fluoroscopy: final report pending. On preliminary examination, findings consistent with mild tracheal collapse
ASSESSMENT:
Mia's thoracic radiographs and thoracic fluoroscopy imaging show signs of mild tracheal collapse. Tracheal collapse is
common in small and miniature dog breeds and its cause is unknown, although a genetic predisposition is suspected.
The diagnosis is usually made based on clinical signs, history, radiologic and fluoroscopic findings. Unfortunately, there is no treatment but it can be managed with medical treatment (cough suppressants, antinflammatory, bronchodilators, antibiotics for eventual secondary bacterial infections). The stent placement is only recommended for those patients with extremely severe clinical signs which cannot be controlled with the medical treatment.
Mia's tracheal collapse and clinical symptoms are mild, but she should be monitored for non-productive cough (goose honking sound), worsening of her exercise intolerance, labored breathing, or a blue tinge to her gums due to a lack of proper oxygenation. If these signs are seen, initiation of medical treatment would be recommended.
RECOMMENDATIONS:
1. Please restrict Mia's activity so as to avoid any episodes of increased respiratory effort.
2. Continue to monitor Mia's respiration for signs of worsening trachea collapse such as goose honking, labored breathing, increased exercise intolerance, or blue tinged gums.
