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Peter Bennett, DVM
Peter Bennett, DVM, Veterinarian
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Experience:  20 years experience as a Small Animal veterinarian
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My 13 yr old pug has a collapsing trachea. He coughs a lot,

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My 13 yr old pug has a collapsing trachea. He coughs a lot, especially at night. The meds my vet have given him barely soothe the cough, but when he isn't coughing he breathes okay (typically puggy snorty breathing). The vet also put him on "bed rest" four weeks ago--no playing, walks (except to potty) etc. We are walking him again( we make sure he doesn't go too fast or far)--he was miserable w/o the play and walk time even though we loved on him instead. We don't see anymore coughing after a walk around the block (sometimes less for a while). Can you suggest anything else we can do to ease the cough. Have asked this already this evening, but would like someone with a vet med background to respond.
Submitted: 8 years ago.
Category: Dog
Expert:  Peter Bennett, DVM replied 8 years ago.

I know you have been to your vet about this, but I'm not aware of how conclusive the diagnosis is, nor what other possibilities have been considered and ruled out.

A collapsing trachea can occur in either the neck region, or the thoracic region of the trachea. Has it been determined just where the collapse is occurring? For that matter, is it demonstrated to be a collapse and not external pressure on the trachea?

I presume this is a relatively recent development? While this is usually a problem starting at a young age, due to a developmental shortcoming of the trachea, it can show up in later years as a structural deterioration of the trachea.

A suddenly appearing, gradually increasing cough may be due to pressure on the trachea from an internal source. An enlarging heart can press and collapse the trachea as it passes the enlargement. As can a tumor in the area. An increase in weight may suggest a fatty buildup further crowding the space in the chest. Or even a problem with the lungs, unless something other has been demonstrated as the cause.

I wish there was a universal cough suppressant to suggest, but so far we are somewhat restricted to using whatever may be available and applicable to the cause of the problem. A true collapsing trachea responds poorly to any sort of cough medicine (unless there is some relief from easing the irritation of constant coughing). That particular cough is in response to the body's impression that there is something 'foreign' in it's airway. In a way, there actually is.

Unfortunately, if there is a physical component to the cough, elimination of the cause will likely be the most successful source of relief... and maybe the only one without some sort of modification of his life style.

I hope this is of some help, none the less.
Customer: replied 8 years ago.

Recent x-rays shows no swelling of the heart or area. The trachea is narrower at the bend where the neck joins the chest, this was discovered many years ago when he had to have x-rays after swallowing a cat toy whole. Tumors have never been brought up by the vet and we've been told that they really don't recommend surgery (He will be 14 later this year). He's also trimmer than most pugs, (we even took him hiking with us for years) and only gained a little weight (about 2lbs) in the last 4 weeks (since the vet said no exercise). We've decreased his food intake a little to compensate and he has lost a bit of the weight gained. We did start taking him on short walks again (10 minutes) during the cool part of the evening. We make sure that he doesn't get winded and the cough has not gotten worse after the walk. Would "home remedies" for soothing a sore throat/cough hurt him? I'm referring to honey w/lemon or honey w/cayenne, etc., not OTC human medication.


We're pretty much resigned to the fact that his health will continue to deteriorate given his age and diagnosis--we'd like to get a little more sleep at night and relieve the stress on his body. I know from personal experience that a constant cough can cause additional lung/bronchial issues in a human and it makes sense to me that it would be the same in any animal.




Expert:  Peter Bennett, DVM replied 8 years ago.
Hi again,

Thank you for the additional information. I think it would be safe to conclude that there has been no evidence pointing to a definite diagnosis of his problem.

Permit me to offer my reasons for saying so, while realizing that there may yet be information you haven't remembered, or thought significant enough to bring up. (One of the major problems with this type of discussion... plus, client's vets don't always reveal all their thoughts, either, and you suddenly find yourselves in a crack between two people trying to be helpful.)

The nature of the cough from a stereotypical collapsing trachea is that it suddenly occurs when the dog starts short, rapid when excited... and which stops just as quickly, as soon as the dog quiets itself. It produces a loud honking sound, non productive cough. A CT cough, a bronchial cough, and a pneumonic cough all have a different sound. Often this is enough to direct the observer to the source.

If this cough presents at other times, under different circumstances, one is tempted to look to a different diagnosis, even in the face of apparent evidence to the contrary. I'm referring to the narrowed trachea you mentioned. A narrowing at the thoracic inlet is not unusual, and does not a CT make.

It is difficult to demonstrate a typical collapsing trachea ( CT for short, if agreeable?) by x-ray since it doesn't 'collapse' except under certain conditions. It can be demonstrated (if present) generally after several x-rays have been taken... if the vet and techs have been successful in creatively recreating the respiratory conditions that cause it to collapse in 'normal' situations. Or, a examination could be done to visualize it. Without either of these, it is not a conclusive diagnosis.

Further, there may be yet another cause for a cough that happens outside the parameters of a CT cough. Dogs with CT do occasionally get pneumonia, or congestive heart failure. (neither of which appear to apply in your case) Might your dog have been exposed to some sort of irritant which has sensitized his lungs to otherwise mild irritants?

You suggest that coughing episodes occur during the night. Is this a recent development, such as within the past year or so? This is very atypical for a CT cough. Is there anything different about nighttime (other than it's darker)?

Before giving up and accepting that there is no recourse other than toughing it out, try to look at this anew, without the taint of CT influencing your thinking. While you ponder, the use of 'home remedies' isn't going to hurt (if you can get them down him?) A mild tranquilizer, such as Atarax (a human prep, or something else your vet may prescribe)) may allow all concerned to get a better night's rest also.

Well, rather than answers to your questions, I seem to have created more questions. Hopefully we can arrive at some answers to the new ones. Let me know if they have sparked any new thoughts in either you or your vet.
Customer: replied 8 years ago.

HIs coughing started back in June after we were doing demo work on our bathroom. He sounds like a honking goose. We (my husband and I) assumed that it was due to the dust/particles/mold/etc. and that it was affecting our dog similarly to the way it was affecting my own allergies. The demo work took place over a weekend and when his coughing became worse and not better over the next few days we took him to the vet. They took the first set of x-rays to rule out anything being caught and pointed out his narrow spot. The first round of hyco. and theophylline seemed to take care of the problem. However, two days or so after the course of meds ran out he was honking again. The same with the with the next two rounds. The vet then retook the x-ray and that was when they concluded "that it is probably a collapsing trachea". I assumed that the collapsing was then a slow process, such as part of the trachea slowly collapsing in on itself.


As toodifferences at nightime. There really isn't any. At first we thought that we were just thinking he coughed more at night because we are there and we are not during the daytime. After the first couple of weekends we still think it is worse at night. Perhaps it is his sleeping position on the bed with us. The bedding and detergents I use haven't changed (allergen free/scent free)


As for getting home remedies down him--I swear he's part goat--he'll eat anything. Anything "disagreeable" (like the vet meds) get hidden in a little canned dog food and he's never the wiser.

Expert:  Peter Bennett, DVM replied 8 years ago.
Again, Hi..

Well, I think you have just solved the origin of your problem. I suspect that you and I are going to be in agreement that your remodel job was/is responsible for the coughing. Alas, however, the solution to it may remain elusive...

You know how much dust is stirred up by 'demolition' of old interior walls, and can imagine the variety of airborne materials that are set loose. Inhaled particulate material penetrates in proportion to the particle size... some goes clear into the alveolar depths. When a cough reflex is stimulated the first action is a deep breath. Similar coughing spells result in additional deep breaths.

Larger particulates, like plaster dust (which is primarily gypsum) and other dusts are irregular objects and have the potential to adhere to the lining of the respiratory tree, where they can act as an irritant as long as they remain. They can create an inflammation in the underlying tissue which may create a long standing sensitivity to much milder irritants. Any such irritation usually means some swelling, which creates turbulence in an airway, which can result in a honking, or otherwise noisy cough

Small particles sucked into the lower pulmonary areas also act as irritants and result in coughing as well. These deeply situated particles are difficult to impossible to be rid of.

I don't think that things like molds were involved in this because it was too sudden in producing the response. While dogs have allergies to the same things we do, their allergies manifest as itching skin.

Ask your vet if this might not be what has happened. A respiratory therapist could opine on the effects of such a happening to you, for example, (or just tell the truth, that it's your dog instead) if you find a need for some support for your (our) diagnosis.

Depending on how far you are wanting to go, diagnostically, a bronchoscopic exam may be in order, maybe even more. If this isn't in the cards, you may elect some anti-inflammatory meds (cortisone compounds come to mind) for a 'diagnostic' and therapeutic evaluation.

I think this is about as good as we can get, even with more tests...the events are too suggestive to be coincidental. Best wishes.
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