Laryngeal collapse develops when there is loss of the rigidity and support provided by the laryngeal cartilage (voicebox), causing the larynx to fold and collapse. When this occurs there is an obstruction that prevents normal movement of air into the trachea.
Laryngeal collapse usually occurs secondary to other long standing upper airway disorders, such as those seen in short-faced dogs like pugs, Boston terriers and English bulldogs. The chronic effect of difficulty “pushing and pulling” air through their deformed upper airways weakens, fatigues, and eventually deforms the cartilage. In rare instances the cartilage may fracture and collapse following trauma to the neck.
Most dogs with advanced upper airway disease are over two years of age, but occasionally this condition may be found in younger dogs. Both males and females are affected.
Laryngeal collapse can result in severe respiratory distress, potentially leading to death.
Signs of laryngeal collapse in dogs may include:
Since the surgical correction of various defects is performed through the mouth, there is no incision to monitor or sutures to be removed. Feed soft food and water for a week or so after the procedure. Avoid excitement or situations in which your dog will pant.
Following a permanent tracheostomy, the surgical site will need to be kept clean and free of debris. Stitches at a permanent tracheostomy site should be removed within 10 to 14 days after surgery.
The opening will need to be checked daily to ensure that it is not closing over and occluding the new airway. Your pet must NEVER swim since water would instantly be drawn into the lungs.
Laryngeal collapse, when it occurs secondary to chronic upper airway obstruction, should be a preventable disease. If the primary airway disorders are addressed in a timely fashion, that is before the dog is two years of age, it is normally possible to prevent the secondary changes in the laryngeal cartilages.
Sometimes, airway problems get overlooked in the brachycephalic breeds of dog because the owner thinks this is just how a pug or bulldog should sound. Have your pet checked regularly by your veterinarian particularly if airway noise becomes increased with moderate exercise or excitement or if your pet seems unable to exercise a reasonable amount. Excessive snoring and snorting is not normal and should be evaluated.
Once the later stages of laryngeal collapse have developed, correction of the primary problems will have very little benefit.
Although there is a surgical option for the treatment of severe laryngeal collapse, the long-term management of the tracheal opening and the increased risk for aspiration pneumonia should not be forgotten. Your pet will be far happier preventing laryngeal collapse by fixing the underlying causes than dealing with a permanent tracheostomy after the fact.
Brachycephalic breeds of dog, greater than two to three years of age with excessive airway noise should arouse suspicion for laryngeal collapse. Some dogs will have been treated for chronic upper airway problems for some time and be well known to your veterinarian.
There are three different stages of laryngeal collapse:
Medical management may palliate some of the problems of laryngeal collapse, particularly in its early and milder forms, but it does not usually provide lasting relief for this deformity of the upper airway.
If your dog has had surgery for stenotic nares, there will usually be fine stitches in the nostrils that will need to be monitored and removed within 10 to 14 days after the procedure. An Elizabethan collar should be used to prevent scratching or rubbing at this site.
Oral surgical procedures do not have any stitches that require removal. Your dog should stay quiet and rested, avoiding exercise and excitement for a few weeks until the surgical site(s) have fully healed. Most dogs will not have a problem eating and drinking after oral surgical procedures, although you should feed the food soft and definitely avoid chew toys or rawhide.
Some dogs may have received a temporary tracheostomy as either an emergency procedure or to allow treatment of the airway disorder. The temporary tracheostomy tube is removed prior to discharge, but there will be a small opening in the neck region that will slowly shrink down and seal over on its own. It will not be stitched closed as this site is contaminated and needs to heal from the inside out. The temporary tracheostomy site should be kept clean by using a cotton ball moistened in warm water and keeping fluid away from the airway opening. Air may continue to move through the opening until it heals.
There may be changes in your dog's bark after upper airway surgery and/or permanent tracheostomy.
Permanent tracheostomy will require daily attention to the surgical site. This may mean cleaning the opening with a cotton-tipped applicator to remove any crusty or dried secretions from blocking the opening. Your dog must never be allowed to swim with a permanent or temporary tracheostomy.
Your veterinarian will check the permanent tracheostomy site periodically to ensure that it shrink in size.
Chest X-rays may be taken periodically to ensure that there is no development of pneumonia.