Long-term outcomes of 54 dogs with tracheal collapse treated with a continuous extraluminal tracheal prosthesis

OBJECTIVE

To describe the surgical placement of a continuous extraluminal tracheal prosthesis (CETP) and report the subsequent postoperative clinical outcomes in dogs with tracheal collapse.

STUDY DESIGN

Retrospective case series.

ANIMALS

Fifty-four dogs.

METHODS

Medical records of dogs in which cervical and/or thoracic inlet tracheal collapse was diagnosed and treated by placement of a CETP between 2010 and 2017 were reviewed to evaluate postoperative complications, changes in respiratory function, and survival. Histological examinations of tracheal tissues performed in 2 dogs at 51 and 57 months after surgery were also reviewed.

RESULTS

Fifty-three (98%) dogs survived to discharge. Postoperative complications included laryngeal paralysis (1 dog), disseminated intravascular coagulation (1 dog), and recurrent tracheal collapse (2 dogs). None of the dogs exhibited clinical evidence of tracheal necrosis. Preoperative dry, harsh cough resolved in 87% of the dogs after surgery. Goose honking cough was resolved in 25 of 26 (96%) dogs. Median follow-up time was 30 months (range, 16 days to 76 months). The survival rate at 36 months was 86% (CI: 75%-96%). On histological examination in 2 dogs, the tracheal tissue surrounding the prosthesis was well preserved and without evidence of chronic inflammation.

CONCLUSION

Continuous extraluminal tracheal prosthesis placement in dogs with tracheal collapse resulted in low postoperative complication rates and good long-term outcomes.

CLINICAL SIGNIFICANCE

Continuous extraluminal tracheal prosthesis placement provides a viable alternative surgical option for managing dogs with tracheal collapse.

Effect of Variations in Stent Placement on Outcome of Endoluminal Stenting for Canine Tracheal Collapse

The study's objective was to determine effects of relative size and placement location of endoluminal stents on incidence of complications and survival for canine tracheal collapse. Measurements were obtained on lateral radiographs before and after stenting to determine percent of the trachea occupied by the stent. These values were monitored over time and compared to complication rates and survival. Overall median survival time was 502 days. Six month survival rate was 78%, 1 yr survival was 60%, and 2 yr survival was 26%. Median percent of trachea occupied by the stent at initial placement was 79% (range, 41-93%). Percent of the trachea occupied by the stent at the time of placement did not significantly correlate to complication rate (0.397) or survival time (0.853). Incidence of serious complications was 37%, including granuloma formation, pneumonia, material failure, and stent migration. For patients experiencing serious complications, median survival was shorter, at 208 days, but was not significantly different from survival without serious complications. Within the margins of the data from this study, the proportion of the trachea occupied by the stent at the time of placement does not appear to impact incidence of complications or survival time in dogs with tracheal collapse.

IMAGING DIAGNOSIS-USE OF RADIOGRAPHY, COMPUTED TOMOGRAPHY, AND ENDOSCOPY IN THE DIAGNOSIS OF ESOPHAGEAL PERFORATION BY AN EXTRA-LUMINAL TRACHEAL RING PROSTHESIS IN A GOLDEN RETRIEVER

A 6-year-old neutered male, Golden retriever presented with regurgitation and excitement-induced coughing. Two years prior, extra-thoracic tracheal collapse was diagnosed and extra-luminal tracheal ring prostheses were placed. Radiographs at presentation showed mineralized and undulant cervical tracheal cartilages. A dorsally broad-based soft tissue opacity bulged into the caudal cervical tracheal lumen. Esophageal dysmotility and barium accumulation were identified at this level on contrast esophography. Computed tomography showed migration of a prosthetic tracheal ring, resulting in perforation of the esophagus. Hair, foreign material, and dynamic tracheal narrowing were identified on esophagoscopy and tracheoscopy, respectively. Esophagostomy and foreign body removal were performed.