The Pomerama

Collapsing Tracheas-
    Difficulty Breathing and Heart Conditions

Maintained by Susann Philbrook

Claire
Just learned today Penny has a significant narrowing of the trachea near her heart. It collapses when she aspirates. She has always had minor spells of "gagging" and we were told when we got her it was nothing to worry about, that lots of Poms are prone to this. Monday she had some surgery and apparently the endo-tracheal tube caused some irritation and she's been coughing/gagging/wheezing, etc. ever since. Vet prescribed Prednisone and it has helped some but after a particularly bad attack last night I took her in today and saw the other vet and he did an X-ray and found the narrowing. Now she's on an anti-tussive, a broncho-dialator, the Prednisone and her antibiotic. Have any of you had this problem and do you have any suggestions? From what he tells me there really isn't anything we can do except for careful monitoring and relieving the symptoms and keeping her calm whenever she has an attack. (Right now any exertion like going up/down stairs or getting excited will send her into an attack.) I haven't had much sleep for the past four nights because as soon as she starts coughing I wake up and want to make sure of course that she is OK. I admit, I wonder if there was some problem in how the endo-trach tube was inserted or removed which has contributed because she has never had such a problem with this before and she's had dentistry before this where she was under general anesthetic. (BTW, she will be turning 10 years old January 1 and except for this problem seems to be very healthy. All her pre-anesthetic testing was excellent.)
My vet also says she has an enlarged heart. At least so far we haven't noticed any problems from it but when the trachea problem is cleared up he is considering trying a vaso-dialater to see if that helps. I'm also hoping to find some sort of treatment that might help. He mentioned there is a blind study going on with a group of veterinary cardiologists with some new vasodilators. He called today to check on Penny and it has since occurred to me that he mentioned "open mouthed breathing" as a symptom. Well we have always called Penny the "smiley dog" because she often sits and watches us and seems to be smiling but now I'm wondering if this isn't the open mouthed breathing he talked about. When I take her back this week for suture removal I'm going to talk to him about it.
From Claire Lancz/email: VFFF00A@prodigy.com


David
We own a beautiful Pom, Buffy that we may like to show. She has only one problem which is incessant snorting, presumably due to an elongated palette.
From David Creely/email: dpcree@ccmail.monsanto.com


George
My Pom occasionally starts to wheeze, kind a like an asthma attack, sometimes this lasts as much as 20 minutes.
From George Doller/email: gd4961@minnie.ail.com


Brenda
My first Pom, a Dog World Award winner in obedience (the first in our area) had very similar symptoms, but they were evident from the time she was 6 months old. At that time the vet said we would come home to find her gone of a heart attack or we would euthanize her. The 2nd option came at 11 years 6 months. This was 25 years ago, so I pray they've done a lot more research and that more options are available to you.
From Brenda Hutton/email: NHWC36A@prodigy.com


Chris
Some Poms are prone to wheezing and snorting. Collapsed trachea is a common complaint with Poms, which used to be dealt with by surgery. Now the consensus of vets (in the UK at least) is to avoid surgery and instead deal with home conditions. Poms have tiny throats and can suffer badly in smoky or dusty conditions. Going the extra mile with cleaning and banning smokers may help a lot. When they do have a coughing attack, pick them up slowly, gently pat them and reassure them. They should stop soon afterwards.
From Chris Galley/email: 70374.3073@compuserve.com


Dianne
This can be a minor irritation until something triggers an acute episode. I have had two dogs to do this on me and it is one of the scariest things I have experienced. Both times I I have had to take these dogs to the vet to even stop the episode they were having. The episodes I have experienced were caused when the dogs became overly upset by something. They are very sensitive little guys and some things are very hard for them to deal with. I have found Torbutol to be very effective in preventing an episode if given when the first signs of a problem appear. Then just keep the dog quiet for a few days to prevent any other problem.
From Dianne Kieffer/email: dkieffer@seidata.com


Ingrid
BOTH our male springer, Charlie and male Pom, Skippy do this asthma like breathing "attack", but not the females. Our vet said not to worry. It seems to happen when they are excited. I usually grab them, pet and say shhh, and they quiet down.
From Ingrid Buxton/email: BUXTONI@vmsa.csd.mu.edu


James
Tazzy does this all the time. Usually when we're playing with the other animals, he'll start wheezing. We just ignore him and it passes in a couple of minutes. I think it could be from fur or something, but Tazz is a BIG baby and likes to get attention so he does this all the time (cries wolf).
From James Bettone/email: a-jamesb@microsoft.com


Lieny
My Pom Marko starts to wheeze badly after he gets excited. This usually happens when I get home from school and he gets all happy and excited to see me. But afterwards, he would wheeze. What I usually do to stop it is by rubbing his throat gently for about 30 seconds. Then he would sneeze and the wheezing stops.
From Lieny Hardiman/email: 2179976@cse.unsw.edu.au


Linda
Just a little tidbit of information. I just recently lost my 5 year old male pomeranian to a severely collapsed trachea. He started to wheeze and sneeze at about 3 years old, but at only certain times of the year, so we thought it was allergies. However, we took him up into the mountains last August and he started hyperventilating and turning blue. We managed to get him to a Vet Hospital where they stabilized him in a 02 tank and gave him epi. When they x-rayed him, they found him to have a narrow trachea plus it had severely collapsed at the bifurcation of the lungs. At the time, the only hope was surgery. However, we were unable to get him off of 02 to get him to the vet who does this surgery and we ended up losing him. According to most of the vets I have talked to, Pomeranians are notorious for collapsing tracheas on varying degrees of severity.
From Linda/email: LPOMER@aol.com


Mary
It's true - there isn't a lot you can do. I had an old gal that would honk now and then, then as she got older it got worse. My vet is of the opinion that the operation to replace the collapsing rings is not a very good risk unless it is to replace one or two healthy rings that have been damaged by trauma. We treated with Pred and Hycodan when she was bad. I DID try putting my gal on CS (Chondroitin Sulfate - Cosequin, or J-Flex) and I can't really say how much it helped. It might have done - she didn't seem to honk as much when she was on it, but she did die of a collapse - so who knows really? Sorry to be so down! It might be worth a try, though.
[Another response from Mary on an additional collapsing trachea issue]
I have had a couple of Poms with collapsing tracheas, so I know how frightening it is. My personal feeling (for what it is worth - which is not much) is that you might want to have an X-ray done independently of the operation. My vet usually does one whilst the dog is relaxed and calm (of course, an anesthetized dog will be calm, but then the endotracheal tube will be in the trachea, so if the collapse is fairly high, you won't see it) and tries to get another when the dog is under a certain amount of stress. Letting the hospital cats into the room is a pretty good way to achieve that. What you see then is to what degree the collapse occurs when the dog is stressed (this is when you will usually hear them "honking"), and be able to compare it to the dog's normal airway. If the trachea is, in fact, collapsing there really is not any cure. Surgery is very difficult to perform and I understand that success rates are not encouraging. I kept my guys on Theophylline (a bronchodialator) on a fairly regular regime, and a tiny dose of Acepromazine (a mild tranquilizer) if the dog was very stressed for any reason.
You mentioned that he coughs after drinking water. I know this sounds left field, but are you sure that he is lapping properly? I have one gal that doesn't know how to lap!!! She doesn't realize that she shouldn't breathe in whilst the water is going down. Not an Einstein among dogs! She does much, much better with a rabbit bottle (one of those things with the nozzles they have to lick) You may want to give it a whirl. They are not overly expensive.
From Mary Allen/email: MFXG02C@prodigy.com


Melanie
I read, I think on r.p.d newsgroup, that holding your dog's nose and forcing him/her to breathe through the mouth slowly will relax the trachea enough to stop the attack. This works on Harley, although sometimes I have to do it more than once. Alternatively, she stops if I pick her up and carry her, but I prefer to treat her like a normal-sized dog and let her walk herself.
From Melanie Chang/email: mlchang@sas.upenn.edu


Sheila
I had a large (15 pound female) with the same wheezing problem. It seemed to frighten her. Touching her seemed to calm her down a little. She lived to be 15 and never had any complications from the wheezing.
From Sheila R. Sheffield/email: ssheffie@mailer.fsu.edu


Sue
I have an older Pom with a narrowed trachea (towards the bottom of the trachea). It usually doesn't bother him too much except certain times of the year. We have come to the conclusion that he has certain allergies which aggravate the condition sometimes. We usually treat him with 1 cc of children's Robitussin and some Pred. The condition usually lasts a week or two and then he doesn't cough anymore. I have had him x-rayed 3 times fearing that it is his heart and the vet assured me each time that it isn't. Enlarged hearts happen fairly often in older Poms. If you are laying a guilt trip on yourself about trying to prevent this from having ever happened, don't! It is a common cause of death in older Poms. If you keep her weight down and keep her relaxed as much as possible, she will most likely have many good years still ahead of her.
Just enjoy her company and let the future take care of itself. I personally would be very interested in knowing if a specialist has any new treatments for either of these conditions.

Update 6/98: Boo Boo (dog mentioned above) died in 1998 from complications due to a severe and totally unexpected dog attack with a friend's Maltese. Two of my other Poms that are over the age of ten have also developed increasingly bad trachea attacks. They have been seen by my vet, a respiratory specialist, and a heart specialist. Due to their age, medication is the only viable means of controlling the attacks. Attacks worsen with excitement, so we try to keep everything calm (when visitors come over, we usually put them in the bedroom to try and keep them from getting too excited). The medicine of choice is a liquid called Marax (it is a human medication and rather hard to find at most pharmacies) as well as months on-and-off of pred (since we are unable to have their teeth treated, bacteria in the lungs is always a threat), and lasix for one of the girls who is suspected of also having a heart condition. We feed them canned food because it is easier for them to swallow and we put their medication in the food rather than forcing it down their throats. We also use a vaporizer in the bedroom. So far, the condition looks stabilized.
From Sue Philbrook (1996/98) email pomathon@bigfoot.com


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