Cool Case Maggie


Maggie03Maggie, a 10-year-old Yorkshire Terrier, presented to NorthStar VETS for acute respiratory distress and cyanosis (turning blue), noticed by the pet-sitter while the owners were returning home from vacation. She had a history of tracheal collapse, but before this episode, she had been doing pretty well. Upon arrival, she had a honking cough and was significantly dyspneic (trouble breathing). She was successfully stabilized by the Emergency team with oxygen therapy and sedation.

Maggie's collapsed tracheaChest X-rays revealed severe collapse of her cervical trachea (as seen in the image). We gave her a few days of attempted medical management; however, she continued to have very noisy breathing, coughing and episodes of cyanosis when taken out of the oxygen cage. Because of the severity of the collapse and her episode, it was elected to manage her condition with a tracheal stent placement.

Tracheal collapse is a condition from cartilage weakness in the trachea that causes the normally open, “C-shaped” cartilage rings to collapse down partially or completely. When this happens, it causes a honking cough and does not allow air to normally pass through it. It is an irreversible and progressive condition common in small-breed dogs, especially Yorkies like Maggie.

It can be managed medically or surgically. Medical management involves cough suppressants, anti-histamines, intermittent steroids, keeping the dogs trim and using harnesses, not collars. In most cases, we can successfully manage their clinical signs and coughing with these treatment options. When the case is more severe, or if it causes life-threatening signs, as in Maggie’s case, we opt for a procedural intervention. This is done by placing a nitinol, meshwork stent inside the tracheal lumen to give it support and keep it open. It does not eliminate the cough completely, but usually improves it significantly and prevents the life-threatening respiratory episodes.

Maggie's tracheal stentUnderstanding the risks of this respiratory procedure, Maggie’s owners decided to move forward with the stent placement. She was placed under general anesthesia and the size of the stent was chosen based on measurements taken via fluoroscopy. The endotracheal tube (tube used to delivery oxygen and anesthetic gas) was removed and the stent was deployed in her trachea covering the collapse area and keeping it nice and open (as seen in the image).
She recovered beautifully, and for the first time since we met her, she was able to breathe quietly and be with us outside of the oxygen cage. She was immediately happy, alert and wanting to eat! It was truly a night-and-day difference.

Maggie went home the next day breathing normally. Months later, Maggie is at home and doing extremely well. She coughs occasionally, which is expected for dogs with tracheal stents, but it is minimal and has not led to any further respiratory distress episodes. We love hearing how well she is doing at home and that she is enjoying time with her family!

Learn more about the Interventional Radiology service at NorthStar VETS.

Melanie Puchot, DVM, DACVIM
Melanie Puchot, DVM, DACVIMDr. Melanie Puchot is a Texas native who received her veterinary degree from Texas A&M University College of Veterinary Medicine in 2013. After graduation, she completed a small animal rotating internship at Cornell University in Ithaca, NY. She then returned to Texas A&M University and completed a 3-year residency in small animal internal medicine in 2017. She has a special interest in endocrinology, nephrology and interventional endoscopy / radiology. Dr. Puchot is excited to join the team at NorthStar VETS.


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