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Background: The grade of tracheal collapse (TC) is assessed by the diameter of the narrowed lumen. However, studies on the relationship between TC grade and clinical symptom severity are lacking. Objectives: To investigate the clinical characteristics of small-breed dogs diagnosed with TC and determine if fluoroscopic grading correlates with cough severity. Methods: We retrospectively reviewed medical records from 2022 to 2024. TC diagnosis was confirmed using fluoroscopic examination. Multiple linear regression was employed to investigate factors influencing cough severity, with a significance level set at p < 0.05. Results: A total of 132 dogs with TC were identified, of which 22 were excluded. The final cohort consisted of 110 dogs, aged between 2-19 years, with no significant sex differences. The majority (97.2%) of dogs had a BCS of =4. Among the top four breeds (Maltese, Pomeranian, Poodle, and Chihuahua), the most severe collapse was observed in the carinal region. The grade of collapse on fluoroscopy was mostly related to high BCS (p < 0.007) and low body weight (p < 0.001). However, interestingly, fluoroscopic findings of collapse location and grade did not correlate with cough severity (p = 0.350). Notably, clinical symptoms improved in 86.6% of cases following interventions such as weight reduction, environmental changes, and pharmacotherapy. Conclusions and clinical relevance: In small-breed dogs, the severity of cough was not associated with the region or grade of TC diagnosed by fluoroscopy. [ABSTRACT FROM AUTHOR]

Abstract Background Stenting has become popular to treat tracheal collapse in dogs, but complications might arise and negatively affect treatment outcome. Objectives Determine the overall prevalence of complications of tracheal stenting in dogs. Methods A bibliographic search was performed of publications from 2000 to 2020. Studies were assessed for quality of evidence and measured prevalence of the 8 most commonly reported complications after tracheal stenting in dogs (stent fracture, stent migration, relapsing collapse, granuloma formation, tracheobronchial infections, and early, late, and clinically relevant late cough). Random effects meta‐analyses were used to estimate pooled complications prevalence. Results Fifteen studies met inclusion criteria. Cough (early: 99%; 95% confidence interval [95% CI]: 95%–100%, late: 75%; 95% CI: 63%–85%, and clinically relevant: 52%; 95% CI: 42%–61%), tracheobronchial infections (24%; 95% CI: 14%–35%), and granulomas (20%; 95% CI: 11%–30%) were common after tracheal stenting. Stent fractures (12%; 95% CI: 5%–20%), relapsing collapse (10%; 95% CI: 5%–15%), and stent migration (5%; 95% CI: 1%–9%) were less frequent. Significant heterogeneity among studies was identified for the estimated prevalence of stent fracture, granulomas, infections, and late cough. Conclusions and Clinical Importance Tracheal stenting in dogs is associated with a high risk of coughing and a moderate risk of tracheobronchial infections and granuloma formation. Because most complications will impact a dog's quality of life, owners must be informed that tracheal stenting is a second‐line procedure that does not necessarily alleviate the need for medical treatment and frequent follow‐up visits. Additional studies are warranted to identify the risk factors of these complications.

Background: Stenting has become popular to treat tracheal collapse in dogs, but complications might arise and negatively affect treatment outcome. Objectives: Determine the overall prevalence of complications of tracheal stenting in dogs. Methods: A bibliographic search was performed of publications from 2000 to 2020. Studies were assessed for quality of evidence and measured prevalence of the 8 most commonly reported complications after tracheal stenting in dogs (stent fracture, stent migration, relapsing collapse, granuloma formation, tracheobronchial infections, and early, late, and clinically relevant late cough). Random effects meta‐analyses were used to estimate pooled complications prevalence. Results: Fifteen studies met inclusion criteria. Cough (early: 99%; 95% confidence interval [95% CI]: 95%–100%, late: 75%; 95% CI: 63%–85%, and clinically relevant: 52%; 95% CI: 42%–61%), tracheobronchial infections (24%; 95% CI: 14%–35%), and granulomas (20%; 95% CI: 11%–30%) were common after tracheal stenting. Stent fractures (12%; 95% CI: 5%–20%), relapsing collapse (10%; 95% CI: 5%–15%), and stent migration (5%; 95% CI: 1%–9%) were less frequent. Significant heterogeneity among studies was identified for the estimated prevalence of stent fracture, granulomas, infections, and late cough. Conclusions and Clinical Importance: Tracheal stenting in dogs is associated with a high risk of coughing and a moderate risk of tracheobronchial infections and granuloma formation. Because most complications will impact a dog's quality of life, owners must be informed that tracheal stenting is a second‐line procedure that does not necessarily alleviate the need for medical treatment and frequent follow‐up visits. Additional studies are warranted to identify the risk factors of these complications. [ABSTRACT FROM AUTHOR]

Abstract Background Tracheal collapse (TC), a common disease in dogs, is characterized by cough; however, little is known about the serum biomarkers that can objectively evaluate the severity of cough in canine TC. Furthermore, studies elucidating the relationship of fluoroscopic characteristics with the severity of cough are lacking. Therefore, this study aimed to evaluate the relationship between cough severity and clinical characteristics, fluoroscopic images, and new serum biomarkers in canine TC. Results Fifty-one client-owned dogs diagnosed with TC based on fluoroscopic and clinical signs were enrolled in this study and divided into three groups according to the severity of cough (grade of cough: 0, 1, and 2). Signalments, comorbidities, and fluoroscopic characteristics were compared among the groups retrospectively. The serum matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), surfactant protein-A (SP-A), and syndecan-1 (SDC-1) levels were measured in all groups. No significant differences in age, breed, sex, or clinical history were observed among the groups. Concomitant pharyngeal collapse increased significantly with the severity of cough (p = .031). Based on the fluoroscopic characteristics, the TC grade of the carinal region increased significantly and consistently with the grade of cough (p = .03). The serum MMP-9 level was significantly higher in the grade 2 group than that in the grade 0 group (p = .014). The serum IL-6 level was significantly lower in the grade 1 group than that in the grade 0 group (p = .020). The serum SP-A and SDC-1 levels did not differ significantly among the groups. Conclusions The severity of cough with the progression of TC can be predicted with the fluoroscopic TC grade at the carinal region. MMP-9 may be used as an objective serum biomarker that represents cough severity to understand the pathogenesis.

Background: Tracheal collapse (TC), a common disease in dogs, is characterized by cough; however, little is known about the serum biomarkers that can objectively evaluate the severity of cough in canine TC. Furthermore, studies elucidating the relationship of fluoroscopic characteristics with the severity of cough are lacking. Therefore, this study aimed to evaluate the relationship between cough severity and clinical characteristics, fluoroscopic images, and new serum biomarkers in canine TC. Results: Fifty-one client-owned dogs diagnosed with TC based on fluoroscopic and clinical signs were enrolled in this study and divided into three groups according to the severity of cough (grade of cough: 0, 1, and 2). Signalments, comorbidities, and fluoroscopic characteristics were compared among the groups retrospectively. The serum matrix metalloproteinase-9 (MMP-9), interleukin-6 (IL-6), surfactant protein-A (SP-A), and syndecan-1 (SDC-1) levels were measured in all groups. No significant differences in age, breed, sex, or clinical history were observed among the groups. Concomitant pharyngeal collapse increased significantly with the severity of cough (p =.031). Based on the fluoroscopic characteristics, the TC grade of the carinal region increased significantly and consistently with the grade of cough (p =.03). The serum MMP-9 level was significantly higher in the grade 2 group than that in the grade 0 group (p =.014). The serum IL-6 level was significantly lower in the grade 1 group than that in the grade 0 group (p =.020). The serum SP-A and SDC-1 levels did not differ significantly among the groups. Conclusions: The severity of cough with the progression of TC can be predicted with the fluoroscopic TC grade at the carinal region. MMP-9 may be used as an objective serum biomarker that represents cough severity to understand the pathogenesis. [ABSTRACT FROM AUTHOR]

Abstract Background Principal and lobar bronchial collapse is increasingly recognized as an isolated entity. Objective Retrospectively describe the procedure and outcomes of dogs undergoing bronchial stenting at a single referral hospital. Animals Nine client‐owned dogs with variable degrees of collapse of the left principal bronchus (LPB), lobar bronchus 1 (LB1), and lobar bronchus 2 (LB2), and with clinically relevant signs of respiratory dysfunction. Methods Data were collected from patient records. All dogs underwent stenting of the LPB and LB2. Anatomic and functional impairment grades were assigned to each case before and 4 weeks after stenting. Data regarding response to stenting and complications were evaluated. Results Bronchial stenting was considered successful in all cases, with all dogs experiencing improved quality of life (QOL), and decreased functional impairment grade at 4 weeks post‐stenting. Follow‐up of >6 months was available for 6 dogs and of these, 5 were alive at 12 months, 3 were alive at 18 months, and 1 was alive at 24 months. Stent‐related complications occurred in 4 dogs, and were resolvable in 3. Two dogs developed pneumothorax, 1 developed recurrent pneumonia, and 1 developed new‐onset coughing. All dogs had mild and manageable coughing post‐stenting. Conclusions and Clinical Importance Stenting of the LBP and LB2 might be an effective option for dogs with advanced collapse of these bronchi and associated signs. Although all included dogs had resolution or improvement of clinical signs considered life‐threatening or as affecting QOL, ongoing coughing is expected. Patient selection appears important with regard to achieving successful outcomes.

Microbial colonization in veterinary stents poses a significant and concerning issue in veterinary medicine. Over time, these pathogens, particularly bacteria, can colonize the stent surfaces, leading to various complications. Two weeks following the stent insertion procedure, the colonization becomes observable, with the aggressiveness of bacterial growth directly correlating with the duration of stent placement. Such microbial colonization can result in infections and inflammations, compromising the stent's efficacy and, subsequently, the animal patient's overall well-being. Managing and mitigating the impact of these pathogens on veterinary stents is a crucial challenge that veterinarians and researchers are actively addressing to ensure the successful treatment and recovery of their animal patients. In addition, irritation of the tissue in the form of an inserted stent can lead to overgrowth of granulation tissue, leading to the closure of the stent lumen, as is most often the case in the trachea. Such serious complications after stent placement require improvements in the procedures used to date. In this review, antibacterial or antibiofilm strategies for several stents used in veterinary medicine have been discussed based on the current literature and the perspectives have been drawn. Various coating strategies such as coating with hydrogel, antibiotic, or other antimicrobial agents have been reviewed. [ABSTRACT FROM AUTHOR]

Background: Principal and lobar bronchial collapse is increasingly recognized as an isolated entity. Objective: Retrospectively describe the procedure and outcomes of dogs undergoing bronchial stenting at a single referral hospital. Animals: Nine client‐owned dogs with variable degrees of collapse of the left principal bronchus (LPB), lobar bronchus 1 (LB1), and lobar bronchus 2 (LB2), and with clinically relevant signs of respiratory dysfunction. Methods: Data were collected from patient records. All dogs underwent stenting of the LPB and LB2. Anatomic and functional impairment grades were assigned to each case before and 4 weeks after stenting. Data regarding response to stenting and complications were evaluated. Results: Bronchial stenting was considered successful in all cases, with all dogs experiencing improved quality of life (QOL), and decreased functional impairment grade at 4 weeks post‐stenting. Follow‐up of >6 months was available for 6 dogs and of these, 5 were alive at 12 months, 3 were alive at 18 months, and 1 was alive at 24 months. Stent‐related complications occurred in 4 dogs, and were resolvable in 3. Two dogs developed pneumothorax, 1 developed recurrent pneumonia, and 1 developed new‐onset coughing. All dogs had mild and manageable coughing post‐stenting. Conclusions and Clinical Importance: Stenting of the LBP and LB2 might be an effective option for dogs with advanced collapse of these bronchi and associated signs. Although all included dogs had resolution or improvement of clinical signs considered life‐threatening or as affecting QOL, ongoing coughing is expected. Patient selection appears important with regard to achieving successful outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate fatigue of three stent designs when various forces are applied and perform a comparative analyses. A computer simulation using the finite element method was performed. In particular, we constructed a three-dimensional finite element model of nitinol stents with three designs (S6: single-woven wire, wire diameter: 0.006 inch; D6: double-woven wire, wire diameter: 0.006 inch, and D7: double-woven wire, wire diameter: 0.007 inch) that are used to treat canine tracheal collapse (TC). The stents were subjected to a 200 mmHg compression force, a pure torsion force in a perpendicular direction, and a bending-torsion force combining perpendicular and axial forces. The von Mises stress was calculated to evaluate the extent of stent displacement, and Goodman diagrams were plotted to compare fatigue life cycles. D7 exhibited a longer fatigue life compared to S6 and D6. Under compression, pure torsion, and bending-torsion forces, displacement was the smallest for D7, followed by D6 and S6. Similarly, the fatigue life was the longest for D7, followed by D6 and S6. S6 showed the greatest displacement when subjected to external forces; among stents designed using the same wire, D6 displayed less displacement than S6, and D7 exhibited superior fatigue life when subjected to varying degrees of force. This study showed that the structural stability and fatigue life of stents could be effectively compared using finite element method D7 has the greatest stability and structural rigidity under cyclic load.

Simple Summary: Tracheal collapse is a common disease in small breed dogs, and imaging techniques such as radiography and fluoroscopy are important for diagnosis. However, there is limited agreement between these two methods in different regions of the trachea. A study was conducted on 29 dogs with tracheal collapse to investigate the agreement between thoracic radiography and fluoroscopy. The results showed that radiography underestimated the degree of collapsing trachea compared to fluoroscopy significantly at carina area. However, the agreement between the methods was found to be only slight at the cervical region. The study suggests that while radiography can be useful for screening, fluoroscopy can detect a greater degree of collapsing trachea than the two-image radiography method. Tracheal collapse is a common disease in small, middle-aged dogs, and imaging tools are essential for its diagnosis. Radiography and fluoroscopy are the main diagnostic modalities used, but their agreement in different regions is not well documented. In this study, the agreement between thoracic radiography and fluoroscopy in tracheal collapse was investigated in 29 dogs. The results showed that radiography detected a lower degree of collapsing trachea compared to fluoroscopy at the carina region (p < 0.001). However, there was no significant difference observed between the degree of collapsing trachea detected by radiography and fluoroscopy at the cervical, thoracic inlet, and intra-thoracic regions (p = 0.780, 0.537, and 0.213, respectively). The kappa statistic indicated a slight agreement at the cervical region at a 16.4% cut-off (κ = 0.20), while the other regions showed a non-agreement. In conclusion, although radiography is useful for screening, fluoroscopy was able to detect the degree of the collapsing trachea greater than radiography in the carina region. Additionally, if a collapse in the cervical region is detected by radiography, it is prone to have a positive relationship with fluoroscopy as well. [ABSTRACT FROM AUTHOR]

Investigating the characteristics of tracheas can help the understanding of diseases related to the trachea, particularly tracheal collapse (TC) in dogs. This study aimed to compare the mechanical properties of tracheas from New Zealand White (NZW) rabbits and dogs and to introduce a method for inducing a model of TC in the normal trachea. Tracheal samples were obtained from NZW rabbit cadavers (n=5) weighing 3.62-3.92 kg and from dog cadavers (n=5) weighing 2.97-3.28 kg. Three live NZW rabbits weighing 3.5-4.0 kg were used to establish the model. The radial forces of both sample sets were measured using a digital force gauge and statistically compared. Subsequently, TC was surgically induced in three female NZW rabbits by physically weakening their tracheal cartilage under general anesthesia. Their clinical signs were monitored for 3 months, and radiographic examinations were performed monthly for 3 months. The mean radial forces of the two sample sets were comparable (P>0.05). The clinical signs, radiographic examinations, and macroscopic examinations were all comparable to those of dogs with TC. The cadaveric study between the rabbits and dogs demonstrated that the surgically induced rabbit model of TC is an excellent candidate for the experimental study of dogs with TC. This study also provides a reference of tracheal radial force values to enable selection of appropriate mesh types and wire diameters of self-expanding metal stents. [ABSTRACT FROM AUTHOR]

Summary: A 9‐year‐old Dartmoor cross‐gelding was referred for investigation and treatment of exercise intolerance, cough and abnormal respiratory noise. Endoscopic examination revealed the presence of left 90‐degree rotation and dorsoventral collapse of the entire cervical trachea. Although the tracheal collapse was not obvious on laterolateral radiographs, these showed the abnormal presence of tracheal cartilages along with the dorsal and ventral limits of the trachea. Oblique radiographs showed partial tracheal collapse in the caudal aspect of the neck. Ultrasound examination revealed the presence of tracheal cartilages on the right side of the neck, dorsal tracheal ligament along with the left side of the neck and the junction between tracheal cartilage and dorsal tracheal ligament coursing over the ventral aspect of the neck. This report highlights the value of detailed examination of standard and non‐standard radiographic and ultrasound imaging of the trachea to achieve correct diagnosis of tracheal collapse when associated with tracheal rotation. [ABSTRACT FROM AUTHOR]

Microbial colonization in veterinary stents poses a significant and concerning issue in veterinary medicine. Over time, these pathogens, particularly bacteria, can colonize the stent surfaces, leading to various complications. Two weeks following the stent insertion procedure, the colonization becomes observable, with the aggressiveness of bacterial growth directly correlating with the duration of stent placement. Such microbial colonization can result in infections and inflammations, compromising the stent’s efficacy and, subsequently, the animal patient’s overall well-being. Managing and mitigating the impact of these pathogens on veterinary stents is a crucial challenge that veterinarians and researchers are actively addressing to ensure the successful treatment and recovery of their animal patients. In addition, irritation of the tissue in the form of an inserted stent can lead to overgrowth of granulation tissue, leading to the closure of the stent lumen, as is most often the case in the trachea. Such serious complications after stent placement require improvements in the procedures used to date. In this review, antibacterial or antibiofilm strategies for several stents used in veterinary medicine have been discussed based on the current literature and the perspectives have been drawn. Various coating strategies such as coating with hydrogel, antibiotic, or other antimicrobial agents have been reviewed.

Fluid clearance from the respiratory system during developmental transitions is critically important for achieving optimal gas exchange in animals. During insect development from embryo to adult, airway clearance occurs episodically each time the molt is completed by performance of the ecdysis sequence, coordinated by a peptide-signaling cascade initiated by ecdysis-triggering hormone (ETH). We find that the neuropeptide Kinin (also known as Drosokinin or Leukokinin) is required for normal respiratory fluid clearance or "tracheal air-filling" in Drosophila larvae. Disruption of Kinin signaling leads to defective air-filling during all larval stages. Such defects are observed upon ablation or electrical silencing of Kinin neurons, as well as RNA silencing of the Kinin gene or the ETH receptor in Kinin neurons, indicating that ETH targets Kinin neurons to promote tracheal air-filling. A Kinin receptor mutant fly line (Lkrf02594 ) also exhibits tracheal air-filling defects in all larval stages. Targeted Kinin receptor silencing in tracheal epithelial cells using breathless or pickpocket (ppk) drivers compromises tracheal air-filling. On the other hand, promotion of Kinin signaling in vivo through peptide injection or Kinin neuron activation through Drosophila TrpA1 (dTrpA1) expression induces premature tracheal collapse and air-filling. Moreover, direct exposure of tracheal epithelial cells in vitro to Kinin leads to calcium mobilization in tracheal epithelial cells. Our findings strongly implicate the neuropeptide Kinin as an important regulator of airway clearance via intracellular calcium mobilization in tracheal epithelial cells of Drosophila.

Background: The grade of tracheal collapse (TC) is assessed by the diameter of the narrowed lumen. However, studies on the relationship between TC grade and clinical symptom severity are lacking., Objectives: To investigate the clinical characteristics of small-breed dogs diagnosed with TC and determine if fluoroscopic grading correlates with cough severity., Methods: We retrospectively reviewed medical records from 2022 to 2024. TC diagnosis was confirmed using fluoroscopic examination. Multiple linear regression was employed to investigate factors influencing cough severity, with a significance level set at p  < 0.05., Results: A total of 132 dogs with TC were identified, of which 22 were excluded. The final cohort consisted of 110 dogs, aged between 2-19 years, with no significant sex differences. The majority (97.2%) of dogs had a BCS of ≥4. Among the top four breeds (Maltese, Pomeranian, Poodle, and Chihuahua), the most severe collapse was observed in the carinal region. The grade of collapse on fluoroscopy was mostly related to high BCS ( p  < 0.007) and low body weight ( p  < 0.001). However, interestingly, fluoroscopic findings of collapse location and grade did not correlate with cough severity ( p  = 0.350). Notably, clinical symptoms improved in 86.6% of cases following interventions such as weight reduction, environmental changes, and pharmacotherapy., Conclusions and Clinical Relevance: In small-breed dogs, the severity of cough was not associated with the region or grade of TC diagnosed by fluoroscopy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kim, Kim, Ryu, Youn, Choi and Seo.)

We tested composite tracheal grafts (CTG) composed of a partially decellularized tracheal graft (PDTG) combined with a 3-dimensional (3D)-printed airway splint for use in long-segment airway reconstruction. CTG is designed to recapitulate the 3D extracellular matrix of the trachea with stable mechanical properties imparted from the extraluminal airway splint. We performed segmental orthotopic tracheal replacement in a mouse microsurgical model. MicroCT was used to measure graft patency. Tracheal neotissue formation was quantified histologically. Airflow dynamic properties were analyzed using computational fluid dynamics. We found that CTG are easily implanted and did not result in vascular erosion, tracheal injury, or inflammation. Graft epithelialization and endothelialization were comparable with CTG to control. Tracheal collapse was absent with CTG. Composite tracheal scaffolds combine biocompatible synthetic support with PDTG, supporting the regeneration of host epithelium while maintaining graft structure. [ABSTRACT FROM AUTHOR]

Canine tracheal collapse is a progressive disease in small breed dogs resulting from chronic inflammation of the tracheal mucosal lining. Polyunsaturated fatty acid EAB-277® is one of the nutraceuticals that can alleviate inflammation and oxidative stress. Heart rate variability (HRV) is a prognostic tool related to sympathovagal balance and oxidative stress level, which is widely used with cardiorespiratory diseases. However, the effect of EAB-277® on HRV in tracheal collapse dogs has rarely been investigated. In this study, 26 tracheal collapse dogs were divided into two groups. In the control group, the dogs received the standard treatment, whereas the dogs in the EAB-277® group received standard treatment combined with EAB-277®. After being treated for 5 weeks, changes in radiographic findings, blood profiles, serum malondialdehyde, inflammatory markers, and HRV were evaluated. This study found that clinical signs were improved in both groups (p < 0.05). However, serum malondialdehyde (MDA), Interleukin-6 (IL-6), and Tumor necrosis factor-alpha (TNF-α) were decreased only in the EAB-277® group after treatment for five weeks (p < 0.05) and the mean percent change of MDA, IL-6, and TNF-α at week five compared to baseline in the EAB-277® group was greater than in the control group (p < 0.05). Additionally, greater sympathovagal imbalance indicated by decreased standard deviation of all normal R-R intervals (SDNN) and standard deviation of the averaged R-R intervals for all 5-minutes segments (SDANN) was found in the control group at week five compared to baseline (P < 0.05), whereas EAB-277® improved SDNN and SDANN and decreased low frequency/high-frequency component (LF/HF ratio) after being treated for five weeks (P < 0.05). This study demonstrates that EAB-277® improves clinical signs and attenuates HRV impairment by reducing oxidative stress and inflammation in tracheal collapse dogs.

Tracheal collapse is a common disease in small, middle-aged dogs, and imaging tools are essential for its diagnosis. Radiography and fluoroscopy are the main diagnostic modalities used, but their agreement in different regions is not well documented. In this study, the agreement between thoracic radiography and fluoroscopy in tracheal collapse was investigated in 29 dogs. The results showed that radiography detected a lower degree of collapsing trachea compared to fluoroscopy at the carina region (p < 0.001). However, there was no significant difference observed between the degree of collapsing trachea detected by radiography and fluoroscopy at the cervical, thoracic inlet, and intra-thoracic regions (p = 0.780, 0.537, and 0.213, respectively). The kappa statistic indicated a slight agreement at the cervical region at a 16.4% cut-off (κ = 0.20), while the other regions showed a non-agreement. In conclusion, although radiography is useful for screening, fluoroscopy was able to detect the degree of the collapsing trachea greater than radiography in the carina region. Additionally, if a collapse in the cervical region is detected by radiography, it is prone to have a positive relationship with fluoroscopy as well.

We tested composite tracheal grafts (CTG) composed of a partially decellularized tracheal graft (PDTG) combined with a 3-dimensional (3D)-printed airway splint for use in long-segment airway reconstruction. CTG is designed to recapitulate the 3D extracellular matrix of the trachea with stable mechanical properties imparted from the extraluminal airway splint. We performed segmental orthotopic tracheal replacement in a mouse microsurgical model. MicroCT was used to measure graft patency. Tracheal neotissue formation was quantified histologically. Airflow dynamic properties were analyzed using computational fluid dynamics. We found that CTG are easily implanted and did not result in vascular erosion, tracheal injury, or inflammation. Graft epithelialization and endothelialization were comparable with CTG to control. Tracheal collapse was absent with CTG. Composite tracheal scaffolds combine biocompatible synthetic support with PDTG, supporting the regeneration of host epithelium while maintaining graft structure. [ABSTRACT FROM AUTHOR]

ABSTRACT The purpose of this study was to verify the applicability of the compressive radiographic technique (pressures of 5, 10, 15 and 20mmHg) in the diagnosis of tracheal collapse in small breed dogs, in lateral cervicothoracic radiography. Out of the 50 dogs evaluated, 25 presented tracheal collapse (TG group), 23 did not present tracheal collapse (CG) and two were excluded because they did not tolerate a pressure of 20 mmHg. The TG group presented a smaller internal diameter of the trachea in the region of the fourth cervical vertebra (D4) and at the entrance of the thorax (TDE) compared to the CG group, in all the radiographic projections performed, as well as within the TG group where the compressive technique differed from conventional. Furthermore, there was a correlation between the clinical sign of coughing during cervical collar use and the presence of radiographic tracheal collapse at a pressure of 20 mmHg. It was concluded that the compressive radiographic technique was feasible and efficient in confirming the diagnosis of tracheal collapse in dogs, especially in the pressure of 20 mmHg, where it was associated with clinical signs, and can be used in isolation or complementary to the conventional technique.

A prospective study was designed to test the hypothesis that the degree and location of tracheal collapse may influence its pattern of cough. Objective evaluation of cough was made in 45 dogs with tracheal collapse. The relationship between location and degree of collapse and cough was tested. Location of collapse did not have a significant effect on cough except for the moderate effect on the nature of cough (P=0.002; rs=0.45) while its degree had a significant effect (P

Abstract Background Dogs with tracheal stents often have positive airway bacterial cultures. The pathogenicity of these organisms and risk factors for infection have not been investigated. Objective Describe bacterial infection in dogs with tracheal collapse before and after tracheal stent placement. Animals Fifty‐three client‐owned dogs. Methods Retrospective review of medical records of dogs receiving tracheal stents with thoracic radiographs, tracheoscopy, and endotracheal lavage. Results There was no difference between the overall prevalence of dogs with positive bacterial cultures before (31/38; 82%) or after stent placement (24/31; 77%) (P = .67). An increased number of geriatric (17/28; 61%) and traditional‐type collapse (TTC) (16/26; 62%) dogs had positive pathogenic airway infections before stent placement, compared to young (8/25; 32%; P = .04) and malformation‐type collapse (MTC) dogs (9/27; 33%; P = .04). After tracheal stent placement, geriatric dogs had a 52% reduction in pathogenic bacteria infection frequency (P = .02) and dogs with TTC had a 56% reduction in pathogenic bacteria infection frequency (P = .01). Significant risk factors for pathogenic infection included a history of pneumonia (OR = 3.6; 95% CI, 0.28‐43.36) and cardiac disease (OR = 1.25; 95% CI, 0.16‐9.92) in geriatric dogs, and hepatomegaly in young dogs (OR = 1.5; 95% CI, 0.12‐19.44). Conclusions and Clinical Importance Tracheal stent placement does not increase the overall rate of pathogenic bacterial infection in dogs with tracheal collapse and can decrease the rate of subsequent pathogenic infections in geriatric dogs and dogs with TTC that require tracheal stenting. Airway culture and cytology should be performed in all dogs undergoing tracheal stent placement.

Tracheal collapse is a chronic and progressively worsening disease; the severity of clinical symptoms experienced by affected individuals depends on the degree of airway collapse. Cutting-edge automated tools are necessary to modernize disease screening using radiographs across various veterinary settings, such as animal clinics and hospitals. This is primarily due to the inherent challenges associated with interpreting uncertainties among veterinarians. In this study, an artificial intelligence model was developed to screen canine tracheal collapse using archived lateral cervicothoracic radiographs. This model can differentiate between a normal and collapsed trachea, ranging from early to severe degrees. The you-only-look-once (YOLO) models, including YOLO v3, YOLO v4, and YOLO v4 tiny, were used to train and test data sets under the in-house XXX platform. The results showed that the YOLO v4 tiny-416 model had satisfactory performance in screening among the normal trachea, grade 1-2 tracheal collapse, and grade 3-4 tracheal collapse with 98.30% sensitivity, 99.20% specificity, and 98.90% accuracy. The area under the curve of the precision-recall curve was >0.8, which demonstrated high diagnostic accuracy. The intraobserver agreement between deep learning and radiologists was κ = 0.975 (P < .001), with all observers having excellent agreement (κ = 1.00, P < .001). The intraclass correlation coefficient between observers was >0.90, which represented excellent consistency. Therefore, the deep learning model can be a useful and reliable method for effective screening and classification of the degree of tracheal collapse based on routine lateral cervicothoracic radiographs., (© 2024 American College of Veterinary Radiology.)

Among the respiratory disorders in dogs from small breeds, tracheal collapse is one of the most commonly found in clinical practice. Presently, acupuncture is widely used as an alternative treatment which was shown to bring about positive effects in the treatment of human respiratory diseases. The present study demonstrated the effect of acupuncture on tracheal collapse dogs. We hypothesized that acupuncture can help dogs suffering from tracheal collapse by improving various parameters including heart rate variability, serum biomarkers for oxidative stress, exercise performance, and quality of life. Twenty client-owned dogs from small breeds with tracheal collapse disease were enrolled. The study was divided into two 5-week periods. During the first period, the dogs received normal veterinary care but received no acupuncture treatment (NAC). After completing that period, all forms of treatment were withheld for one week before the beginning of the second period. In the second period, all dogs restarted normal veterinary care and underwent acupuncture treatment (AC) once a week for five consecutive weeks. Blood was collected at the beginning and end of each of the two periods for malondialdehyde (MDA) level measurement. Heart rate variability (HRV) was recorded at the 1st, 3rd and 5th weeks of both periods. Exercise tests were performed at the beginning and end of AC period and questionnaire interviews with the owners were accomplished at the end of each period. The results showed that acupuncture can alleviate clinical signs of tracheal collapse, reduce MDA level, and improve sympathovagal balance. We suggest that acupuncture treatment could be used as an adjunct treatment for canine tracheal collapse.

Tracheal collapse is a common cause of cough and is caused by weakening of artilage support for the large airways The purpose of this study is to measure the prevalence rate of tracheal collapse in dogs, investigate risk indicators, and finally evaluate and type radiographs as they are the main means of confirming tracheal collapse. This study reports the results of a descriptive study of 21 cases of tracheal collapse diagnosed in 5701 dogs treated for 7 years at the clinic of the National School of Veterinary Medicine of Sidi Thabet (Tunisia) in the Department of Equine and Carnivore Internal Medicine. The results show that the prevalence of tracheal collapse in dogs is quite low: 0.36%, CI 95%. The results of this study highlight the importance of signaling in the evaluation of dogs with tracheal collapse. Two risk indicators for the condition were identified in this study. Geriatric dogs (> 6 years) (p < 0.001) were more commonly affected compared to younger dogs (< 6 years) (OR =44). It also appears that poodle dogs account for 62% of affected dogs, small breed dogs are most commonly affected by tracheal collapse (85%). (p < 0.001). This is the first known study describing tracheal collapse in dogs in Tunisia. The retrospective design of this study further limits the results of this investigation. [ABSTRACT FROM AUTHOR]

Background: Extraluminal surgical procedures for intrathoracic tracheal collapse in dogs are not routinely performed. The patients are normally treated with different drugs or by intraluminal stents. However, in more severe cases, drug treatment does not always have good outcomes, and intraluminal prostheses can be correlated to several postoperative problems. In order to obtain better results, we aimed to develop a surgical technique for implantation of a new extraluminal helical prosthesis in the thoracic segment of the trachea through cervical access, associated with pneumatic mediastinoscopy for certification of the technique and minimization of possible complications. Materials, Methods & Results: Seven canine corpses (CCs) from non-traumatic death, weighing between 2 and 7 kg, were used. A ventral cervical approach to the trachea was associated with blunt mediastinal dissection. Trans cervical pneumatic mediastinoscopy was used for evaluation of the dissection and location of the implant. These were compared with the necropsy findings by the exact Wilcoxon two-sample test, with P < 0.05. The results of necropsy and mediastinoscopy did not present significant differences at P < 0.05. During the examinations, the presence of some mediastinal visceral lesions caused by the prosthesis, the integrity of the mediastinum and possible lesions to RLN and blood vessels (BV) were analyzed. We also investigated the location of the distal part of the prosthesis in the thoracic segment of the trachea and its dissection. To evaluate the technique, statistical comparison was made between mediastinoscopy and necropsy findings. The data were compared by the Wilcoxon test at 5% probability. The tracheas of all CCs were efficiently dissected, but in some cases problems that can happen during the procedure were noticed. This was checked by mediastinoscopy and confirmed by necropsy. The median of the scores was 1 (good dissection and visualization), with variance of zero for mediastinoscopy and 0.14 for necropsy. In the mediastinoscopy of one CC, the prosthesis crossed the tracheal bifurcation, involving the posterior vessels of this region, which was confirmed by necropsy. However, the dissection showed no vascular lesions. The integrity of the mediastinum was assessed only by mediastinoscopy. There was no impairment caused by any of the procedures performed. This resulted in a median score of 1 (integrity) with zero variance. When the positioning of the prosthesis was evaluated in relation to the tracheal bifurcation, identical values were obtained by both methods. The median score was 1, with variance of 0.62. No statistical differences were found between the two evaluation methods for the analyzed variables. This demonstrates the strong potential of the proposed evaluation techniques. Discussion: Our results show that the execution of the technique is possible, but some complications may occur. Mediastinoscopy as an evaluation procedure can pose some complications, these considerations are important, but by using technique proposed in this study, these factors are minimized due to the ease of technical implantation of the extraluminal tracheal stent, without the need for several instruments competing in the inflated mediastinal space. We concluded that the technique is viable and a safe method with minimal invasion for investigation and treatment of mediastinal diseases, presenting low impairment of the paratracheal structures, and that mediastinoscopy can be used as a transoperative evaluation method to minimize complications. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy, complications, and outcome of Dumon silicone stent placement for dogs with grade IV tracheal collapse., Animals: 12 client-owned dogs., Clinical Presentation: Each dog was diagnosed with grade IV TC unresponsive to medical therapy and had severe obstructive respiratory failure., Results: 12 dogs were included in the study. By the end of the study, 5 of 12 (41.7%) remained alive, while 7 of 12 (58.3%) dogs died. Survival times after stent placement ranged from 97 to 1,310 days (mean, 822.43 days; median, 810 days). Three of the 12 (25%) dogs died spontaneously, while 4 of 12 (33.3%) were euthanized. The cause of death was determined for 6 of 7 (85.7%) dogs and was TC related for 3 of 7 (50%). Causes of death related to TC were progressive airway collapse (2/3 [66.6%]) and incoercible cough (1/3 [33.4%]). Complications occurred in 9 of 12 (75%) cases and included granulation tissue growth (3/12 [25%]), incoercible cough (2/12 [16.7%]), stent migration (1/12 [8.3%]), and stent deformation (1/12 [8.3%]). Reduction of obstructive dyspnea and episodes of asphyxiation was achieved after Dumon silicone stent placement., Clinical Relevance: The placement of an intraluminal Dumon silicone stent was a successful salvage treatment for TC in dogs that did not respond to medical management. Disease progression is inevitable, but substantial improvement of respiratory function may be achieved for months to years.

This study aimed to evaluate fatigue of three stent designs when various forces are applied and perform a comparative analyses. A computer simulation using the finite element method was performed. In particular, we constructed a three-dimensional finite element model of nitinol stents with three designs (S6: single-woven wire, wire diameter: 0.006 inch; D6: double-woven wire, wire diameter: 0.006 inch, and D7: double-woven wire, wire diameter: 0.007 inch) that are used to treat canine tracheal collapse (TC). The stents were subjected to a 200 mmHg compression force, a pure torsion force in a perpendicular direction, and a bending-torsion force combining perpendicular and axial forces. The von Mises stress was calculated to evaluate the extent of stent displacement, and Goodman diagrams were plotted to compare fatigue life cycles. D7 exhibited a longer fatigue life compared to S6 and D6. Under compression, pure torsion, and bending-torsion forces, displacement was the smallest for D7, followed by D6 and S6. Similarly, the fatigue life was the longest for D7, followed by D6 and S6. S6 showed the greatest displacement when subjected to external forces; among stents designed using the same wire, D6 displayed less displacement than S6, and D7 exhibited superior fatigue life when subjected to varying degrees of force. This study showed that the structural stability and fatigue life of stents could be effectively compared using finite element method D7 has the greatest stability and structural rigidity under cyclic load., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Introduction:  Esophageal atresia (EA) is often accompanied by tracheobronchial malformations leading to stridor, recurrent bronchitis, and occasionally to life-threatening obstructive apnea after surgical repair. The aim of this study was to identify the presence of tracheomalacia in patients with EA and tracheoesophageal fistula (TEF) pre- and postoperatively and to find endoscopic correlates leading to clinical airway symptoms.Methods:  In a cohort of 362 patients with EA-TEF who underwent 595 tracheoscopies at the Children's Hospital of Cologne between January 1983 and December 2002, impaired tracheal lumen, localization of TEF, tracheal pulsations, and corresponding clinical symptoms were retrospectively analyzed.Results:  The incidence of tracheomalacia was higher in patients with EA and TEF (Gross B-D) compared with patients with EA alone (Gross A) and average tracheal collapse does not significantly change before and after surgical repair of the esophagus in all types. Patients with cyanosis while eating and obstructive apnea presented with an average tracheal collapse of 89%. The presence of respiratory symptoms such as cough, stridor, or bronchitis was not associated with a higher grade of tracheal collapse compared with patients without any airway symptoms (average tracheal collapse of 37% in symptomatic patients vs. 33% in nonsymptomatic patients).Conclusion:  Tracheomalacia tends to be present independently of surgical procedure. Tracheomalacia should be measured by tracheoscopy (in % of tracheal collapse). Patients with a tracheal collapse of >80%, a ventral pulsation, and obstructive apnea or cyanosis in combination, are at risk for life-threatening situations and further surgical treatment should be considered. [ABSTRACT FROM AUTHOR]

A prospective study was designed to test the hypothesis that the degree and location of tracheal collapse may influence its pattern of cough. Objective evaluation of cough was made in 45 dogs with tracheal collapse. The relationship between location and degree of collapse and cough was tested. Location of collapse did not have a significant effect on cough except for the moderate effect on the nature of cough (P=0.002; rs=0.45) while its degree had a significant effect (P<0.0001) on all cough parameters except for nature of cough (P=0.354). The pattern of cough associated with tracheal collapse is mainly influenced by the degree of collapse rather than its location. [ABSTRACT FROM AUTHOR]

Background : Rabbits have long been used as experimental models for tracheal disease, but very little information has been published about the diagnosis and management of naturally occurring pathology in this species. Case Description : A 7-year-old rabbit with concurrent upper respiratory disease was diagnosed with tracheal collapse using diagnostic imaging and tracheoscopy. Tracheal resection and anastomosis was performed to remove the affected area and produced resolution of clinical signs for approximately 6 months. The patient's signs eventually returned due to development of granulation tissue at the anastomosis site. Debridement, application of topical medications, and removal of suture material were ultimately unsuccessful in resolving the patient's respiratory distress, and the rabbit was euthanized 10 days later. Conclusions & Case Relevance : Based on the outcome of this case, tracheal resection may provide temporary relief from clinical signs of tracheal collapse in rabbits, but further research is required to determine which surgical techniques provide the best outcome and to better define contraindications. [ABSTRACT FROM AUTHOR]

Background: Dogs with tracheal stents often have positive airway bacterial cultures. The pathogenicity of these organisms and risk factors for infection have not been investigated. Objective: Describe bacterial infection in dogs with tracheal collapse before and after tracheal stent placement. Animals: Fifty‐three client‐owned dogs. Methods: Retrospective review of medical records of dogs receiving tracheal stents with thoracic radiographs, tracheoscopy, and endotracheal lavage. Results: There was no difference between the overall prevalence of dogs with positive bacterial cultures before (31/38; 82%) or after stent placement (24/31; 77%) (P =.67). An increased number of geriatric (17/28; 61%) and traditional‐type collapse (TTC) (16/26; 62%) dogs had positive pathogenic airway infections before stent placement, compared to young (8/25; 32%; P =.04) and malformation‐type collapse (MTC) dogs (9/27; 33%; P =.04). After tracheal stent placement, geriatric dogs had a 52% reduction in pathogenic bacteria infection frequency (P =.02) and dogs with TTC had a 56% reduction in pathogenic bacteria infection frequency (P =.01). Significant risk factors for pathogenic infection included a history of pneumonia (OR = 3.6; 95% CI, 0.28‐43.36) and cardiac disease (OR = 1.25; 95% CI, 0.16‐9.92) in geriatric dogs, and hepatomegaly in young dogs (OR = 1.5; 95% CI, 0.12‐19.44). Conclusions and Clinical Importance: Tracheal stent placement does not increase the overall rate of pathogenic bacterial infection in dogs with tracheal collapse and can decrease the rate of subsequent pathogenic infections in geriatric dogs and dogs with TTC that require tracheal stenting. Airway culture and cytology should be performed in all dogs undergoing tracheal stent placement. [ABSTRACT FROM AUTHOR]

Tracheal collapse is a common cause of cough and is caused by weakening of artilage support for the large airways The purpose of this study is to measure the prevalence rate of tracheal collapse in dogs, investigate risk indicators, and finally evaluate and type radiographs as they are the main means of confirming tracheal collapse. This study reports the results of a descriptive study of 21 cases of tracheal collapse diagnosed in 5701 dogs treated for 7 years at the clinic of the National School of Veterinary Medicine of Sidi Thabet (Tunisia) in the Department of Equine and Carnivore Internal Medicine. The results show that the prevalence of tracheal collapse in dogs is quite low: 0.36%, CI 95%. The results of this study highlight the importance of signaling in the evaluation of dogs with tracheal collapse. Two risk indicators for the condition were identified in this study. Geriatric dogs (> 6 years) (p < 0.001) were more commonly affected compared to younger dogs (< 6 years) (OR =44). It also appears that poodle dogs account for 62% of affected dogs, small breed dogs are most commonly affected by tracheal collapse (85%). (p < 0.001). This is the first known study describing tracheal collapse in dogs in Tunisia. The retrospective design of this study further limits the results of this investigation. [ABSTRACT FROM AUTHOR]

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Background Canine tracheal collapse is a complex airway pathology without promising treatment results. Currently nitinol stents are the best surgical option; however, some professionals are doubting if stent placement is the best option due to the associated complications. Objective Determine the technical feasibility, safety, and long-term follow-up after the implantation of a new tracheal stent designed for canine tracheal collapse. Methods Thirteen healthy, adult female New Zealander rabbits were involved in this pilot study.A new intra-tracheal device (Reference number 902711 patent registered as CasMin-Twine) was implanted in ten animals. Deployment was performed under general anesthesia, making a puncture incision via a 21 Gauge needle in the intra-tracheal space where the stent was introduced with a screwing process. The device was fixed to the tracheal wall with a non-absorbable suture. Computerized Tomography (CT) and an endoscopy to study structural abnormalities were performed after 30, 90 and 365 days after stent placement. Results Technical and clinical success was 100%. There was no significant change in behavior or respiratory disorders. CT studies showed no significant alterations. After the 30 days, 60% of the animals showed partial endothelization in the endoscopy study, and only one animal still presented partial endothelization after 12 months. Mucus accumulation was only present in 40% of cases and classified as low, without respiratory consequences. Only one animal presented a single granuloma at caudal stent tip. Conclusions This new tracheal stent (CasMin-Twine) is an effective and safe procedure with promising results, and also shows the possibility of removing the device after endothelization has been produced. New studies should be carried out to evaluate the effectiveness in patients with tracheomalacia. Clinical Significance/Impact This new product can give veterinarians a new option of treatment for this complicated pathology. Minimizing specific equipment for its deployment, CasMin-Twine will be more accessible for all professionals.

Background Canine tracheal collapse is a complex airway pathology without promising treatment results. Currently nitinol stents are the best surgical option; however, some professionals are doubting if stent placement is the best option due to the associated complications. Objective Determine the technical feasibility, safety, and long-term follow-up after the implantation of a new tracheal stent designed for canine tracheal collapse. Methods Thirteen healthy, adult female New Zealander rabbits were involved in this pilot study.A new intra-tracheal device (Reference number 902711 patent registered as CasMin-Twine) was implanted in ten animals. Deployment was performed under general anesthesia, making a puncture incision via a 21 Gauge needle in the intra-tracheal space where the stent was introduced with a screwing process. The device was fixed to the tracheal wall with a non-absorbable suture. Computerized Tomography (CT) and an endoscopy to study structural abnormalities were performed after 30, 90 and 365 days after stent placement. Results Technical and clinical success was 100%. There was no significant change in behavior or respiratory disorders. CT studies showed no significant alterations. After the 30 days, 60% of the animals showed partial endothelization in the endoscopy study, and only one animal still presented partial endothelization after 12 months. Mucus accumulation was only present in 40% of cases and classified as low, without respiratory consequences. Only one animal presented a single granuloma at caudal stent tip. Conclusions This new tracheal stent (CasMin-Twine) is an effective and safe procedure with promising results, and also shows the possibility of removing the device after endothelization has been produced. New studies should be carried out to evaluate the effectiveness in patients with tracheomalacia. Clinical Significance/Impact This new product can give veterinarians a new option of treatment for this complicated pathology. Minimizing specific equipment for its deployment, CasMin-Twine will be more accessible for all professionals. [ABSTRACT FROM AUTHOR]

Abstract Objective Suprastomal collapse is a complication of pediatric tracheotomy with a potential impact on decannulation success. The aim of this study was to review the experience in the management of pediatric suprastomal collapse in a tertiary-care center, detailing the surgical technique employed. Methods This study included 12 tracheotomised children with the diagnosis of suprastomal collapse in the last 5 years. All patients of the study underwent surgical intervention to manage suprastomal collapse to achieve tracheotomy decannulation. The surgical procedure entailed dissection of the pre-existing tracheotomy tract down to the trachea, then excision of the tract flush with the anterior tracheal wall. The tracheal opening was closed transversely with 3–4 interrupted absorbable sutures placed in craniocaudal direction. Results At the end of treatment all patients were decannulated successfully. No intraoperative complications were reported. Minor postoperative complications were reported in 3 children in the form of mild surgical emphysema (n = 2) and wound infection (n = 1). Those patients were successfully managed conservatively. Conclusion This technique is a simple and effective procedure enabling immediate decannulation with very low morbidity. In a long term follow up period, no recurrence has been reported and all patients returned to their usual quality of life. [ABSTRACT FROM AUTHOR]

Fluid clearance from the respiratory system during developmental transitions is critically important for achieving optimal gas exchange in animals. During insect development from embryo to adult, airway clearance occurs episodically each time the molt is completed by performance of the ecdysis sequence, coordinated by a peptide-signaling cascade initiated by ecdysis-triggering hormone (ETH). We find that the neuropeptide Kinin (also known as Drosokinin or Leukokinin) is required for normal respiratory fluid clearance or "tracheal air-filling" in Drosophila larvae. Disruption of Kinin signaling leads to defective air-filling during all larval stages. Such defects are observed upon ablation or electrical silencing of Kinin neurons, as well as RNA silencing of the Kinin gene or the ETH receptor in Kinin neurons, indicating that ETH targets Kinin neurons to promote tracheal air-filling. A Kinin receptor mutant fly line (Lkr f02594) also exhibits tracheal air-filling defects in all larval stages. Targeted Kinin receptor silencing in tracheal epithelial cells using breathless or pickpocket (ppk) drivers compromises tracheal air-filling. On the other hand, promotion of Kinin signaling in vivo through peptide injection or Kinin neuron activation through Drosophila TrpA1 (dTrpA1) expression induces premature tracheal collapse and air-filling. Moreover, direct exposure of tracheal epithelial cells in vitro to Kinin leads to calcium mobilization in tracheal epithelial cells. Our findings strongly implicate the neuropeptide Kinin as an important regulator of airway clearance via intracellular calcium mobilization in tracheal epithelial cells of Drosophila. [ABSTRACT FROM AUTHOR]

This retrospective study included 222 dogs suspected to have tracheal collapse (TC) and examined between 1 January 2012 and 31 December 2015. Fluoroscopic and radiographic images and medical records were evaluated to investigate the fluoroscopic characteristics of TC and cervical lung herniation (CLH), and to detennine their relationships to various influencing. Grade of TC, existence of tracheal kinking, location of CLH (right or left side), and grade of CLH were evaluated fluoroscopically. One hundred ninety-nine dogs (89.6%) were diagnosed with TC. Presence of TC was not associated with the patients' cough history; however, CLH was positively correlated with cough history (odds ratio [OR], 2.896; 95% confidence interval [Cl], 1.556 to 5.390) and was affected by tracheal kinking (OR, 3.841; 95% Cl, 1.884 to 7.831). Chronic cough was not related with CLH. Since TC can be observed in patients without a histoiy of cough, presence of TC should be ruled out by using physical examination and diagnostic imaging. Although CLH is associated with a history of cough, it is a common appearance in dogs, and transient coughing can elicit CLH in patients without a history of cough. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: The opened or closed status of the glottis might influence tracheal size changes in inspiratory and expiratory computed tomography (CT) scans. We investigated if the glottis status makes the tracheal collapse differently correlate with lung volume difference between inspiratory and expiratory CT scans.Materials and Methods: Forty patients with chronic obstructive pulmonary disease whose glottis was included in the acquired scanned volume for lung CT were divided into two groups: 16 patients with the glottis closed in both inspiratory and expiratory CT, and 24 patients with the glottis open in at least one CT acquisition. Lung inspiratory (Vinsp) and expiratory (Vexp) volumes were automatically computed and lung ΔV was calculated using the following formula: (Vinsp - Vexp)/Vinsp × 100. Two radiologists manually measured the anteroposterior diameter and cross-sectional area of the trachea 1 cm above the aortic arch and 1 cm above the carina. Tracheal collapse was then calculated and correlated with lung ΔV.Results: In the 40 patients, the correlations between tracheal Δanteroposterior diameter and Δcross-sectional area at each level and lung ΔV ranged between 0.68 and 0.74 (ρ) at Spearman rank correlation test. However, in the closed glottis group, the correlations were higher for all measures at the two levels (ρ range: 0.84-0.90), whereas in the open glottis group, correlations were low and not statistically significant (ρ range: 0.29-0.34) at the upper level, and moderate at the lower level (ρ range: 0.51-0.55).Conclusions: A closed or open glottis influences the tracheal size change in inspiratory and expiratory CT scans. With closed glottis, the tracheal collapse shows a stronger correlation with the lung volume difference between inspiratory and expiratory CT scans. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

A 5-year-old, 3.72-kg female Pekin duck ( Anas platyrhynchos domestica) was presented for acute respiratory distress, head shaking, and collapse. Similar spontaneously resolving episodes had previously occurred. Physical examination revealed severe inspiratory and expiratory dyspnea. Due to poor prognosis, euthanasia was elected. Postmortem examination revealed severe tracheal collapse involving the proximal trachea. The tracheal lumen was reduced in size by 75%. Histologic evaluation revealed ossification of the tracheal rings for approximately 60%-100% of their circumference. The bone trabecules presented characteristics of mature bone with a medullar cavity containing hematopoietic cells and adipocytes. There was also osseous metaplasia of the cartilage. In the lamina propria, there was lymphocytic infiltration and fibrosis, both moderate. To our knowledge, tracheal collapse has not been reported in a Pekin Duck. [ABSTRACT FROM AUTHOR]

Objective To report the management of a dog that required 2 treatments with mechanical ventilation; firstly for severe tracheal collapse and secondly following deployment of a nitinol tracheal stent that immediately preceded a nonoxygen responsive pulmonary thromboembolism (PTE), suspected to have originated from the right atrium. Case Summary A 9-year-old female spayed Shetland Sheepdog was presented for management of a gallbladder mucocoele. Pertinent history included iatrogenic hyperadrenocorticism and tracheal collapse. The dog became clinical for tracheal collapse following laparoscopic cholecystectomy. Thoracic radiographs revealed moderate to severe tracheal collapse at the level of the thoracic inlet. Arterial blood gas was consistent with hypoventilation and mechanical ventilation was instituted. Given the severity of tracheal collapse, self-expanding nitinol tracheal stent placement was elected. Immediately following tracheal stent placement, the dog developed nonoxygen responsive hypoxemia requiring mechanical ventilation. Additional diagnostic tests revealed changes consistent with a PTE and a large thrombus in the right atrium. The dog was humanely euthanized. New or Unique Information Provided Dislodgement of a preexisting atrial thrombus has not been described as a complication following tracheal stent deployment. Additionally, although PTE is frequently considered to be oxygen responsive, it may not be if the embolism is severe enough. [ABSTRACT FROM AUTHOR]

Investigating the characteristics of tracheas can help the understanding of diseases related to the trachea, particularly tracheal collapse (TC) in dogs. This study aimed to compare the mechanical properties of tracheas from New Zealand White (NZW) rabbits and dogs and to introduce a method for inducing a model of TC in the normal trachea. Tracheal samples were obtained from NZW rabbit cadavers (n=5) weighing 3.62-3.92 kg and from dog cadavers (n=5) weighing 2.97-3.28 kg. Three live NZW rabbits weighing 3.5-4.0 kg were used to establish the model. The radial forces of both sample sets were measured using a digital force gauge and statistically compared. Subsequently, TC was surgically induced in three female NZW rabbits by physically weakening their tracheal cartilage under general anesthesia. Their clinical signs were monitored for 3 months, and radiographic examinations were performed monthly for 3 months. The mean radial forces of the two sample sets were comparable (P>0.05). The clinical signs, radiographic examinations, and macroscopic examinations were all comparable to those of dogs with TC. The cadaveric study between the rabbits and dogs demonstrated that the surgically induced rabbit model of TC is an excellent candidate for the experimental study of dogs with TC. This study also provides a reference of tracheal radial force values to enable selection of appropriate mesh types and wire diameters of self-expanding metal stents.

Background Most information about pharyngeal collapse in dogs is anecdotal and extrapolated from human medicine. A single case report describing dynamic pharyngeal collapse in a cat has been published, but there is no literature describing this disease process in dogs. Objective To describe the signalment, clinical presentation, concurrent disease processes, and imaging findings of a population of client-owned dogs with pharyngeal collapse. Animals Twenty-eight client-owned dogs with pharyngeal collapse. Methods Radiology reports of dogs for which fluoroscopy of the respiratory system was performed were reviewed retrospectively. Patients with a fluoroscopic diagnosis of pharyngeal collapse were included in the study population. Data regarding clinical signs, diagnostic, and pathologic findings were evaluated. Results Twenty-eight dogs met the inclusion criteria. The median age of affected patients was 6.6 years, whereas median body condition score was 7/9. The most common clinical signs were coughing (n = 20) and stertor (n = 5). In 27 of 28 cases, a concurrent or previously diagnosed cardiopulmonary disorder was detected. The most common concurrent disease processes were mainstem bronchi collapse (n = 18), tracheal collapse (n = 17), and brachycephalic airway syndrome (n = 8). Fluoroscopy identified complete pharyngeal collapse in 20 of 28 dogs. Conclusions Pharyngeal collapse is a complex disease process that likely is secondary to long-term negative pressure gradients and anatomic and functional abnormalities. Based on the findings of this study, pharyngeal fluoroscopy may be useful diagnostic test in patients with suspected tracheal and mainstem bronchial collapse to identify concurrent pharyngeal collapse. [ABSTRACT FROM AUTHOR]

Among the respiratory disorders in dogs from small breeds, tracheal collapse is one of the most commonly found in clinical practice. Presently, acupuncture is widely used as an alternative treatment which was shown to bring about positive effects in the treatment of human respiratory diseases. The present study demonstrated the effect of acupuncture on tracheal collapse dogs. We hypothesized that acupuncture can help dogs suffering from tracheal collapse by improving various parameters including heart rate variability, serum biomarkers for oxidative stress, exercise performance, and quality of life. Twenty client-owned dogs from small breeds with tracheal collapse disease were enrolled. The study was divided into two 5-week periods. During the first period, the dogs received normal veterinary care but received no acupuncture treatment (NAC). After completing that period, all forms of treatment were withheld for one week before the beginning of the second period. In the second period, all dogs restarted normal veterinary care and underwent acupuncture treatment (AC) once a week for five consecutive weeks. Blood was collected at the beginning and end of each of the two periods for malondialdehyde (MDA) level measurement. Heart rate variability (HRV) was recorded at the 1st, 3rd and 5th weeks of both periods. Exercise tests were performed at the beginning and end of AC period and questionnaire interviews with the owners were accomplished at the end of each period. The results showed that acupuncture can alleviate clinical signs of tracheal collapse, reduce MDA level, and improve sympathovagal balance. We suggest that acupuncture treatment could be used as an adjunct treatment for canine tracheal collapse. [ABSTRACT FROM AUTHOR]

Dogs with tracheal collapse may present with life-threatening upper airway obstruction. In most instances, a conservative approach to treatment including oxygen support coupled with sedation and cooling measures will relieve respiratory effort and thus relieve airway obstruction. Dogs that fail this conservative approach require endotracheal intubation to ensure a patent airway. This population of patients would benefit from a more definitive, yet palliative treatment option to acutely relieve upper airway obstruction. Placement of a self-expanding metallic stent that spans the affected portion of the trachea will acutely provide the patient with a sustained patent airway and optimize the likelihood of a positive outcome. [ABSTRACT FROM AUTHOR]

BACKGROUND: Severe tracheomalacia (STM) is being increasingly recognized as a cause for respiratory failure in the ICU. The diagnosis is often overlooked, as chest radiography appears normal, and the role of invasive diagnostic testing for this diagnosis is not well described in the ICU setting. The prevalence and risk factors for STM are not known, and computed tomography (CT) based diagnostic criteria for ventilated patients are not well studied. METHODS: Patients admitted between January 2008 and December 2010, with respiratory failure and who failed ventilator discontinuation or required reintubation, were screened for the presence of any tracheal collapse, utilizing prior CT of the chest. Bronchoscopically confirmed cases were compared with age and sex matched controls to identify risk factors. RESULTS: Twenty-five subjects were identified as having STM, which represented 0.7% of ICU admissions and 1.6% of subjects with respiratory failure. The mean ICU stay was significantly longer in STM (30 d, 95% CI 19.7-40 d), compared to controls (4.4 d, 95% CI 3.6 -5.2 d). Obesity (odds ratio 1.26, 95% CI 1.04 -1.54) and gastro-esophageal reflux (odds ratio 31, 1.7- 586) were associated with increased risk for STM. The pre-intubation PaCO2 (68 mm Hg, 95% CI 57-79 mm Hg) was significantly higher in STM, compared to controls (38 mm Hg, 95% CI 35-41). The distal tracheal antero-posterior diameter (2.80 mm, 95% CI 2.15-3.46) was significantly lower in STM. A receiver operating characteristic analysis showed a distal tracheal antero-posterior diameter < 7 mm to be the optimal cutoff measurement to diagnose STM. CONCLUSION: STM was associated with prolonged ICU stay. A distal tracheal anteroposterior diameter < 7 mm on a non-intubated CT chest was suggestive of STM that required a confirmatory bronchoscopy. Gastroesophageal reflux disease and obesity were potential risk factors. [ABSTRACT FROM AUTHOR]