Recent experiences with stents for collapsing trachea - YorkieTalk.com Forums

orkies · 08-22-2010, 04:51 PM

Does anyone have a recent (last 12 months) with using a stent to control collapsing trachea? Our Zoey who's only 6 has had the condition for the last few years. Recently it's gotten much worse. We need to use drugs to knock her out every day. She gets so excited from little things like being hungry or thirsty. We have to watch her constantly. Its not good for us or for her. We are seriously thinking of having a stent inserted, The vet makes it sound like it's very safe. It seems like there are lots of post but very few of them recent.

Thanks

kjc · 08-22-2010, 08:35 PM

As per my research, all surgery is very risky and not recommended. Medication seems the best path to take. Cough suppressants, bronchodialators, and glucosamine/chondroitin supplementation to help with cartilage strengthening.

Also from: TRACHEAL COLLAPSE in Dogs - Chinaroad Lowchens of Australia

How is tracheal collapse treated?
Most cases of tracheal collapse are treated with cough suppressants, bronchodilators, corticosteroids (to control inflammation), and/or antibiotics. In obese patients, weight loss helps decrease respiratory effort. Although treatment is not curative, a study released in 1994 showed that 71 percent of dogs treated medically showed a good long-term response.

If medical management produces no response in two weeks, or if severe signs compromise the pet’s functionality, surgery is recommended. Various surgical techniques have been described, but the application of prosthetic polypropylene rings to the outside of the trachea is the current treatment of choice, with an overall success rate reported to be in the 75- to 85-percent range. In general, the outcome of surgery is poorer for dogs older than six years. It is a tricky, specialized surgery that is best performed by a skilled surgeon, usually at a referral centre.

What else can pet guardians do if their dog has a collapsed trachea?
Whether medical or surgical treatment is chosen, pet owners can help relieve signs by keeping their pet’s weight down (even slightly under is ideal), switching from a collar to a chest harness, and avoiding respiratory irritants.

ladyjane · 08-23-2010, 12:40 AM

I would not do a stent if it were my dog. I have not ever seen one live for longer than a year after that surgery. I am not saying it never happens. I just have not seen it happen. I had a foster who died this past Christmas...he had CT and it was severe. I spoke with three different vets and one was a board certified surgeon and not one of them recommended the surgery. They were frank with me about the low successes in this surgery.

The following site has detailed information about stents. I am not so sure about their numbers, though.
ACVS - Tracheal Collapse

This site also has information:
Small Animal Surgery Services UF|Veterinary Medical Center

I am sorry you are going through this. It is an awful condition and stressful on everyone.

Have you tried Lomotil? If not, ask your vet about it. It helped my pup and has helped others that I have told about it. It is an anti diarrheal, but for some reason does help with CT. If your vet has not heard of it's use, tell him it is in Kirk's Veterinary Therapy book!

I am sure you are aware that it is good to keep excess weight off of CT pups. Also, they need to be in a stress free environment and air conditioned. Heat and humidity exacerbate the symptoms.

fifeandshaffer · 08-23-2010, 06:06 PM

I had a dog with ct, he was 4 when he was diagnosed, and 6 when i needed to put himn to sleep, I am a doctor myself not a vet but a dr, i went to 3 different vets all top surgeons in the country they all said the same thing its risky and the best you will get is probably 2 years at the most, and the chance he will need a stent inside the stent is high, also the dog will need to be on steriods all the time, and long time steroid use is a bad idea. Do you know where the collapse is in your dog, dependong on where it is, your dog may not even be a candidate for a stent. May I ask what meds yor dog is on now? I know how hard it is, my dog was diagnosed at 4 had a pretty good life til 5, and did ok til 6 but the heat in june made it so much worse and his quality of life was down to zero so I needed to put him to sleep. I know i tried everything I could for him, the meds would work for a while then just stop then tried another and another and another til we ran out of things to try, I am so sorry your dog has this. I still hear the wheezing and honks in my head.

ladyjane · 08-23-2010, 07:38 PM

Quote:

Originally Posted by fifeandshaffer

I had a dog with ct, he was 4 when he was diagnosed, and 6 when i needed to put himn to sleep, I am a doctor myself not a vet but a dr, i went to 3 different vets all top surgeons in the country they all said the same thing its risky and the best you will get is probably 2 years at the most, and the chance he will need a stent inside the stent is high, also the dog will need to be on steriods all the time, and long time steroid use is a bad idea. Do you know where the collapse is in your dog, dependong on where it is, your dog may not even be a candidate for a stent. May I ask what meds yor dog is on now? I know how hard it is, my dog was diagnosed at 4 had a pretty good life til 5, and did ok til 6 but the heat in june made it so much worse and his quality of life was down to zero so I needed to put him to sleep. I know i tried everything I could for him, the meds would work for a while then just stop then tried another and another and another til we ran out of things to try, I am so sorry your dog has this. I still hear the wheezing and honks in my head.

I am so sorry......I totally understand. I still hear my little foster, Ozzy...he was a dear little guy. It still breaks my heart.
This is one of the worst conditions I have ever seen in a pup. Just totally heartbreaking.

orkies · 08-24-2010, 07:05 PM

Thanks so much for all of this information. How long ago was this? We're wondering if the techniques have improved over time? We did go to a vet in LA a few weeks ago who recommended the surgery so the dog "theoretically" is a candidate. Of course, we're having trouble trusting that because of all the negatives we hear about what can happen. So much of the day, she's fine and sometimes for several days in a row, but then stress brings it on and we end up having to use acepromazine in addition to the regular meds they're now trying. She's taking so much attention and it's all so painful. We don't know what to do. It feels like she's too healthy to put to sleep most of the time but when it hits, it's pretty unbearable for us to live through.

Quote:

Originally Posted by fifeandshaffer

I had a dog with ct, he was 4 when he was diagnosed, and 6 when i needed to put himn to sleep, I am a doctor myself not a vet but a dr, i went to 3 different vets all top surgeons in the country they all said the same thing its risky and the best you will get is probably 2 years at the most, and the chance he will need a stent inside the stent is high, also the dog will need to be on steriods all the time, and long time steroid use is a bad idea. Do you know where the collapse is in your dog, dependong on where it is, your dog may not even be a candidate for a stent. May I ask what meds yor dog is on now? I know how hard it is, my dog was diagnosed at 4 had a pretty good life til 5, and did ok til 6 but the heat in june made it so much worse and his quality of life was down to zero so I needed to put him to sleep. I know i tried everything I could for him, the meds would work for a while then just stop then tried another and another and another til we ran out of things to try, I am so sorry your dog has this. I still hear the wheezing and honks in my head.

orkies · 08-24-2010, 07:07 PM

Do you know anything at all about the success rate of the stent surgery currently? Is it something you looked into?

Quote:

Originally Posted by ladyjane

I am so sorry......I totally understand. I still hear my little foster, Ozzy...he was a dear little guy. It still breaks my heart.
This is one of the worst conditions I have ever seen in a pup. Just totally heartbreaking.

ladyjane · 08-24-2010, 07:17 PM

The older way with the rings was extremely invasive. The newer stents are not invasive like that, but they collapse in time so it is only a temporary fix. I just personally would not do it after speaking with all of the vets I did. No one was optimistic.

My decision was not money based as I will pay whatever it takes to help a pup.....it was just that I felt that the outcome was going to be the same in the end and I just was not willing to put him through surgery with such a low success rate.

Sure...many of them are candidates and you can always find vets who do the surgery.....the question to ask is how long is it going to last. What happens when it fails...can the surgery be repeated? What is the real long term success rate.

I also used Acepro....I had syringes preloaded with that and Torb for really bad nights. The sounds are honestly worse than what is going on...often they sound really horrible but still have pink mucous membranes and pretty decent oxygenation. In the end, Ozzy was requiring trips to the vet and the EC for oxygen...that was when it was almost over for him.

I still find myself staring at his picture here on the wall above my computer. He was such a little trooper....I will never forget him and his struggles. Just made me sick. One day I will see him again...at least I know he no longer struggles to breathe and is running free.

I will say this: I spoke with four different vets...two were board certified and not one of them felt the surgery would be a good solution...and one of them was willing to do it. I have never regretted that decision. I believe he would have been dead by now anyway. It is a horrid condition....makes me so sad that dogs are having to suffer such things.

ladyjane · 08-24-2010, 07:23 PM

Quote:

Originally Posted by orkies

Do you know anything at all about the success rate of the stent surgery currently? Is it something you looked into?

They post high numbers online, but the one surgeon I use a lot for other cases told me it is not that high. He told me the surgery is temporary. Also, this was not a young pup. I am not so sure he would have even survived the anesthesia.

I talk to a lot of people...and a lot of vets. I also see lots of posts here and on other sites. I have yet to find a dog that has had long term success with either type of surgery. I asked my regular vet if she has any clients at all that have had the surgery and are still living...nope..not one. Just not something I was comfortable with.

I urge you to find long term cases. Ask around. Ask your vet if he/she has seen any. Ask the specialist if he has any cases that you could meet and talk with. And...go for another opinion. Mine was seen by two board certified vets...one was more than willing to operate...but even she was honest that it was not a high success rate.

It is an extremely difficult decision.....I spent hours agonizing until I finally decided it was not right for him. There were some days at first when he was honking that I felt like I should do it......but in the end I could not put him through it.

I will pray for your baby...and for you. It is hard to make decisions like this.

There is one person here on YT who has a puppy .. she is his foster parent. That rescue did have the surgery done on him. You might want to follow his progress. Just do a search for CT and I am sure you will find the thread about him.

fifeandshaffer · 08-25-2010, 07:20 AM

my decison not to have the surgery done on fife was not based on money either, he had legg perthes and needed to hip surgeries and he also had g4 lp and needed 2 knee surgeries, when his trachea started to collapse i took him to several surgeons, most explained it would give him 2 years at best, that was the best any dog had ever lived with the surgery and half of them died within the 1st year, and of the ones that lived longet than a year needed a second stent. For the most part fife lived a pretty comfortable life for 2 years, I knew what to do an when, i knew the signs and contrary to what your vet will say with dosage you will learn what works and when, i didnt always follow the dosage they suggested, i always tried a little less i could always give more I did want fife comfortable but not knocked out. I also used ace when i knew i would have visitors just to take teh edge off, i found marax worked pretty well too, hycoden worked for some time, same as most of the drugs,
I tried them all, in the end even the steroids didnt work. I needed to put fife to sleep in june, he wasnt fife anymore and the heat was killing him. Everyone told me I would knwo when it was time but i thought i knew so many times this was the end then fife would rally and be fine for weeks on end. I also asked my vet to make sure to tell me when she thought it was the end, but infact i really did know. I kept oxygen at home, that also seemed to help, fife didnt love it but it helped. I know its not an easy choice to have the surgery done or not, but you need to do what is right for you and your dog. I didnt think fife would be better off with the surgery. I miss him terribly but i know I did the right thing for him. I wish you the best, and i am sorry.

CindyM · 09-01-2010, 11:24 PM

We have an 8yr old yorkie who has had a collapsing trachea for about 3 years..and progressively gotten worse. In April of this year, we felt we had no other option but to have the stent placed. We had the procedure in April 2010 and have used drugs to keep him calm during his recovery...His cough was only occasional throughout the summer, until about a week or so ago when he began to cough and "honk" again. We took him back to the vet who did Xrays and said the stent still looked good, but now the cervical area (above the stent) is starting to collapse. This will require cervical rings to be placed with a more extensive surgery.

We are still trying to decide if we should have the cervical rings placed--but do not regret the decision we made for the stent. The stent placement cost about $5K total- which gave us 5 happy months with Nikko.

Good Luck.

08-22-2010, 04:51 PM	#1
orkies YorkieTalk Newbie! Join Date: Aug 2010 Location: los angeles, ca us Posts: 3	Recent experiences with stents for collapsing trachea Does anyone have a recent (last 12 months) with using a stent to control collapsing trachea? Our Zoey who's only 6 has had the condition for the last few years. Recently it's gotten much worse. We need to use drugs to knock her out every day. She gets so excited from little things like being hungry or thirsty. We have to watch her constantly. Its not good for us or for her. We are seriously thinking of having a stent inserted, The vet makes it sound like it's very safe. It seems like there are lots of post but very few of them recent. Thanks

08-22-2010, 08:35 PM	#2
kjc I♥PeekTinkySaph&Finny Donating Member Join Date: May 2009 Location: Baltimore, Maryland Posts: 18,866	As per my research, all surgery is very risky and not recommended. Medication seems the best path to take. Cough suppressants, bronchodialators, and glucosamine/chondroitin supplementation to help with cartilage strengthening. Also from: TRACHEAL COLLAPSE in Dogs - Chinaroad Lowchens of Australia How is tracheal collapse treated? Most cases of tracheal collapse are treated with cough suppressants, bronchodilators, corticosteroids (to control inflammation), and/or antibiotics. In obese patients, weight loss helps decrease respiratory effort. Although treatment is not curative, a study released in 1994 showed that 71 percent of dogs treated medically showed a good long-term response. If medical management produces no response in two weeks, or if severe signs compromise the pet’s functionality, surgery is recommended. Various surgical techniques have been described, but the application of prosthetic polypropylene rings to the outside of the trachea is the current treatment of choice, with an overall success rate reported to be in the 75- to 85-percent range. In general, the outcome of surgery is poorer for dogs older than six years. It is a tricky, specialized surgery that is best performed by a skilled surgeon, usually at a referral centre. What else can pet guardians do if their dog has a collapsed trachea? Whether medical or surgical treatment is chosen, pet owners can help relieve signs by keeping their pet’s weight down (even slightly under is ideal), switching from a collar to a chest harness, and avoiding respiratory irritants. __________________ Kat Chloe Lizzy PeekABooTinkerbell SapphireInfinity

08-23-2010, 12:40 AM	#3
ladyjane Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas Posts: 27,451	I would not do a stent if it were my dog. I have not ever seen one live for longer than a year after that surgery. I am not saying it never happens. I just have not seen it happen. I had a foster who died this past Christmas...he had CT and it was severe. I spoke with three different vets and one was a board certified surgeon and not one of them recommended the surgery. They were frank with me about the low successes in this surgery. The following site has detailed information about stents. I am not so sure about their numbers, though. ACVS - Tracheal Collapse This site also has information: Small Animal Surgery Services UF\|Veterinary Medical Center I am sorry you are going through this. It is an awful condition and stressful on everyone. Have you tried Lomotil? If not, ask your vet about it. It helped my pup and has helped others that I have told about it. It is an anti diarrheal, but for some reason does help with CT. If your vet has not heard of it's use, tell him it is in Kirk's Veterinary Therapy book! I am sure you are aware that it is good to keep excess weight off of CT pups. Also, they need to be in a stress free environment and air conditioned. Heat and humidity exacerbate the symptoms. __________________ CLOUD NINE BEDS--YORKIE HAVEN RESCUE MY ETSY SHOP

08-24-2010, 07:17 PM	#8
ladyjane Resident Yorkie Nut Donating YT 20K Club Member Join Date: Sep 2006 Location: Texas Posts: 27,451	The older way with the rings was extremely invasive. The newer stents are not invasive like that, but they collapse in time so it is only a temporary fix. I just personally would not do it after speaking with all of the vets I did. No one was optimistic. My decision was not money based as I will pay whatever it takes to help a pup.....it was just that I felt that the outcome was going to be the same in the end and I just was not willing to put him through surgery with such a low success rate. Sure...many of them are candidates and you can always find vets who do the surgery.....the question to ask is how long is it going to last. What happens when it fails...can the surgery be repeated? What is the real long term success rate. I also used Acepro....I had syringes preloaded with that and Torb for really bad nights. The sounds are honestly worse than what is going on...often they sound really horrible but still have pink mucous membranes and pretty decent oxygenation. In the end, Ozzy was requiring trips to the vet and the EC for oxygen...that was when it was almost over for him. I still find myself staring at his picture here on the wall above my computer. He was such a little trooper....I will never forget him and his struggles. Just made me sick. One day I will see him again...at least I know he no longer struggles to breathe and is running free. I will say this: I spoke with four different vets...two were board certified and not one of them felt the surgery would be a good solution...and one of them was willing to do it. I have never regretted that decision. I believe he would have been dead by now anyway. It is a horrid condition....makes me so sad that dogs are having to suffer such things. __________________ CLOUD NINE BEDS--YORKIE HAVEN RESCUE MY ETSY SHOP

08-23-2010, 06:06 PM	#4
fifeandshaffer YT Addict Join Date: Mar 2009 Location: cherry hill, nj usa Posts: 306	I had a dog with ct, he was 4 when he was diagnosed, and 6 when i needed to put himn to sleep, I am a doctor myself not a vet but a dr, i went to 3 different vets all top surgeons in the country they all said the same thing its risky and the best you will get is probably 2 years at the most, and the chance he will need a stent inside the stent is high, also the dog will need to be on steriods all the time, and long time steroid use is a bad idea. Do you know where the collapse is in your dog, dependong on where it is, your dog may not even be a candidate for a stent. May I ask what meds yor dog is on now? I know how hard it is, my dog was diagnosed at 4 had a pretty good life til 5, and did ok til 6 but the heat in june made it so much worse and his quality of life was down to zero so I needed to put him to sleep. I know i tried everything I could for him, the meds would work for a while then just stop then tried another and another and another til we ran out of things to try, I am so sorry your dog has this. I still hear the wheezing and honks in my head.

08-25-2010, 07:20 AM	#10
fifeandshaffer YT Addict Join Date: Mar 2009 Location: cherry hill, nj usa Posts: 306	my decison not to have the surgery done on fife was not based on money either, he had legg perthes and needed to hip surgeries and he also had g4 lp and needed 2 knee surgeries, when his trachea started to collapse i took him to several surgeons, most explained it would give him 2 years at best, that was the best any dog had ever lived with the surgery and half of them died within the 1st year, and of the ones that lived longet than a year needed a second stent. For the most part fife lived a pretty comfortable life for 2 years, I knew what to do an when, i knew the signs and contrary to what your vet will say with dosage you will learn what works and when, i didnt always follow the dosage they suggested, i always tried a little less i could always give more I did want fife comfortable but not knocked out. I also used ace when i knew i would have visitors just to take teh edge off, i found marax worked pretty well too, hycoden worked for some time, same as most of the drugs, I tried them all, in the end even the steroids didnt work. I needed to put fife to sleep in june, he wasnt fife anymore and the heat was killing him. Everyone told me I would knwo when it was time but i thought i knew so many times this was the end then fife would rally and be fine for weeks on end. I also asked my vet to make sure to tell me when she thought it was the end, but infact i really did know. I kept oxygen at home, that also seemed to help, fife didnt love it but it helped. I know its not an easy choice to have the surgery done or not, but you need to do what is right for you and your dog. I didnt think fife would be better off with the surgery. I miss him terribly but i know I did the right thing for him. I wish you the best, and i am sorry.

09-01-2010, 11:24 PM	#11
CindyM YorkieTalk Newbie! Join Date: Sep 2010 Location: Kirkland, Wa Posts: 1	We have an 8yr old yorkie who has had a collapsing trachea for about 3 years..and progressively gotten worse. In April of this year, we felt we had no other option but to have the stent placed. We had the procedure in April 2010 and have used drugs to keep him calm during his recovery...His cough was only occasional throughout the summer, until about a week or so ago when he began to cough and "honk" again. We took him back to the vet who did Xrays and said the stent still looked good, but now the cervical area (above the stent) is starting to collapse. This will require cervical rings to be placed with a more extensive surgery. We are still trying to decide if we should have the cervical rings placed--but do not regret the decision we made for the stent. The stent placement cost about $5K total- which gave us 5 happy months with Nikko. Good Luck.