What is the treatment for a tracheal collapse in small dogs? What could cause an enlarged heart in dogs?

Original Question: My 11-year-old Shih Tzu has been diagnosed with a collapsed trachea. Last Monday he was breathing bad and had been coughing for a few months. The vet said it could be his trachea or heart problems. Mondays x-ray showed a collapse and that his heart is enlarged. The vet gave him Tramadol, steroids and an antibiotic for 2 weeks. What is the long-term outcome for this disease? I don't have much money and any keep paying hundreds for treatments. Are the medications he’s on the right ones? His breathing is very laboured and is home now. What would be my next steps? Thanks in advance. - Joan

Jun 5, 2017

Hi Joan,

I’m sorry to hear your little guy isn’t doing well. As our pets age, it is common for them to develop many of the problems you have noted here. Collapsing trachea (AKA the “windpipe”) can be a very scary thing to deal with, and also difficult to treat. Tracheal collapse in small dogs such as yours is common and is usually not preventable. Essentially, what happens is the tracheal rings begin to weaken, and don’t keep the trachea open. This makes it hard for air to pass through. Collapsing trachea is often treated with medications to deal with the symptoms. There is no definitive treatment or “cure.” It is mostly focused on managing the symptoms (coughing). It generally does progress as the pet ages, unfortunately, leading to uncontrollable coughing and an inability to breathe normally. In some cases, surgery can be performed to “stent” the trachea. This is a very specialized procedure that would require a referral board-certified veterinary surgeon.

An enlarged heart in dogs could be caused by heart disease, and you mentioned that it was enlarged on the X-rays. It is definitely possible there is more than one disease process going on here. If there is any indication of a heart problem what I often recommend doing is a heart ultrasound (or echocardiogram or “echo) to further investigate the heart. This is the most definitive way to determine if your pet has heart disease, how bad it is, and how to manage it appropriately. While this test is not cheap, the knowledge we gain from this test is very important. It can really make a difference long-term in helping select the right treatment for your pet. Heart disease can be manageable for long periods of time depending on the underlying cause and severity, and I always encourage people to give treatment a try as it can make a world of difference.

I would really encourage you to check-in with your veterinarian if your dog is continuing to have difficulties breathing. There may be more that can be done to help manage his symptoms and to make him more comfortable. I hope this is helpful.