Managing Tracheal Collapse in Dogs | Jean Dodds, DVM

If you google “tracheal collapse vs. reverse sneezing in dogs”, you will see thousands of videos demonstrating the coughing difference between the two conditions. Truth be told, I only saw two videos that clearly distinguished the two – and I’m a vet! The problems are: both conditions can produce slightly different but similar coughing sounds; they predominantly affect small breeds; they have similar triggers; and, the dog breed’s size and shape can affect tonality.

Let’s compare the two.

Reverse Sneezing

  • Episodic – lasts a few seconds and dog recovers.
  • Also known as “pharyngeal gag reflex”.
  • A frontline of body defense response, as it is commonly provoked by an irritation to the throat, pharynx or larynx. Sometimes respiratory infections can provoke a reverse sneeze. Dogs with elongated soft palates (Bulldogs, Pugs) will occasionally suck the palate into the throat and cause a sneeze.
  • Typically a choking or asthma sound but can sound like honking.
  • Dog generally stands with elbows spread apart, head extended or back, eyes bulging, and stomach looks like it is retching.
  • Stimuli include leash pulling, tight collars, physical exertion and excitement, euphoria.
  • Most common stimuli are environmental, inhalant irritants such as pollen, cleaning supplies, pollutants, room odor sprays, colognes, etc.
  • Common throughout all breeds but small breeds are more likely to have frequent episodes. 

Tracheal Collapse

  • Progressive, chronic disorder that weakens or relaxes the trachea tube’s cartilage from a “C” shape to a “U” shape – making breathing more difficult and labored.
  • Congenital, inherited or acquired malformations. Congenital or inherited tracheal collapse is relatively common in pets born with incomplete C-ring cartilage that surrounds most of the circumference of the trachea. Acquired form is usually due to chronic respiratory disease, Cushing’s disease (overactive adrenal gland activity), or heart disease.
  • Chronic cough occurs (“goose honk”, dry and hacking).
  • Cough can worsen with excitementenvironmental irritants, stress, exercise, leash pulling and collars. Drinking and eating can provoke retching, gagging or choking.
  • Fainting episodes and/or “turning blue” of the tongue or gums (cyanosis) can occur in severe attacks.
  • Occurs most commonly in small breed dogs particularly in the Chihuahua, Lhasa Apso, Maltese, Pomeranian, Pug, Shih Tzu, Toy Poodle and Yorkshire Terrier.


As you can see, several triggers of both tracheal collapse and reverse sneezing overlap and a dog with a collapsed trachea could have a reverse sneezing episode. However, the treatment options are not the same for the two conditions unless a flare-up occurs due to a respiratory infection. In that case, veterinarians would prescribe the right antibiotic to clear up the infection, but it would not cure the underlying tracheal collapse. One of the common tips for pet caregivers to help a companion dog get over a reverse sneezing episode is to cover the companion dog’s nostrils briefly, causing him to swallow, to clear the irritation and stop the sneezing. This is definitely worth a try – if it truly is reverse sneezing. However, if the condition is an undiagnosed tracheal collapse or any other condition, you could send your dog into cardiac arrhythmia or even arrest.

I have used reverse sneezing as a comparison to tracheal collapse here, since it is so common. Accurate diagnosis of tracheal collapse is imperative though because the symptoms are similar to other anatomical respiratory abnormalities, infections, or cardiovascular diseases such as heart disease. At this time, the available diagnostic tools are x-ray, bronchoscopy (endoscopy), and fluoroscopy. A bronchoscopy is invasive and needs to be done delicately as it could cause additional damage. A fluoroscopy is a continuous moving x-ray that gives vets a movie of the air moving in and out of the lungs. The fluoroscopy technology is expensive and new so you may need to go to a veterinary school or specialist clinic to have it done.

Conventional Treatments

Conventional treatment options such as cough suppressants, bronchodilators (like asthma medication for humans), and oral or inhaled corticosteroids or a corticosteroid-antihistamine combination often control inflammation. This is important since inflammation creates a never ending cycle of cough and more inflammation.

Dogs with tracheal collapse are highly prone to upper respiratory infections due to the inability to clear bacteria. Antibiotics would then be prescribed.

Surgery should only be performed in extreme cases.

Management Techniques

If you have followed my articles, you will know that I discourage the routine chronic use of corticosteroids due to the long-term side effects. Further, unnecessary use of antibiotics can build up resistant strains of microorganisms to impair their effective use in future. Pet care management tools are available to avoid this options as much as possible.

1. Harnesses only! 
Collars constrain the trachea and can also contribute to thyroid and salivary gland damage.

2. Weight Control 
Additional pounds or ounces cause respiratory distress because hauling weight around requires a higher level of exertion. So, please keep your companion dog (and yourself) slim. Many pet parents may struggle with this point if their companion dogs require exercise restriction or are taking corticosteroids prescribed to dampen the inflammation as they often cause weight gain. It’s a vicious cycle. Definitely work with your veterinarian or animal nutritionist on a weight loss plan.

I always suggest a thyroid check as obesity or recent weight gain can be a symptom of hypothyroidism. So, if you can control the hypothyroidism with medication, the weight may come off more easily. Please note that tracheal collapse is not usually secondary to hypothyroidism. The goal is to control the weight with food caloric restriction, and annual thyroid screens.    

3. Stress Reduction/Anxiety Control
It’s very important that the caregiver or others be taught what to do to calm the panicked dog (and person) when a stress-related “attack” occurs. Pet Rescue Remedy should be applied in the mouth plus lavender aroma therapy (dab on nose, behind both ears, and on harness). Lavender aroma spray, essential oil or sachets can be spread around the home as well.  

Anxiety is also highly linked to thyroid deterioration. Again, I recommend an annual thyroid screen to help manage the thyroid and to minimize any thyroid dysfunction – related coughing attacks.  

4. Immune Support
A healthy immune system allows the body to fight off infection and avoid antibiotics as much as possible.

5. Glucosamine/Chondroitin
Chondroitin sulfate works in conjunction with glucosamine to reduce joint and other tissue inflammation, to slow the deterioration of cartilage (the building block of the trachea), and stimulate cells found in cartilage (chondrocytes). Make sure the companion dog does not have a food sensitivity to any of the ingredients in these supplements, as most are made from shellfish.

6. Moisture Rich Diet
Dogs often swallow kibble whole. Kibble is also hard to digest unless it is first moistened and softened. This combination may lead to retching or gagging, which may provoke coughing. It can also predispose to aspiration pneumonia if any food gets into the trachea during the coughing. I strongly encourage feeding canned, reconstituted freeze dried or dehydrated, home cooked or raw diets as they pass more easily down the esophagus.

7. CPR & Heimlich Maneuver for Dogs
Most importantly, please learn CPR and the Heimlich Maneuver for dogs as a coughing attack from tracheal collapse can be fatal.

W. Jean Dodds, DVM
Hemopet / NutriScan
11561 Salinaz Avenue
Garden Grove, CA 92843


Becker, Karen, DVM. “How to Perform the Heimlich Maneuver on Choking Pets." Healthy Pets. Mercola.com, 14 Nov. 2015. Web. 17 Sept. 2016.http://healthypets.mercola.com/sites/healthypets/archive/2015/11/14/pet-choking-emergency.aspx.

Becker, Karen, DVM. "How to Recognize an Episode of Reverse Sneezing.” Healthy Pets. Mercola.com, 3 Dec. 2012. Web. 17 Sept. 2016.http://healthypets.mercola.com/sites/healthypets/archive/2012/12/03/reverse-sneezing.aspx.

Dodds, W. Jean, DVM, and Diana Laverdure, MS. Canine Nutrigenomics: The New Science of Feeding Your Dog for Optimum Health. Wenatchee, WA: Dogwise, 2015. Print.

Dodds, W. Jean., DVM, and Diana Laverdure, MS. The Canine Thyroid Epidemic: Answers You Need for Your Dog. Wenatchee, WA: Dogwise, 2011. Print.

“New Guidelines for CPR in Dogs, Cats.” American Veterinary Medical Association, 15 July 2012. Web. 17 Sept. 2016. https://www.avma.org/news/javmanews/pages/120715g.aspx.

Spector, Donna, DVM. “What You Need to Know About Collapsing Tracheas in Dogs.” Vetstreet, 15 Oct. 2012. Web. 17 Sept. 2016. http://www.vetstreet.com/our-pet-experts/what-you-need-to-know-about-collapsing-tracheas-in-dogs.

“Tracheal Collapse in Dogs: Signs, Causes, and Treatment." Pets. WebMD, n.d. Web. 17 Sept. 2016. http://pets.webmd.com/dogs/tracheal-collapse-dogs.