Endoscopic Placement of an Intraluminal Stent for the Treatment of a Grade IV Tracheal Collapse in a Dog
André L. Selmi, DVM, MS, PhD; Tatiane M. Ferrarias, DVM; Adriana T. Nishyia, DVM, MS; Cláudio A. Moura, DVM, MS; Adriani Provasi, DVM, MS; Franz N. Yoshitoshi, DVM, MS; Fernanda A.B. Auler, DVM; Luciano Pereira, DVM, MS; Ana C. Teixeira
Tracheal collapse is a common cause of dyspnea in toy breeds and treatment varies from conservative management to intra or extra-luminal surgical stenting of the collapsed segment. The authors describe the use of a non-covered nitinol stent in a toy poodle with a grade IV tracheal collapse. The dog was presented with an abdominal breathing pattern, cyanosis, systolic murmur in the mitral focus and eventual syncope. Radiographs during inspiration and expiration confirmed the collapse from the cervicothoracic region to the mainstem bronchi. Conservative management consisting of aminophylline, prednisone and chondroitin sulphate had been administered for 18 months prior to presentation with no clinical improvement. Enalapril maleate was given to the dog the week before endoscopic surgery. General anesthesia was induced with fentanyl and etomidate and maintained with isoflurane delivered via a face mask. A 10mm X 80 mm biliary stent was delivered under endoscopic visualization of the collapsed segment and radiographies were taken to determine the exact location of the device. The dog made an uneventful recovery and a marked improvement was observed in the breathing pattern. Prednisone and amoxicilline-clavulanate was administered for 14 days postoperatively. Follow-up clinical and radiographic examination (2 months postop.) did not show dislodgement of the stent or worsening of the clinical signs, but the dog showed eventual coughing after excitement episodes. The authors conclude that the non-covered nitinol stent may be an alternative technique for treatment of severe cases of tracheal collapse.