Does your dog ever honk like a goose?

Believe it or not, “honking” is one of the most common reasons for dogs to land in my office. When I was in general practice, clients would complain of their dogs honking as a nuisance. In emergency practice, I have discovered that middle-of-the-night honking takes on a new urgency since it interferes with owners’ sleep.

The activity that is colloquially referred to as honking is in fact coughing. It generally is caused by a specific type of cough: one that is tracheal in origin.

The trachea is the windpipe, and anything that causes irritation of the windpipe will cause a dry, loud, honking cough. The honks often come in groups. Sometimes after a series of honking coughs dogs will spit up a small amount of white, foamy material — saliva that has been frothed up by all of the coughing.

Help, I’ve got a goose in my throat

Tracheal irritation, which causes those honking coughs, is itself caused by a number of factors. It may be because your dog has inhaled irritating chemicals or allergens. An enlarged heart can lead to compression of the trachea inside the chest. Infections, most notably infectious tracheobronchitis — better known as kennel cough — commonly cause honking coughs. And last, but not least, a syndrome known as collapsing trachea often causes irritation of the windpipe. These causes are not mutually exclusive, and they often occur together.

Regardless of the underlying cause, dogs with windpipe issues behave as if they suffer a tickle in the throat. Anything that stimulates the windpipe, such as rapid air movement or outside pressure, may trigger coughing. Therefore, dogs with windpipe issues are prone to coughing when they are excited or when their throats are stimulated by pressure.

What causes collapsing trachea?

Although many potential causes for tracheal irritation and honking exist, two are most common. Kennel cough is a brief, generally opportunistic, and self-limiting syndrome that rarely leads to significant complications for dogs. Collapsing trachea, on the other hand, is potentially more serious — and it is very common.

Collapsing trachea is rampant, nearly to the point of ubiquity, in toy and small breeds of dogs such as Yorkshire Terriers and Miniature or Teacup Poodles. However, it is not limited to these breeds; all small dogs are predisposed. Small dogs are prone to a congenital irregularity in the firm structures that hold the windpipe open during breathing. As they mature, the structures weaken, predisposing the windpipe to distort, narrow, and in severe cases collapse.

The condition also is common in Pugs, Bulldogs, and other so-called brachycephalic (short-nosed) breeds. Dogs in this category needn’t be small — I have seen collapsing trachea occur in Bullmastiffs. In these dogs, the trachea collapses secondary to chronic resistance in the upper airway (ie, the contorted passages of the snout). Dogs that suffer from a condition called laryngeal paralysis (Labrador and Golden Retrievers are predisposed) may similarly develop collapsing trachea.

How do I know whether my dog has a collapsing trachea?

You can get a definitive diagnosis by asking your vet to perform radiographs (X-rays) or endoscopy. However, be aware that sometimes X-rays do not pick up the condition because in most instances the dog’s trachea collapses only intermittently. Therefore, the timing of the X-rays must coincide with the collapse of the windpipe for the condition to be evident.

Collapsing trachea sometimes is diagnosed presumptively based upon clinical findings and history. Your vet may be able to detect the condition by palpating the windpipe.

The consequences of collapsing trachea depend upon the severity of the condition. Fortunately, most dogs with the condition, especially small dogs, rarely suffer from severe tracheal collapse. For these individuals, the condition is primarily a nuisance. However, some unfortunate individuals may experience tracheal collapse that is severe enough to compromise breathing and thus may be prone to life-threatening crises from the condition.

How do I prevent or ameliorate collapsing trachea?

1. Stop using neck leashes. The most basic treatments involve minimizing stress on the windpipe and respiratory system. Using neck leads can put pressure on the windpipe, and they should be avoided in any dog with collapsing trachea (and, in fact, I recommend avoiding them in all dogs since nobody benefits from windpipe stress).

2. Put your dog on a healthy diet. Obesity dramatically complicates and exacerbates the symptoms of collapsing trachea. Therefore, weight management is one of the most crucial steps that must be taken for any dog.

3. Avoid heat exhaustion and overexertion. Dogs regulate their body temperatures by panting, so dogs with collapsing trachea may experience compromised effectiveness of panting. Hot and humid days therefore may be troublesome, and excessive activity and excitement can trigger respiratory crises.

4. Get your dog a full checkup. Collapsing trachea often occurs simultaneously with other conditions, such as heart disease or chronic bronchitis, that can compromise breathing. Treatment of these so-called comorbidities is especially important.

Treating collapsing trachea with medication and surgery

Cough suppressants are common, especially during symptom flare-ups, for dogs with mild cases. Bronchodilators do little to prevent collapse of the windpipe, but they can help move air through the lower portions of the lungs.

Some veterinarians advocate the use of anti-inflammatory medications for the condition. In my experience, the benefits of long-term anti-inflammatory medications often are limited, and these drugs should be used cautiously and judiciously.

Finally, surgical interventions are available for severe cases. Some clinicians place stents (devices to hold the trachea open) inside of the trachea. This technique generally is preferred in developed countries, but may not be available everywhere and usually is performed only by specialists. Other vets advocate use of a surgical technique that involves external stent placement. This technique may be employed by non-specialists, but it has the potential to lead to complications such as laryngeal paralysis.

Collapsing trachea is a very common syndrome, but please don’t panic if your dog is diagnosed with it. In most cases, weight management and judicious management of activity, excitement, and heat exposure are sufficient to cope with the condition.

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Got a question for Dr. Barchas? Ask our vet in the comments below and you might be featured in an upcoming column. (Note that if you have an emergency situation, please see your own vet immediately!)