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When to Euthanize a Dog with Tracheal Collapse?

Veterinary reviewed by Dr. Linda Simon.

Tracheal collapse in dogs is a severe and debilitating disease. It can result in complete obstruction of the airways and instant death when it’s not properly controlled. 

Many techniques for managing tracheal collapse have been described in veterinary science over the years.

Some involve surgical procedures and others medication, but the truth is that there isn’t a one-size-fits-all strategy that treats this difficult disease.

The trachea is the windpipe that connects the upper respiratory structures (nose, mouth, and throat) to the lower respiratory structures (lungs). Its anatomical features make it quite a rigid and strong structure.

Basically, it’s a muscle that connects cartilage rings.

The rings are in the form of the letter ‘C’ and don’t form full circles. The open end faces the animal’s back and it’s covered with a membrane sometimes referred to as the trachealis muscle.

Breathing happens when the flat muscle (diaphragm) that separates the chest cavity from the abdominal cavity flattens while in the meantime the muscles between the ribs (intercostal muscles) move – the air gets in the lungs due to change of pressure.

When the same muscles move oppositely the air is pushed out.

In this physiological activity, the trachea is a pathway used to bring air into the lungs.

One part of it is located inside the chest (intrathoracic portion) and one part outside the chest (extrathoracic portion).  

Boston Terrier at the vet.
Photo by Rido on Shutterstock

Tracheal collapse in dogs is a chronic disease with a progressive character.

The condition is most prevalent among toy-breed dogs. Commonly affected breeds include Pomeranians, Poodles, and Yorkshire Terriers.

Most of the time the first symptoms become apparent when the dog is middle-aged, although they can occur at any age.

Tracheal Collapse Explained

Understanding the underlying condition is crucial when it’s time to decide when euthanizing might be worth a discussion (and when it’s time for treatment).

Let’s quickly dive into the science behind a collapsing trachea.

When the cartilage rings of the tracheal wall weaken, the whole organ collapses.

The weakening of the rings is called tracheomalacia – the rings simply become soft and spongy. The usual ‘C’ shape of the rings loses its curvature and form.

All of that makes the tracheal membrane on the open end stretch. Stretching makes the trachealis muscle loosen and become floppy.

The once rigid muscle now oscillates when air passes through the windpipe.

When the trachea collapses inside the chest, breathing in causes the membrane to balloon outward, and exhaling results in occlusion.

The moment the membrane touches the tracheal lining the tickling feeling makes the dog cough.

If the obstruction completely blocks the air passage dogs become severely distressed.

If the trachea collapses in the neck (extrathoracic) the occlusion happens when the dog breathes in and the membrane balloons while exhaling.

Worst case scenario is when the cartilage rings become soft and spongy near the bronchi. The bronchi are two large airways feeding each lung.

Patients with such conditions have the worst type of coughing and the worst prognosis.

Most frequently the trachea collapses at the place where it enters the chest through the diaphragm.

Causes & Symptoms

What causes a tracheal collapse in dogs remains a controversial subject.

The fact that some of the signs appear when dogs are 6 months of age or less supports the theory that the abnormality of the cartilage rings is of congenital origin.

In contradiction, the progression of the symptoms later on in life indicates that the problem could be acquired after birth.

The third notion is that both are true. Tracheal collapse is indeed a congenital disease, but secondary factors are necessary to initiate the condition to become symptomatic later on in life.

Secondary factors include:

  • Airborne irritants (dust, cigarette smoke, allergens)
  • Anesthesia and placing of endotracheal tubes
  • Respiratory infections (most commonly kennel cough)
  • Congestive heart failure
  • Excessive barking
  • Obesity

In more than half of the cases of dog tracheal collapse, there has been one of the concurrent problems listed above that contribute to making it a clinically significant condition.

Often, taking care of the secondary factors clears the symptoms of tracheal collapse as well (weight loss, air filters, etc.).

Clinical symptoms associated with tracheal collapse include:

  • Dry cough – often described as goose honk cough
  • Labored breathing
  • Exercise intolerance
  • Coughing when the dog is picked up
  • Coughing when someone pulls the dog’s collar
  • Cyanosis (blue gums)
  • Collapse after excitement
  • Collapse
  • Wheezing when breathing in

The symptoms get more apparent when there is inflammation in the trachea.

Due to the collapse, the surface of the windpipe gets inflamed and the secretion increases.

The dog starts coughing more often because of it. The inflammation worsens and the products of the inflammation soften the tracheal rings even more.

If left untreated the tracheal tissue undergoes irreversible changes making the condition unbearable.

When Should You Euthanize a Dog With a Collapsing Trachea?

Dogs with mild to moderate symptoms can live a quality life without significant shifts in life expectancy with proper medications.

Therapeutic management is life-long and the contributing factors must be addressed as well. If that means you planned on quitting smoking, this is the right time to do it.

Advanced cases might require surgery as outlined below.

Dog snuggled in bedsheets.
Photo by Igor Normann on Shutterstock

Once you exhausted all options and the symptoms become so severe that the quality of your dog’s life diminishes, it might be better to put him to sleep.

Euthanizing is indicated when the pup fights for every breath and no medication or surgery can help him feel better anymore.

Personally, I recommend getting opinions and thorough diagnostics from at least two licensed veterinarians.

If they confirm the dire prognosis and your dog is not able to enjoy his life anymore and is lethargic, you may have to might this difficult call.

Knowledge about the different stages will help with deciding where to go from here.

Stages of Tracheal Collapse in Dogs

The grade of the tracheal collapse determines the course of action.

Whereas milder cases might be treated by avoiding exposure to secondary factors and prescribing antibiotics, advanced cases might require emergency surgery.

  • Grade 1 – the ring remains in normal shape, the membrane is loose and the space in the trachea is reduced by 25%
  • Grade 2 – the rings are slightly flattened, the membrane is wide and loose and the space in the trachea is reduced by 50%
  • Grade 3 – the rings are almost flat, the membrane is in contact with the surface of the trachea, and the space in the trachea is reduced by 75%
  • Grade 4 – the cartilage is completely flat, the membrane is lying on the trachea, and space in the trachea is completely closed

As the disease is so progressive, the end stages may be reached within a few years, and dying from respiratory distress is one of the most terrifying ways to go.

When It’s Time To Treat

Since dogs with collapsed trachea have a hard time getting rid of infectious microorganisms from the lungs, they’ll need to be periodically treated with antibiotics.

Tramadol, hydrocodone, and other cough suppressants might come in handy when the pup experiences harsh coughing episodes.

To decrease the inflammation and reduce the mucus secretion inside the trachea prednisone and similar corticosteroid hormones are indicated for treatment.

However, there are potential side effects of long-term use so they need to be taken into consideration with caution.

Because they suppress the immune response, corticosteroids can promote infection that damages the cartilage even more.

Minimizing the side effects of corticosteroids can be achieved by delivering the medication in the form of spray directly with inhalers.

The prognosis is not favorable for more complicated cases though.

It highly depends on how progressed the tracheal collapse is and whether there are other treatable or non-treatable concurrent diseases that contributed to the condition.

An emergency reaction due to tracheal collapse is necessary when the dog is in severe respiratory distress.

The gums are an indicator as they become bluish due to the lack of oxygen in the blood.

The vet will stabilize the dog with tranquilizers to relieve the anxiety and oxygen therapy in addition to the usual medications.

When medications don’t help alleviate the symptoms dogs need to go to surgery.

There are two types of procedures being performed – placing a tracheal stent and placing steel tracheal rings.

The first procedure is more frequently performed in the last few years.

The average life span for dogs that needed to go to surgery is around 2 years, though many will live for 2-3 years more.

Can Collapsing Trachea Kill a Dog?

A collapsing trachea has the potential to end a dog’s life. The narrowing of the space inside of the trachea can be so serious that not enough air can get into the lungs.

In such a case the dog will die of respiratory distress.

Most of the time the condition won’t progress so far and the symptoms will only be limited to coughing and exercise intolerance.

My Dog Died Due To a Collapsed Trachea

If your dog died from a collapsed trachea, there are ways to reflect and learn from it to prevent incidents in the future.

First off, I’m extremely sorry anybody has to go through the experience of losing their dog to a medical issue.

If you didn’t notice the collapsing trachea or wrote it off, it’s crucial to learn more about symptoms of various conditions and, if in doubt, to consult a licensed veterinarian.

But if you noticed it and went to the vet, you may have questions and want to know whether the treatment was according to protocol.

It’s true that passing due to a collapsing trachea is usually not a pleasant way to go and euthanasia should be discussed in extremely advanced cases unresponsive to treatment.

Vets can mistakes and if you assume your vet has made a grave error of judgment, do contact them and find out what went wrong.

Dog Tracheal Collapse Home Treatment

To be clear, a dog who is suspected of suffering from a collapsing trachea needs to see a vet.

But some cases can be, after discussing this with your vet, helped at home with clean air, a healthy weight, a body harness, and perhaps omega-3 fatty acids and antioxidants in their diet.

Make sure the air is well-ventilated and free of irritants (dust, cleaning products, cooking fumes).

A harness is beneficial for your dog’s neck.

Omega-3 and antioxidant compounds have anti-inflammatory properties that may calm down the surface of the trachea.

Patients with collapsed trachea need to live stress-free lives because anxiety makes things even worse.

Holistic vets often prescribe CBD, flower essence, and aromatherapy as they might help calm your pup’s nerves down.

Benadryl for Tracheal Collapse

Benadryl is an antihistaminic widely used in dogs.

The only time it can be given to patients with tracheal collapse is when allergies are suspected to be the secondary trigger for the condition.

Otherwise, Benadryl won’t have any effect on a collapsed trachea because the problem is of anatomical nature.

Do not medicate with over-the-counter medicine at home in any case without veterinary supervision.

Bronchodilators for Dogs

Airway dilators or bronchodilators are used to treat coughs in dogs that are a result of bronchoconstriction or bronchospasm.

The two most widely used bronchodilators in dogs are Theophylline and Terbutaline. Their use in treating tracheal collapse is controversial.

Although they can dilate the lower respiratory portions, they might not have any effect on the trachea itself.

However, since the lower airways will be dilated, the pressure in the thoracic cavity might not be so big and the trachea won’t collapse as greatly when breathing in.

Whatever you decide to do, please visit your vet if you suspect any respiratory issues with your dog or otherwise notice irregular behavior or symptoms.

Putting a dog to sleep should be the last resort as euthanizing a healthy dog that just suffers from temporary trachea issues is the last thing any dog owner should want.

If a vet has determined treatment options are exhausted and your dog suffers so strongly that you consider euthanasia but have a low income, please refer to this low-cost euthanasia resource.

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Disclaimer: This blog post does not substitute veterinary attention and does not intend to do so. I am not a veterinarian or pet nutritionist. If your dog shows any sign of illness, call your vet.

About Danielle

Equipped with 5+ years of expertise as a Rottweiler owner, I partner with licensed veterinarians and trainers to share research-backed and actionable advice for you and your furry friend.

Christine Hamilton

Sunday 18th of June 2023

My dog had been having a terrible cough and fairly lethargic over the last few weeks I took her to vet and had all types of test run they said everything was ok Dr stated of my concern and hat perhaps tracheal collapse but never mentioned any kind of treatment or that it could be life threatening sadly last night my dog became so distressed and labored breathing she finally died


Sunday 18th of June 2023

Hi Christine, I'm so sorry for your loss, there are no words to describe the feeling of losing your dog. I'm not a vet and don't know any specifics in this case but it does sound rather strange how the vet went about this, I would definitely suggest reaching out to them as it should never happen this way.


Tuesday 31st of May 2022

Thank you SO much for this information. I have a very active 15 yo Poodle Maltese. Her cough started 2 years ago. We purchased a stroller and still use it when it is hot or she seems tired. We have never put her on a collar w leash but adopted her at 1 yo so not sure if the trachea was damaged then but her symptoms started 2 yrs ago at age 12-13 yo but after placing her on hydrocodone w hystotropine her symptoms stopped and rarely had to give her meds at all. However, she started having seizures in Nov and started Keppra in March. Her breathing issues have exacerbated in last 2 weeks and she has really struggled last few days. A neighbor told me about her yorkie who is on herbs from a holistic vet for collapsed trachea and also ozone therapy. Do you think herbs and ozone therapy can be advantageous? Sidebar-she was diagnosed in April w a 3-4 heart murmur. We have a six year old who doesn’t bark but excites our 15 yo who is a barker when people ( we have 3 teenagers) come home, packages delivered etc. Should we try to minimize barking and how? Again, so wonderful of you to offer help. Thank you!! I will be taking her in the morning to her regular vet and contacting the holistic vet but wondered what you thought on the herbs and ozone therapy.


Tuesday 13th of September 2022

@Danielle, My 15.9 yorktese has had collapsing trachea since a pup but it didn’t bother her much until about six months ago when she started coughing a lot. Then about a month ago the vet told me her teeth were stage 4 and painful so I agreed to dental procedure. However, the endotracheal tub exacerbated her coughing to an unbearable degree. She was already on Hydrocodone and Trazodone. The vet added cough meds and Gabapentin along with. Benedryl at night. She has a grade 3-4 heart murmur snd is also on vetmedin. She also has kidney disease so the vet is cautious about steroids but she can take 1/4 twice a day. With all this she still coughs, is lethargic and doesn’t eat well. Eating and drinking cause coughing. I’m grappling with euthanasia. Any other ideas! Oh, her enlarged heart is pressing on her left bronchial stem as well.


Thursday 2nd of June 2022

Hi Jill, glad you found the information helpful. Definitely sounds like you haven't tried everything yet and the fact that she's still active sounds great.

It seems as if the meds helped, but of course, the seizures are a serious side effect if, in fact, it comes from these meds. Definitely ask your vet if you can switch meds or what other possibilities are out there, you can also ask them to coordinate with a holistic vet if they're open to that.

Herbs and ozone therapy can certainly be used in conjuncture with conventional treatment or if the conventional treatment failed altogether. I've heard positive things about ozone therapy and many holistic vets write articles about it. Haven't encountered it personally yet and it's used for a pretty wide range of medical issues. Similarly, many claim that herbs will help and it's certainly worth a try if used under a vet's supervision.

In regards to the barking: Of course, you can try to minimize that but if it doesn't seem to worsen her condition or cause pain, it shouldn't be that big of a deal if she occasionally barks. A very busy household can be difficult for senior dogs in general so I'd personally just make sure to minimize stress and provide her with a calm resting spot, sleep, a healthy diet, and the proper amount of (mental) exercise.

Hope your pup will make great progress. Let us know how it goes. Danielle

Sally Smelser

Wednesday 16th of March 2022

Thank you for this information. It was of great help. I realized my dog was not getting better, nothing was working, and that he was miserable. I had him euthanized after another terrible night of coughing, moaning, and difficulty breathing. Information helps make informed decisions.


Wednesday 16th of March 2022

Hi Sally, I'm so sorry for your loss. If no conventional or even alternative treatments are working, he's clearly in constant distress and your vet agrees that the quality of life just isn't there, then that's often the best choice for your dog to avoid unnecessary suffering.