Extraluminal Tracheal Ring Prosthesis in Dogs

The trachea is a structure located in your dog’s neck that connects the nose and mouth to the lungs and stomach. Both air and food travel through this important pathway, making it a vital structure to your dog’s health and well-being. From time to time dogs suffer what is known as tracheal collapse. Extraluminal tracheal ring prosthesis is a surgical treatment that is used to treat severe cases of tracheal collapse in dogs who have not responded well to medical treatment such as the administration of various drugs. This procedure is one of several surgical treatment options your vet will have to choose from and will need to be performed by a skilled veterinary surgeon.

Installation of an extraluminal tracheal ring prosthesis requires a precise surgical procedure. Your dog will need to be admitted to the hospital for several days, beginning with the morning of the surgery. Because anesthesia will need to be administered, you will need to prepare your dog by withholding food and water. This will help prevent complications such as aspiration pneumonia post-surgery. Your vet will also request a full blood panel to confirm your dog is healthy enough for surgery and to eliminate potential complications.

During the surgery, an incision will be made in your dog’s neck. The surgical specialist will open up the layers of skin and tissue to expose the trachea. Plastic prostheses are then attached externally to the trachea. These plastic pieces are rigid and will gently pull the trachea outward, supporting the structure and replacing the natural tissues. Many nerves and blood vessels will need to be carefully cut, manipulated and then replaced. The surgeon will then close up the incision and your dog will be monitored as it regains consciousness. Follow-up imaging such as ultrasound or x-rays will be used to confirm the prostheses are in place and are not shifting after surgery.

In otherwise healthy dogs, extraluminal tracheal ring prosthesis is an effective treatment of tracheal collapse. In 75-85% of cases, dogs will make a full recovery and will lead healthy lives without recurring issues. 

Extraluminal tracheal ring prosthesis is a secondary treatment option. Your veterinarian will first attempt to treat the condition medically. This is done with the use of corticosteroids, antihistamines, and administration of antibacterial drugs to clear up any potential infection. When these methods fail, surgery is the last option. Internally placed prostheses, known as stents, are also sometimes used. Whether your surgeon decides to use external prosthesis or internal stents will depend on the severity of the condition and the overall health of your pet. Recovery and effectiveness of treatment are similar in both surgical procedures with internally placed stents having slightly fewer complications given the less invasive nature of the procedure.

As with any surgery, your dog will need to be kept in a calm, quiet space once they are discharged from the hospital. In order to prevent scratching or aggravating the incision site, your dog may need to wear a cone or other access limiting device around their neck. Your vet may prescribe a special diet of soft foods while your dog recovers in order to avoid aggravating any internal trauma from the surgery. Your dog will need to be kept on a regular schedule of antibiotics to prevent infection and will also be given pain medication. Within several weeks, the incision site will begin to heal with complete healing taking up to six to eight weeks. Your vet will ask for at least one post-surgery follow-up to ensure the prosthesis remains in the appropriate location and that the surgery has been successful in correcting the collapse.

Extraluminal tracheal ring prosthesis requires a sophisticated surgical procedure and costs can be quite high. Costs may vary with the size of your dog and the length of time needed in order to perform the procedure. General costs for a surgical procedure of this magnitude will range from $2,500 to $4,000, including anesthesia, surgery, post-surgical imaging, and medications. This is in addition to medical treatment prior to surgery, which would only entail medications and imaging and diagnosis, but may not cure the collapse in all cases.

As with any surgical procedure, there are potential risks with extraluminal tracheal ring prosthesis. Surgical specialists must carefully avoid major blood and nerve supplies. In some cases, dogs have suffered from laryngeal paralysis after the surgery. With effective application and technique, extraluminal tracheal ring prosthesis is a long-term solution to correct tracheal collapse and the condition should not recur as long as the prosthesis stays in place.

Tracheal collapse can happen for a variety of reasons. Certain breeds have found to be predisposed more than others, which means there may be a genetic component to tracheal collapse. Dogs that suffer from this condition should be removed from breeding programs and should not reproduce. Certain bacterial infections that affect the trachea and airways can be prevented with proper care and immunization of puppies and throughout the life of your dog. Proactive treatment of any signs of cough or cold in your dog will also help correct the condition before it progresses to the point that surgery is needed.