Self‐expanding tracheal stent placement in a cat with primary tracheal collapse

Abstract

A 12‐year‐old mixed‐breed spayed female cat presented with dyspnoea, open‐mouthed breathing, and cyanosis that was difficult to control with medical pharmacotherapy; the cat was diagnosed with the primary tracheal collapse of the neck and chest regions. The diagnosis was confirmed by dynamic chest radiography, tracheal endoscopy, and computed tomography (CT). Tracheal endoscopy and CT showed dropsy of the dorsal membranous wall over most of the trachea. A self‐expanding Nitinol cross‐and‐hook braided stent was placed along the entire tracheal lumen using surgical X‐ray fluoroscopy. Bacterial cultures in the trachea were negative. Dyspnoea disappeared immediately after the endotracheal stent was implanted. Although the long‐term prognosis remains under observation, the short‐ to medium‐term prognosis was very good. These results suggest that stenting may be useful in the treatment of primary tracheal collapse in cats.

Medical management of primary tracheal collapse in a cat

“…Plain lateral radiographs are diagnostic in only 59% of canine cases, 10 and definitive diagnosis usually requires either tracheobronchoscopy or CT 1,3–5,7 . As in the current case, these diagnostic techniques were considered necessary to confirm the diagnosis both by directly examining the dorsal tracheal ligament and mucosal prolapse and also by excluding intra‐ or extratracheal compressions 1,3–5,11 …”

“…This case is the first description of a primary tracheal collapse in a cat that was successfully treated with medical management. This condition is uncommon in cats, and surgery is considered to be the only definitive treatment 3,5 . Unlike dogs, where it is a common condition, feline primary tracheal collapse has been rarely reported in veterinary literature 3,5 .…”

“…This condition is uncommon in cats, and surgery is considered to be the only definitive treatment 3,5 . Unlike dogs, where it is a common condition, feline primary tracheal collapse has been rarely reported in veterinary literature 3,5 . Moreover, virtually all of these cases occurred secondary to intra‐ or extraluminal obstruction from neoplasia, epithelial polyps, trauma with secondary tracheal stricture or persistent aortic arch 3,4,9 .…”

“…The principle factor is thought to be a primary cartilage abnormality that causes inherent weakness of the tracheal rings, but secondary factors are required that can initiate clinical signs 1,2 . Tracheal collapse is rare in cats and has most often been associated with secondary intra‐ or extraluminal obstruction 3–5 …”

“…Surgery is the treatment of choice, providing permanent, long‐term management of the condition. The surgical techniques most‐commonly used to manage tracheal collapse are extraluminal rings and intraluminal stents, both of which provide structural support to the collapsed tracheal cartilage 3,5,6 . When surgery is not possible, treatment in dogs includes weight loss, low‐dosage corticosteroids to decrease the level of inflammation of the tracheal mucosa and antitussive drugs, but with much less clinical success than surgery 1,2,7…”