What are some treatment options for a dog living with tracheal collapse? May 14, 2018

What are some treatment options for a dog living with tracheal collapse?

Original Question: Please tell me, his C-rings are degenerating (i.e. Dx tracheal collapse) approximately 5 years ago. Tussigon (hydrocodone 5mL/mG, Homatropine 1.5mL/1.5mG) is a life-saving agent taken and is prescribed as follows: Give 1.5 to 2.5 mL PO Q6-8H to control cough. It roughly breaks down to approximately 300mL/1 month. Of course, there is some (or shall I say, a lot) of resistance to his compromised ability to feed and drink and the very chronic nature of this condition leaves a caregiver pretty much bleak prognosis’ if he was to be sedated and the enduring a controversial procedure (‘stents’, various, various, and more various applications in the procedure itself, as well as it’s pessimistic prognosis (regardless of age, in fact) and a veterinarian surgical science that has not much evolved since it’s very inception. Not to mention, it now appears that universities across the union have training interns (under instructional guidance, of course) as the only medical facility to go forward with rather outrageous follow-up appointments and the lowest price I found came to a whopping $9,300 with little hope. Well, any suggestions? Thanks :) - Xavier

Hi Xavier,

Thanks for your question.

I can sense the frustration you have in your question. Your dog is currently on a good treatment plan and the medication regime is ideal. This is a progressive degenerative condition so regardless of how great the treatment plan is, the state of this condition will continue to decline. It sounds like you are now seeing an advanced stage of it if surgery is now being considered.

I find one of your statements extremely surprising. In fact, I think your frustration is so strong that it is impairing your ability to rationally understand and assess your current options. This comment about veterinary surgical science not progressing is so obtuse I really have no desire to advise you on it. The more concerning comment you make is that the surgical options for this condition are ‘controversial’ and ‘have a pessimistic prognosis….regardless of age’. These statements are simply wrong and it worries me about the source of your information. I have seen many patients receive this procedure and they consistently do well with it and have good outcomes. I see dogs live for years after it is performed.

Perhaps the real frustration comes from the price of this procedure. Only board-certified surgeons can perform this type of procedure and because of the airway being manipulated during it, the procedure is commonly performed at a specialty centre where other specialists and highly specialized equipment needs to be used. An anesthesiologist is commonly needed to monitor the anesthesia and equipment such as respirators need to be on hand in case of any breathing problems during the procedure. The price you have found is higher than I have encountered but not by a lot and it isn’t a surprising figure when you consider that you have multiple specialists required for the procedure that have easily spent more than 10 years in post-secondary training and additional years in practice to achieve the proficiency to offer this option. I’d like you to know that the average veterinarian working today, at least in Canada, makes less than a 6 figure salary and most often have debt that lasts for a decade or more after they complete their training. They are not wealthy people and I’ve never met one who got into this career for the money. They all did it because they wanted to save lives.

I’m sorry to hear you’re going through this. When our pets are towards the end of their lives, this is when expensive and dramatic medical intervention is needed, just like ourselves. However, I will leave you with a thought or two. I think it’s important to say to yourself that this is a challenging issue and that you shouldn’t feel guilty if you do not decide to proceed.

I wish you the best and good luck.

Dr. Greenway

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