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Heart Disease And Tracheal Collapse

Tracheal collapse is often found in small dogs that are middle aged or older, and owners often ask whether a long-lasting cough is the windpipe or the heart. Veterinary sources give a more tangled answer. Both can be present at once. This page lays out what they say.

Why Vets Check The Heart

VCA Animal Hospitals says other causes of coughing, including congestive heart failure, must be ruled out, and that sometimes heart disease and a collapsed trachea are present at the same time. The American College of Veterinary Surgeons uses chest X-rays partly to look at heart size and lists an echocardiogram, an ultrasound of the heart, among the tests to evaluate cardiac function. Cornell University College of Veterinary Medicine lists heart disease with obesity as a coinciding condition that can contribute to more severe signs.

What One Study Found

a 2024 Seoul National University study of 110 small dogs looked at dogs with tracheal collapse that were coughing. It excluded dogs whose heart or lung conditions were not well controlled. Even so, 55.4 percent of the dogs had myxomatous mitral valve disease, a heart valve disease, at stage B or higher, and 26 percent had pulmonary hypertension, high pressure in the lung blood vessels. Because the study only included dogs with controlled disease, it does not tell us how often a dog with uncontrolled heart disease also has a collapsing trachea.

In the same study, the presence of heart disease and of pulmonary hypertension did not significantly predict how severe the cough was before treatment. The authors found that the location and grade of collapse did not predict it either.

Which Cough Is Which?

This is hard, and even specialists say so. In a study of 329 dogs with a long-lasting cough at an English specialty hospital, of 329 dogs with a chronic cough seen at one English specialist hospital, airway collapse was the most common diagnosis, at about 31 percent, followed by chronic bronchitis (24 percent), tumors (19 percent), and infectious bronchopneumonia (16 percent). The authors also note that whether heart disease causes coughing by itself has always been a controversial topic: some clinicians think an enlarged left atrium and heart failure can cause chronic coughing on their own, while others think there is another cause that heart disease aggravates. They also write that cough and heart disease often occur together but are not necessarily linked. For the clues owners usually notice, see Honking Cough Or Heart Disease?

What It Can Change

• Outlook. Cornell says dogs with additional underlying conditions such as heart disease may have a poorer long-term outcome.
• Treatment plan. Cornell says underlying conditions such as obesity and heart disease must be addressed along with the windpipe.
• Anesthesia. The English cough authors say it is possible that heart ultrasounds were done in small dogs to assess the risks of general anesthesia, which is needed for a scope, particularly in dogs with a murmur. They say they could not confirm that reasoning from the records.
• Procedures. Mizzou lists patients with other severe illness among those for whom a tracheal stent is not always a good option.

Risk Factors Named By An Insurer's Article

Embrace Pet Insurance, in an article reviewed by a veterinarian, lists heart disease among the additional risk factors for tracheal collapse, along with obesity, Cushing's disease, chronic respiratory conditions, and exposure to smoke or other airborne irritants.

Questions To Ask Your Vet

• Has the heart been checked, and how? A stethoscope exam, X-rays, or an echocardiogram?
• If my dog has a murmur, does it explain the cough?
• If both problems are present, which one are we treating first?
• Does my dog's heart change the plan for any procedure or for anesthesia?
• How should I tell the two kinds of cough apart at home?

A phone video of the cough and a note of when it happens (at rest, at night, with excitement, with a collar) are useful to bring. Heart and airway problems can overlap, and only tests can sort out what is going on in your dog.

To see listed practices near you that say they treat tracheal collapse, use Find A Practice. We show every listed practice that serves your area, and you choose who, if anyone, to contact.