Specialists? approach to tracheal collapse: survey-based opinions on diagnostics, medical management, and comorbid diseases

OBJECTIVETo describe the current standard of care among specialists for the routine diagnostic evaluation and medical manage-ment of stable tracheal collapse in dogs, identifying gaps between practice and scientific evidence to facilitate the development of future prospective studies. A secondary objective was to describe the perceived incidence of selected comorbid disorders in dogs with tracheal collapse and the diagnostic tests performed to evaluate for those disorders.SAMPLE180 veterinary specialists in 22 countries.PROCEDURESAn electronic survey was sent to 4 specialty listservs to target diplomates. Respondents completed multiple-choice and free-response questions related to the diagnostic evaluation and treatment of a theoretical stable dog with suspected tracheal collapse.RESULTSMost respondents routinely utilized radiography, tracheobronchoscopy, and fluoroscopy to diagnose tracheal col- lapse and performed airway sampling, sedated airway examination, and echocardiograms to rule out comorbidities. The most frequently perceived comorbid disorders included chronic bronchitis, bronchomalacia, and myxomatous mitral valve disease. Respondents most often prescribed opioid antitussives, glucocorticoids, anxiolytics, and anti-biotics as treatments. Less frequently, they utilized bronchodilators and nonopioid medications for cough. CLINICAL RELEVANCEDespite a lack of published guidelines, specialists have similar approaches in their diagnostic and therapeutic ap-proach to a stable dog with suspected tracheal collapse and believe evaluating for comorbid disorders is important. A description of a typical diagnostic approach and knowledge of realistic treatment goals will assist the general practitioner managing dogs with stable tracheal collapse. Additionally, gaps between current practices established via this survey and data supporting those practices exist, specifically concerning the use of antibiotics and nonopi- oid medications for cough, representing areas for further study.