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Tracheal Collapse and stents

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Tracheal Collapse and stents

Post  northernwitch on 6/21/2012, 5:13 pm

My new foster boy has a number of health issues--one of which appears to be a severely collapsed trachea. There are numerous other issues which I'll go into later, but I need to know what people's experience is with this and especially this procedure.

The surgeon says that the outcome isn't guaranteed and that stents for severe collapsing trachea bring their own risks that can be as bad as the collapsed trachea.

He is now on hycodon (hycodan?) and prednisone until July 4th when his surgery is scheduled (we are having to remove both his eyes due to neglect by owner). He is 7.5 years old.

In either case, he is now likely a hospice pug as no matter what we do--medical management or surgery--he will be eyeless with a significantly shortened life due to the trachea.

So let's hear your experience.....
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Re: Tracheal Collapse and stents

Post  Renee on 6/21/2012, 5:22 pm

Awe, this breaks my heart for him.

I don't have any experience with collapsed trachea surgery. Jana Papa needs to chime in here, because her pug Baby Girl (RIP), had tracheal surgery. Sadly, my only experience with a bad trachea ended in euthanizing the pug. Crying or Very sad

Good luck for your new boy. I would love to hear all about him. So glad he is with you now.
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/21/2012, 5:29 pm

Renee wrote:Awe, this breaks my heart for him.

I don't have any experience with collapsed trachea surgery. Jana Papa needs to chime in here, because her pug Baby Girl (RIP), had tracheal surgery. Sadly, my only experience with a bad trachea ended in euthanizing the pug. Crying or Very sad

Good luck for your new boy. I would love to hear all about him. So glad he is with you now.
I'm inclined at this point not to do it--for a couple of reasons--dogs over the age of 6 have a poorer outcome and this guy is coming up on 8. The collapse is severe so the surgery would be risky and expensive--and right now the rescue probably can't cover it and it doesn't have a good outcome in many cases. I'm hoping against hope that the meds will help and I can give him some good time.

His eyes are bloody awful. No tear production and badly abraded from entropion and disticia which should have been corrected years ago, but of course, wasn't.
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Re: Tracheal Collapse and stents

Post  Renee on 6/21/2012, 5:35 pm

If you don't do the tracheal surgery, will you still do surgery to remove the eyes?
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/21/2012, 5:40 pm

Renee wrote:If you don't do the tracheal surgery, will you still do surgery to remove the eyes?
Absolutely. His eyes have to be removed. We're holding our own with constant lube, etc, but they aren't save-able.

I did read Jana's post on CT. I'm thinking the surgery probably isn't in the cards for this guy. But would love to talk to Jana
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Re: Tracheal Collapse and stents

Post  Renee on 6/21/2012, 5:43 pm

Do you think he will be cleared to have the eye surgery, with his trachea being so compromised? I wonder if they will be willing to put him under for the surgery?

Probably best to hook up with Jana on FB. I have not seen her over here in a long time... come to think of it, I don't see her on FB a lot, but I bet that would be a faster way to get in touch with her.
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Re: Tracheal Collapse and stents

Post  Saira on 6/21/2012, 5:45 pm

Renee wrote:Do you think he will be cleared to have the eye surgery, with his trachea being so compromised? I wonder if they will be willing to put him under for the surgery?

Probably best to hook up with Jana on FB. I have not seen her over here in a long time... come to think of it, I don't see her on FB a lot, but I bet that would be a faster way to get in touch with her.

I left Jana a FB message to check out this thread.
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/21/2012, 10:59 pm

Renee wrote:Do you think he will be cleared to have the eye surgery, with his trachea being so compromised? I wonder if they will be willing to put him under for the surgery?

Probably best to hook up with Jana on FB. I have not seen her over here in a long time... come to think of it, I don't see her on FB a lot, but I bet that would be a faster way to get in touch with her.
The reality is they would have to put him under to see the whole trachea, larynx anyway. And the intubation would keep his airway open way better than his body does. The issue is going to be if the meds work or not. If the meds work then we'll manage him medically and not surgically.

I've done a ton of research now on this and it's a very costly and risky surgery for no guaranteed good outcome and the possible problems and side effects are legion.
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Re: Tracheal Collapse and stents

Post  Aussie Witch on 6/22/2012, 12:59 am

Goddam and bloody hell. That poor boy. Crying or Very sad
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Re: Tracheal Collapse and stents

Post  Snifter&Toddy on 6/22/2012, 9:10 am

Poor guy.

I was at a pug health seminar recently (run by the specialists who saved Toddy) and they covered airway issues.

It is certainly true that the intubation will give him plenty of air while he is under. Apparently whilst in recovery many brachy dogs (bulldogs in particular) don't fight the trach tube at all as they wake; they seem to be delighted that they are getting so much air all of a sudden.

They did say that the surgery for a collapsed trachea is very difficult. A permanent tracheotomy may be the way to go. They have had issues with owners not being too good about managing the hole so it kept closing up. One such owner was a lady who had one of those ghastly (well, I think they are) giant holes in her ear lobe held open with a flesh tube (I think that is what they are called.) Anyway, she suggested to the vet that they install a flesh tube in the trach hole to keep it open, and it works a treat apparently.
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Re: Tracheal Collapse and stents

Post  lisamak on 6/22/2012, 10:18 am

I had a foster last year we though was going to need the surgery (ER vet said she thought it was definite for dog to make it). She came in with pneumonia, choking from tight collar, and about 6 lbs. overweight. It took several days in the ER on oxygen and lots of drugs and a lot of work when she came home to us but after we got through the pneumonia and got the weight off she's still 'at-risk' but lives a normal life (no meds needed even). I know your guy is in much worse shape but I'd hope fixing some of the other problems might improve his situation overall without the surgery - which is risky and not guaranteed.

I hope he's able to be comfortable and that the eye surgery goes well.
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/22/2012, 10:55 am

lisamak wrote:I had a foster last year we though was going to need the surgery (ER vet said she thought it was definite for dog to make it). She came in with pneumonia, choking from tight collar, and about 6 lbs. overweight. It took several days in the ER on oxygen and lots of drugs and a lot of work when she came home to us but after we got through the pneumonia and got the weight off she's still 'at-risk' but lives a normal life (no meds needed even). I know your guy is in much worse shape but I'd hope fixing some of the other problems might improve his situation overall without the surgery - which is risky and not guaranteed.

I hope he's able to be comfortable and that the eye surgery goes well.
He's a bit heavy but not grotesquely overweight. And right now he can't do any exercise at all--not even walking across my kitchen without loud strained breathing. He isn't an ideal candidate for the surgery, frankly. If the meds don't work then managing all the other stuff won't make a significant difference in his overall well being. If he was morbidly obese, it would be one thing, but he's not.

And the fact that he has laryngeal paralysis also increases his risk factors for the surgery..

We'll see. I'm hoping the meds work--although so far no noticeable difference, but he's only been on them 24 hours.
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Re: Tracheal Collapse and stents

Post  sallyandtilly on 6/22/2012, 2:16 pm

Hoping he'll have a good outcome. Poor little man.
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Re: Tracheal Collapse and stents

Post  Puggered on 6/22/2012, 2:40 pm

I have seen some great recovery from surgery on rescues, but you do need an expert surgeon and of course do a complete blood work-up first. A really good surgeon will not recommend surgery unless it has a decent chance of improving their lifestyle.
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Re: Tracheal Collapse and stents

Post  papaspugs on 6/22/2012, 3:15 pm

I am here. I do check in often, but just do not have the mental capacity by the end of the day to post. It is heart breaking to read about pugs, or any dog, with CT. If you have read my posts then you will realize that it is a crap shoot. Even with the trachea stent the dog can have problems, including death. If they aren't medically or financially eligible for the stent, then I might be inclined to make the tough decision and put them down. I know it sounds horrible to say that, but them going under and being trached could do more damage to the trachea and you could end Up in a much worse situation. Sadly with all the medidal issues this poor little guy is facing, he seemed to have an uphill battle. Baby Girls surgery and success were not the norm, we just lucked out. But everyone has to weigh the risks and make the best decision they can given what information they have at the time. Sorry for the typos I am using an ipad
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/22/2012, 4:38 pm

Puggered wrote:I have seen some great recovery from surgery on rescues, but you do need an expert surgeon and of course do a complete blood work-up first. A really good surgeon will not recommend surgery unless it has a decent chance of improving their lifestyle.
Angela--he has seen the specialist, had X-rays, full blood panel. Specialist said that the only thing we could do if the meds didn't work is surgery. He is a grade 4. With laryngeal paralysis already. And the reality is there is no predicting how he will do with the surgery. his risk factors are high for all manner of trouble--but there is some hope that he will come through fine, but it seems to be the exception rather than the rule--we could lose him on the table, he could get aspirate pneumonia, he could end up with a tracheostomy, he could have any one of a number of bad outcomes. And this is expensive surgery. And we don't have the money to do it.

papaspugs wrote:I am here. I do check in often, but just do not have the mental capacity by the end of the day to post. It is heart breaking to read about pugs, or any dog, with CT. If you have read my posts then you will realize that it is a crap shoot. Even with the trachea stent the dog can have problems, including death. If they aren't medically or financially eligible for the stent, then I might be inclined to make the tough decision and put them down. I know it sounds horrible to say that, but them going under and being trached could do more damage to the trachea and you could end Up in a much worse situation. Sadly with all the medidal issues this poor little guy is facing, he seemed to have an uphill battle. Baby Girls surgery and success were not the norm, we just lucked out. But everyone has to weigh the risks and make the best decision they can given what information they have at the time. Sorry for the typos I am using an ipad
Jana--I was hoping you'd show up. I agree with you. I think the risks are too high, the cost too prohibitive and the outcome too questionable. What I'd like to do is see if we can manage him medically for the time being and get rid of his bloody eyes. They are God awful and he is in pain. If we can enucleate him, at least I can give him some good time without pain until the tracheal issues become too severe. They may already be too severe--but if we are going to continue on with him, and not do the stent surgery, then we need to get those eyes out for him to have any quality and life without pain.

I've sent the specialist a list of questions and am waiting to hear back. Bottom line, this is a case where all the medical intervention in the world may not have any impact and may make him worse and we'd have broken bank for nothing--and have to leave other dogs in shelters and mills that we could have helped with money spent on the stent.

If the outcome odds were better, I'd spend the money in a heart beat--we spent 11 grand on one dog--but all fixable issues with no long term consequences. But this? I'm not so confident this makes any sense financially or in this dog's best interests. Just because we can operate on him doesn't mean we should.
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Re: Tracheal Collapse and stents

Post  Pugsaunt on 6/23/2012, 4:59 pm

Poor baby! As in humans with horrendous chronic conditions, there often comes a time when quantity of life vs quality of life becomes an issue, and balancing exceptionally risky (and expensive) treatment with probable results. It seems to me that you are making the right decision - get rid of the eyes, and hope like hell that the meds work. Surgery for this boy is just too risky, and stands a good chance of extending his suffering. Fingers crossed and saying a prayer that the meds give him some good quality of life.
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Re: Tracheal Collapse and stents

Post  leslyeb on 6/23/2012, 8:09 pm

Poor baby. Taz had the tie back surgery for te LP. Tt was horrible enough. I would not put mine through the LP surgery or a stent for a tracheal issue.
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/23/2012, 8:20 pm

leslyeb wrote:Poor baby. Taz had the tie back surgery for te LP. Tt was horrible enough. I would not put mine through the LP surgery or a stent for a tracheal issue.
Yeah--we initially thought it was "just" ESP and LP and that LP surgery sounded grim. When I found out he was a grade four CT--I began to sweat heavily and hyperventilate.

And Jana--I can't thank you enough for talking to me on the phone about this. Your perspective was really invaluable in helping me make a very very hard decision.
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Re: Tracheal Collapse and stents

Post  papaspugs on 6/23/2012, 9:00 pm

It was great to talk to you, I just wish it were for better reasons. This poor guy has so much stacked against him. Of course rescue has to pick up the pieces :(
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/23/2012, 9:50 pm

papaspugs wrote:It was great to talk to you, I just wish it were for better reasons. This poor guy has so much stacked against him. Of course rescue has to pick up the pieces :(
Isn't that the truth! And of course, he's utterly charming, bright and engaging and sweet as a pecan pie. And I have to let him go.
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Re: Tracheal Collapse and stents

Post  PugLady3 on 6/24/2012, 8:56 am

northernwitch wrote: Bottom line, this is a case where all the medical intervention in the world may not have any impact and may make him worse and we'd have broken bank for nothing--and have to leave other dogs in shelters and mills that we could have helped with money spent on the stent.

northernwitch wrote: And of course, he's utterly charming, bright and engaging and sweet as a pecan pie. And I have to let him go.

Oh Blanche, I'm so sorry that you have to make this decision. This is one of the very worst parts of rescue for me. I just watched the video that you posted and while his eyes do look incredibly painful, that struggling to breathe is what really got to me. That poor sweet boy. I'll be keeping you all in my thoughts.
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Re: Tracheal Collapse and stents

Post  Renee on 6/24/2012, 3:01 pm

northernwitch wrote:
papaspugs wrote:It was great to talk to you, I just wish it were for better reasons. This poor guy has so much stacked against him. Of course rescue has to pick up the pieces :(
Isn't that the truth! And of course, he's utterly charming, bright and engaging and sweet as a pecan pie. And I have to let him go.

So sorry Blanche. Like I said, when we had a dog with really bad CT, we had to let her go too. We even went in for ESP surgery, and the surgeon came out once he had her under and let us know that things were much too bad. It was terrible. CT is the worst. Crying or Very sad
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Re: Tracheal Collapse and stents

Post  Pugsaunt on 6/25/2012, 6:34 pm

I'm so sorry, Blanche, that it has come to letting him go. I'll say a prayer for him.
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Re: Tracheal Collapse and stents

Post  northernwitch on 6/25/2012, 10:33 pm

He's going to the Bridge tomorrow. It looks like we now have pneumonia and possibly heart failure going on. I spoke to one of the surgical techs and his X-ray showed that his entire trachea is collapsed--from top to bottom--so there never was much hope that the surgery would work.

But we had some play today--he had to stop often to catch his breath, but this is how I'll remember Gabriel. It's so very little happiness to send him on his way, but it's all I've got to give him.

http://illiweb.com/fa/pbucket.gif4
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