ctquesstions

YAP Collapsing Trachea

Questions and Answers

Question: How long do the dogs live after surgery with the stents and the rings?

Answer: (From Dr. Mark W. Bohling, DVM, PhD, Diplomate, American College of Veterinary Surgeons
Assistant Professor of Surgery, Department of Small Animal Clinical Sciences, College of Veterinary Medicine
University of Tennessee):

What I have been telling folks is that the dogs that get past the first few
months without problems generally go on to have a reasonably long future
(2-5 yrs) with stents. We did a statistical study that looked at the old
stents that we are no longer using, so it may not be strictly applicable to
the results we will be getting from the Infiniti stents. At this point
nobody can say for sure.

Regarding rings, again we are dealing with old data out there. Some dogs
had rings and went out a year or two, then failed because of progressive
collapse. Until the advent of stenting, there was nothing to do for these
dogs and they were put down. Now with stents, we can probably extend these
dogs significantly if rings fail due to new areas of collapse. So again,
the survival may be longer than it was even 5 years ago.

So for me, the bottom line on prognosis for longevity is this: If your dog
does well post-stenting and the stent embeds and there are no
complications, we can reasonably expect (not guarantee) to get from one to
two years. After that, other factors such as the dog's age and general
health make longer term predictions a lot harder to make, BUT, if the dog
is middle-aged and in good health and not fat, and well-maintained, etc,
etc - THEN my best prediction is that the stent could be reasonably
expected to last for another two years for a total of three to four years.
If you get more than that, it's all gravy as they say.

About your question on antibiotic use: We prescribe them because the
tracheal mucociliary ladder (the constant upward "sweeping" action that
removes bacteria and crud from the trachea) is inhibited by the stent,
which is an intraluminal foreign body. Also being a foreign body, the
stent may help incite a mild inflammatory reaction even though the material
is considered nonreactive. Finally, the prednisone that is given to damp
down the inflammation may suppress immunity somewhat and predispose to
infection. Taken together, these factors predispose the patient to tracheal
infections that could easily migrate down into the lungs. So, antibiotics
are given until the stent embeds and is (hopefully) no longer a problem.

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