Precautions for Tracheal Collapse in Maltese and a Lifelong Health Care Guide by Age

RespiratoryBreed HealthMeongsiljang Veterinary Advisory Board

We’ve compiled the symptoms and treatment options for tracheal collapse, the most common respiratory condition in Maltese dogs, along with key age-specific health care tips from puppyhood through senior years.

What Is Tracheal Collapse in Maltese?

Tracheal collapse in Maltese dogs is a progressive respiratory condition in which the C-shaped cartilage rings that support the trachea weaken and degenerate, causing the airway to flatten and collapse. Early detection is crucial. If your dog exhibits a persistent, honking cough reminiscent of a goose’s call, prompt veterinary evaluation is essential. While tracheal collapse is commonly seen in toy and small-breed dogs, its exact cause remains unclear. Since Maltese dogs fall into the small-breed category, they are considered at risk. Therefore, it is advisable to monitor for early signs such as coughing and maintain consistent care from the early stages of life.

Why Tracheal Collapse Is Common in Maltese

Tracheal collapse is relatively common in toy and small breeds, including Maltese, although the exact cause remains unclear. It is believed to be linked to a deficiency in the substances that keep cartilage firm, leading to degeneration and weakening of the cartilaginous rings. Various factors, such as genetics, nutrition, and inflammation, are hypothesized to play a role. Additionally, direct pressure on the trachea from collars, the burden of obesity, and chronic tracheal irritation can exacerbate symptoms. Coughing tends to worsen significantly during excitement, hot and humid weather, exercise, or while eating and drinking, which is related to the narrowed structural characteristics of the trachea.

Checklist of Main Symptoms of Tracheal Collapse

Goose honk cough: A distinctive "honking" or "hacking" sound caused by tracheal irritation

Exercise intolerance: Becoming quickly fatigued and panting even after a short walk

Cyanosis: A serious sign where the gums or tongue turn blue

Worsening with excitement: Coughing that suddenly intensifies when the pet is excited or playing

Nocturnal coughing: Coughing that worsens around bedtime

Postprandial coughing: Coughing that occurs immediately after eating

If any of these symptoms recur, a thoracic radiograph is necessary.

Symptoms Requiring Immediate Visit to an Emergency Animal Hospital

If your pet appears to be struggling significantly to breathe, or if their gums and tongue turn blue or pale, take them to an emergency animal hospital immediately. During transport, minimize excitement, heat, and stress, and carry them gently supported by a towel or pad instead of using a leash.

Grades of Tracheal Collapse and Treatment Options

Tracheal collapse is classified into four grades (Grade I–IV) based on the degree of airway narrowing. In Grade I, the trachea is narrowed by approximately 25%; in Grade II, the cartilage is mildly flattened, resulting in about 50% narrowing; in Grade III, the narrowing reaches approximately 75%; and in Grade IV, the trachea is almost completely collapsed. Relatively mild cases (Grades I–II) are managed with medical treatment, including cough suppressants, bronchodilators, exercise restriction, and, if necessary, steroids to reduce mucosal inflammation. Medication is the cornerstone of managing tracheal collapse, and many patients can maintain long-term symptom control with medical management alone. For Grades III–IV, where symptoms are difficult to control with medication alone, tracheal stenting may be considered. Maintaining an appropriate body weight and other lifestyle management strategies are also beneficial adjuncts to treatment.

A Maltese receiving treatment at a veterinary clinic

Key Points for Age-Specific Health Care in Maltese

Item	1–2 Years Old	3–6 Years Old	7 Years and Older
Main Risk	Early signs of tracheal collapse	Worsening tracheal collapse and weight gain	Accompanying heart valve disease (MMVD)
Checkup Interval	6 months–1 year	6 months	3–6 months
Key Management	Wear a harness, prevent obesity	Maintain weight, minimize excitement	Combined heart and trachea monitoring
Recommended Tests	Chest radiograph	Chest radiograph + blood test	Cardiac ultrasound + chest radiograph

Checkup intervals may vary based on the veterinarian's judgment

Home Management for Tracheal Collapse

Switch from a collar to a harness: Collars can press directly on the trachea and worsen symptoms, so always use a harness.

Weight management: Obesity can strain the respiratory system, so maintaining a healthy weight is important.

Temperature and humidity control: Hot and humid environments increase the risk of overheating and can worsen symptoms, so keep your pet in a cool environment.

Manage excitement: Prevent excessive excitement during activities like guest visits or playtime.

Air purification: Irritants such as dust, perfumes, and cigarette smoke can irritate the airways, so it’s best to avoid them.

However, remember that these home care measures are only supportive. The foundation of symptom management is medical treatment under the guidance of a veterinarian.

A Maltese wearing a harness during its morning walk

Additional Precautions for Maltese Owners

Tracheal collapse in Maltese dogs is a progressive condition that can gradually worsen with age, and it may co-occur with other respiratory or cardiovascular issues such as heart disease or chronic bronchitis. In cases where left-sided heart failure is present, additional findings such as an enlarged cardiac silhouette may be observed. Therefore, it is advisable for older Maltese dogs to undergo both tracheal evaluation and concurrent cardiac auscultation and imaging. If you notice any coughing or changes in breathing that differ from your dog’s normal pattern, be sure to inform your veterinarian.

Reviewed by a veterinarian

Dr. Tony — Punnawat Phongkittirak

Veterinarian

A veterinarian who majored in veterinary medicine at Khon Kaen University, Thailand, and completed the IVSA program at North Carolina State University in the United States. Drawing on clinical experience at animal hospitals, he works in the pet healthcare field and is dedicated to building a digital care environment that connects pet parents with veterinarians.

Frequently Asked Questions

Can tracheal collapse in Maltese dogs be completely cured?

Rather than aiming for a complete cure, we approach this condition with a focus on management. Symptoms can be significantly reduced through internal medicine treatments and lifestyle adjustments, and in severe cases, stent placement can improve quality of life. The earlier the condition is detected, the more treatment options are available.

If my dog has tracheal collapse, can they still go for walks?

It’s not that your pet can’t go for walks at all. Just make sure to use a harness, avoid the hottest parts of the day, and opt for short walks in the cooler morning or evening hours. If symptoms are severe, consult your veterinarian to adjust the exercise intensity accordingly.

When is a tracheal stent procedure recommended?

This option is considered for dogs with stage 3 or 4 tracheal collapse when symptoms are difficult to control with medication alone. The procedure must be performed at a clinic equipped with specialized imaging technology and staffed by veterinarians with extensive procedural experience. Additionally, lifelong regular follow-up care is required after the procedure.

How can you tell the difference between tracheal collapse and simple bronchitis?

Coughing caused by tracheal collapse sounds like a honking "goose-like" bark and tends to worsen after excitement or immediately after drinking water. An accurate diagnosis can only be confirmed through chest X-rays or tracheal endoscopy, so it's best to have your veterinarian evaluate your pet.

Can young Maltese dogs also develop tracheal collapse?

Yes, if there are congenital factors, symptoms can appear as early as 1 to 2 years of age. If your pet experiences recurrent coughing at a young age, don’t ignore it—getting a chest X-ray is a good idea. Early detection can significantly impact long-term prognosis.

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References

[1] Johnson LR, Pollard RE. Tracheal collapse and bronchomalacia in dogs: 58 cases (July 2001–January 2008). J Vet Intern Med. 2010;24(2):298-305.

[2] Ettinger SJ, Feldman EC, Côté E. Textbook of Veterinary Internal Medicine, 8th Ed. Ch: Diseases of the Trachea and Upper Airways. Elsevier, 2017.

[3] Boswood A, et al. Textbook of Cardiovascular Medicine in Dogs and Cats. Ch: Myxomatous Mitral Valve Disease — Epidemiology and Etiology.

[4] Nuttall T, Harvey RG, McKeever PJ. BSAVA Manual of Canine and Feline Dermatology, 4th Ed. Ch: Breed Predispositions to Skin Disease. BSAVA, 2023.