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Questions To Ask Before A Stent Or Ring Surgery

A stent or ring surgery is a big decision, and the consult can go by fast. A written list helps. Each question below is tied to something a veterinary school, a college of specialists, or a published study says, so you know why it is worth asking. A shorter list is at Questions To Ask The Surgeon, and a comparison of the published numbers is at Stents And Rings: What Studies Report.

Is This A Last Step For My Dog, Or Not Yet?

University of Missouri Veterinary Health Center calls stent placement a salvage treatment and says generally good candidates are dogs with severe signs that cannot be controlled with medical management. It lists patients whose signs can be controlled with medicine, or with less than 50 percent collapse, among those for whom a stent is not always a good option. The American College of Veterinary Surgeons says medical management may work for up to 70 percent of dogs, particularly those with mild collapse. Ask: what has been tried, and what would tell us medicine is no longer enough?

Where Is The Collapse, And Which Procedure Fits That?

The ACVS says rings treat collapse in the neck, while stents can treat collapse in the neck or the chest. Mizzou says rings are only useful when the collapse is in the neck. Ask: what did the imaging show, and why this procedure for this location?

Are The Bronchi, Larynx, Heart, Or Anything Else Involved?

The ACVS says dogs with laryngeal or bronchial disease have more complications and a poorer long-term outcome, and that dogs with bronchial collapse are much more likely to have problems after a stent or rings. Mizzou lists other severe illness, severe bronchial collapse, and uncontrolled respiratory infection among the situations where a stent is not always a good option. Ask: what tests checked these, and how do they change the plan? See Bronchial Collapse.

What Can Go Wrong, And What Happens Then?

Mizzou lists possible complications for stents: airway irritation that causes cough, laryngeal paralysis, stent fracture, granulation tissue, airway and lung infection, stent migration, and tracheal rupture. It also says that, although rare, dogs are at risk of death during or after stent placement. The ACVS says ring surgery can result in coughing, bleeding, airway damage, or paralysis of the larynx, and that a dog with a paralyzed larynx may need emergency surgery or a temporary breathing hole in the neck. It says stents that cross the thoracic inlet, where the trachea enters the chest, can break, and stents that are too small can move. Ask: how often do you see each of these, and how are they handled here?

Who Does The Procedure?

VCA Animal Hospitals says the surgery is done by an experienced veterinary surgeon, as do Cornell and the ACVS, who describe a surgeon with specialty training and certification in surgery. Ask: who will do my dog's procedure, and how many have they done? The ACVS page on what a veterinary surgeon is explains that only certified veterinarians can call themselves surgical specialists.

What Will Still Be Needed Afterward?

The ACVS says medical management continues for life even after other interventions, and that many dogs keep coughing for the rest of their lives, though usually more mildly. Cornell says surgery is not a substitute for ongoing medical management. Ask: what medicines continue, what rechecks are planned, and what will the cough likely be like?

What Will Recovery Ask Of Us?

The ACVS says most pets go home 1 to 2 days after surgery and lists a body harness instead of a neck lead, about two weeks of limited activity, weight loss, and avoiding smoke and other airway irritants. Mizzou says periodic chest X-rays will be needed, with an occasional repeat scope. Ask: what is the schedule? See Recovery Timeline.

What Is The Cost, In Writing?

One university hospital, Mizzou, listed its own stent prices as $2,000 to $3,500 for the workup, $3,200 to $3,600 for placement, and $5,900 to $6,500 for both as of June 2023, and says these include hospitalization and associated charges. Ask for a written estimate that covers the workup, the procedure, the hospital stay, and early rechecks. See Paying For Surgery.

Bring this page, a list of your dog's medicines, and any imaging. 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.