Tracheal signs and associated vascular anomalies in dogs with persistent right aortic arch

Medical records of 55 dogs with 1 or more vascular rings around the esophagus and trachea were reviewed to determine the nature and frequency of related vascular anomalies and to determine the reliability of tracheal deviation on radiographs for the diagnosis of persistent right aortic arch (PRAA). Fifty-two (95%) of the 55 dogs had PRAA. Of the 52 dogs with PRAA, 44% had coexisting compressive arterial anomalies: 17 had retroesophageal left subclavian artery and 6 had double aortic arch with atretic left arch. Characteristic tracheal deviation was consistently present in dogs with PRAA. Moderate or marked focal leftward curvature of the trachea near the cranial border of the heart in dorsoventral (DV) or ventrodorsal (VD) radiographs was found in 100% of available radiographs of 27 dogs with PRAA. Moderate or marked focal narrowing of the trachea also was noted in 74% of DV or VD radiographs and 29% of lateral radiographs of the dogs. Tracheal position in 30 of 30 dogs with megaesophagus and 62 of 63 control dogs was midline or rightward in VD or DV radiographs. Histology in a neonatal dog with PRAA revealed evidence of tracheal deviation and compression even before birth. Focal leftward deviation of the trachea near the cranial border of the heart in DV or VD radiographs is a reliable sign of PRAA in young dogs that regurgitate after eating solid food, and contrast esophagrams are not necessary to confirm the diagnosis of vascular ring compression.