By Jennifer Coates, DVM
If you don’t know what is going on, watching a pet reverse sneeze can be a terrifying experience. To identify when reverse sneezing is normal (and more importantly, when it is not), pet parents need to know exactly what reverse sneezes are, what causes them, and how and when they should be treated.
Identifying a Reverse Sneeze
Reverse sneezing is very common in dogs, less so in cats. When pets reverse sneeze, they typically stand, extend their head and neck, pull back their lips, and inhale repeatedly and forcefully through their nose. A distinctive, loud “snorking” sound is heard each time they inhale. Generally, a pet will reverse sneeze a few times in a row, and the entire episode will be over within 10 to 15 seconds or so.
This video does a good job of showing what reverse sneezing looks and sounds like.
Normal Causes of Reverse Sneezing
Reverse sneezing and “regular” sneezing are closely related reflexes. The purpose of both is to expel an irritant from the upper part of the respiratory tract (coughing plays the same role further down). Irritation to the nasal passages (e.g., a snout-full of dust) causes “regular” sneezing. Irritation to the nasopharynx (the area that lies behind the nasal cavities and above the soft palate) causes dogs to “reverse” sneeze.
You don’t panic every time your pet sneezes. Similarly, the occasional episode of reverse sneezing is perfectly normal. It’s just the body’s way of getting rid of something that is irritating the nasopharynx.
That said, when a pet experiences frequent bouts of reverse sneezing, it’s time to take notice. Excessive reverse sneezing indicates that whatever is irritating your pet’s nasopharynx isn’t being expelled. Make an appointment with your veterinarian if you think your pet’s reverse sneezing is out of the ordinary.
Health Problems That Cause Reverse Sneezing
When a veterinarian evaluates a pet for reverse sneezing, he or she will take a thorough health history and perform a complete physical examination, paying particular attention to the respiratory tract and mouth. Sometimes X-rays, rhinoscopy (the use of an instrument to examine the nasal passages), or other procedures will also be necessary.
Possible causes of excessive reverse sneezing include allergies, infections, masses, foreign material (e.g., grass awns), or anatomical abnormalities that affect the nasopharynx.
Nasal mites, small parasites that can infest the nasal passages and sinuses of dogs, are another possible cause of reverse sneezing.
They are transmitted from dog to dog and possibly through contact with contaminated environments and are therefore more commonly diagnosed in dogs who are boarded or otherwise have contact with other dogs.
How Is Reverse Sneezing Treated?
Mild, infrequent bouts of reverse sneezing are usually normal and don’t require any form of treatment. If you want to try to help shorten your pet’s episode, you can softly blow in his face, massage his throat, or hold his nostrils closed for a few seconds. This may bring the bout of reverse sneezing to a quicker end.
Appropriate treatment for excessive reverse sneezing depends on the underlying cause. Dogs with nasal mites are typically given ivermectin, milbemycin, or selamectin several times over the course of a few weeks.
Sometimes veterinarians will treat dogs with these medications without a definitive diagnosis of nasal mites since the parasites are not always easy to find. Foreign material within the nasal passages or nasopharynx may be able to be removed by hand or via rhinoscopy.
Surgery is usually necessary to remove masses and correct anatomical abnormalities. Infections can be treated with proper antibiotics for dogs or other medications. Allergy medicine for dogs may be prescribed if a pet’s reverse sneezing is thought to be caused by allergies.
If you have any questions regarding your pet’s symptoms, try to catch an episode on video and show it to your veterinarian during your pet’s examination. Chances are, no matter how frequently something happens at home, it won’t occur during your appointment.