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Reverse Sneeze

Occasionally we receive phone calls from distressed clients describing clinical signs of “sucking in air”, “snorting fits” and “upper respiratory congestion” in pet dogs and cats. These signs could be attributed to a common ailment called the “reverse sneeze”. While a good veterinary examination is often necessary to rule out other causes of upper airway congestion, the reverse sneeze is not a medical emergency. Below is some information about reverse sneezing in cats and dogs. Please schedule an appointment with us if you have any questions or concerns about your pet this holiday season!
—Dr. Suzy Jones

A “reverse sneeze” is an audible paroxysm of strong inspiratory (sucking in) efforts made against a closed portion of a structure in the throat called the larynx or glottis. Although a reverse sneeze is not a form of respiratory distress, clients often report it as such. Fortunately these paroxysms are short-lived, lasting less than a few minutes, and the patient is normal afterwards. Both large and small breeds of dogs can be affected as can cats.

A reverse sneeze is the body’s attempt to clear irritants from the nose. Sneezing is a normal reflex to an irritant in the front part (or “anterior” portion) of the nasal cavity. Reverse sneezing, (forceful inspiratory airflow) is a normal reflex to an irritant in the back-end (or “posterior” portion) of the nasal cavity.

Any nasal, pharyngeal, or sinus irritation can result in a reverse sneeze. Underlying causes for consideration include include nasal mites, foreign objects (e.g. a foxtail), drainage of secretions, allergies, nasal irritation, soft tissue masses, lower airway diseases and anatomical issues such as elongated soft palate. Lower airway diseases can also result in a reverse sneeze.

The patient may stand with its neck outstretched and lips drawn back. Rapid and repeated forced inhalation through the nose results in loud sounds which are audible without a stethoscope. Diagnosis is based on clinical signs and it is often helpful for clients to bring a video of the animal partaking in these clinical signs.

Occasional reverse sneeze episodes may not need to be diagnostically pursued. A sudden onset of frequent reverse sneezing should be more thoroughly investigated for underlying causes. Determining the underlying cause of the irritation will require oropharyngeal examination, posterior rhinoscopy and/or radiographs.

No treatment is usually necessary. If necessary, owners can pinch the patient’s nose and scratch its throat or lightly blow in its face. Sometimes treatment for nasal mites may be helpful in some cases. If the problem is persistent or frequent, treatment is directed at the underlying cause. Antihistamines and/or corticosteroids may help if the problem is allergy-related and serious or chronic in nature.