Meet the Reverse Sneeze
A reverse sneeze is a respiratory sound in a category all its
own. Also known as a pharyngeal gag reflex or backwards sneeze, the reverse
sneeze is a commonly observed respiratory sound in dogs, and less commonly in
cats. While a true sneeze occurs on the exhale, the reverse sneeze occurs as
the dog inhales. The result is a reverberating snorting, wheezing, episodic
sound that lasts for a few seconds to a minute or two. A reverse sneeze is a
completely harmless sound and dogs do not suffer any immediate health threat
from these episodes.
How can you tell it’s a reverse sneeze?
There is no easy explanation of the sound- you just have to
hear it and you’ll recognize it. Click on this link to see and hear an example
of a dog’s reverse sneeze episode…Reverse sneeze video
Part of my enjoyment on the weekly national radio program, Animal Radio®, is describing the
peculiar smells, sounds and essences of veterinary medicine with our listeners.
On many an occasion when speaking to callers, I have re-created the sounds of
reverse sneezing. I’m no Rich Little, but I do take pride in my impersonation
of a canine reverse sneeze, which is admittedly better in person with the visuals to
complement the throaty sound.
Characteristics of a dog displaying a reverse sneeze include:
- Vibrational coughing/wheezing sound
- Stiff, extended neck
- Facial grimace
- No discharge from nose
- Not followed by coughing or vomiting up material
- Not involving collapse episodes
- Animal is completely normal after event
What causes a reverse sneeze?
Some reverse sneeze episodes occur when a dog gets very
excited or pulls against a leash. Brachycephalic breeds (short faced breeds) like
Pugs and Boston terriers commonly display reverse sneezing due to their upper
airway conformation.
Allergies,
respiratory infections, nasal mites, inhaled foreign bodies and masses can also
trigger reverse sneezing. Dogs with inflammatory conditions such as lymphoplasmacytic
rhinitis can also display bouts of reverse sneezing. And sometimes reverse
sneezing occurs in the wee hours of the night, while a dog is sleeping, for no
apparent reason. In fact, many veterinarians receive panicked phone calls at
2am from pet owners, concerned of impending asthma attacks or respiratory
arrest, only to have it turn out just to be a typical case of reverse sneezing.
What to Do?
There is no required treatment for a reverse sneeze episode.
However, I recommend stroking a dog’s throat while gently speaking to him in a
calm manner until the episode subsides. Some advocate closing/pinching the
nostrils off, which forces a dog to swallow and curtails the reverse sneeze
episode. Whatever the approach, reverse sneezing episodes are over within
minutes, so no emergency treatment is indicated. Antihistamines may be
prescribed to minimize reverse sneezing episodes.
When to Worry?
If all of a sudden your dog is having repeated bouts of
reverse sneezing, evaluation by your veterinarian is indicated. Consult with
your veterinarian if your dog is reverse sneezing along with other symptoms
such as facial rubbing, nasal bleeding, nasal discharge, coughing, or
significant sneezing episodes.
Nasal mites are a common cause of reverse sneezing and may
be noted after a recent boarding visit, especially if multiple dogs in a
household are involved. Nasal mite treatment is easily pursued with anti-parasite
injections of ivermectin (or in collie breeds- the alternative Milbemycin.) If
reverse sneezing is excessive and prolonged, the nasal and pharyngeal areas
should be evaluated by a veterinarian through rhinoscopy- a procedure performed
under anesthesia in which the nasal passages and pharyngeal areas are
visualized with an endoscope, a micro camera. This is how foreign objects and
masses are typically identified. In other cases, further tests may be needed
including a CT scan or with biopsy samples from sinus passages.
Final Thought
The good news is that most of reverse sneezing episodes are
harmless, and do not indicate any serious illness. Arm yourself with
information by learning what a reverse sneeze looks like and you may save
yourself an unwanted emergency veterinary visit over this peculiar but non-life
threatening occurrence.
