Monday, March 31, 2014

Its Not Doggie Asthma- It’s a Reverse Sneeze

What dog owner hasn’t heard that frightening sound that dogs make- part cough, part sneeze and often described as a dog being unable to catch his breath. But it really isn’t asthma, or some kind of bone stuck in your dog’s throat- it’s a reverse sneeze. So before you panic and run into the veterinary office on emergency, ensure you know what a reverse sneeze is.

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.

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