This Traumatic Episode May Horrify You, but Not Your Dog

Analysis by Dr. Karen Shaw Becker

Story at-a-glance -

  • Reverse sneezing is a usually harmless and common condition in small and flat-faced dogs
  • In a reverse sneeze, the air is pulled in through the nose rather than pushed out
  • A dog who is reverse sneezing often looks and sounds as if something is seriously wrong
  • Fortunately, reverse sneezing almost never requires treatment — episodes pass very quickly and the dog is back to normal
  • Frequent or prolonged episodes should be investigated by a veterinarian to rule out possible underlying causes or conditions

Reverse sneezing, which is also called mechanosensitive aspiration reflex, inspiratory paroxysmal respiration and pharyngeal gag reflex, is a common respiratory issue in dogs. It tends to happen more often in small breeds, perhaps because they have smaller throats and windpipes.

Brachycephalic (flat-faced) breeds such as Pugs and Bulldogs have elongated soft palates, and occasionally suck the palate into the throat, which can trigger an episode of reverse sneezing. Thankfully, the condition is very rare in kitties.

What to Watch and Listen For

In a regular sneeze, air is pushed out through the nose. As the name implies, in a reverse sneeze, air is pulled rapidly and noisily in through the nose. Some dogs reverse sneeze so often it's sort of a normal event. Just as sneezing is a part of life for many humans, reverse sneezing is a part of many dogs' lives.

The sound of a reverse sneeze is typically sudden and can be rather startling, which is why many pet parents think their dog is either choking or having an asthma attack.

A dog who is reverse sneezing will often stand still with his front legs apart, neck extended or head back, and with eyes bulging as he makes sort of a loud snorting sound. The strange stance on top of the strange noise is why many dogs end up getting rushed to the veterinarian or the emergency animal clinic by their panicked guardians.

Episodes of reverse sneezing can last from a few seconds to a minute or two. As soon as it passes, the dog breathes normally once again, acts as if nothing happened, and goes about his day.

Causes of Reverse Sneezing

Reverse sneezing is caused by a spasm of the throat and soft palate. The spasm is triggered by an irritation to the throat, pharynx or laryngeal area. Most common triggers include:

  • Excitement
  • Exercise intolerance
  • A collar that's too tight
  • Pulling on the leash
  • Environmental irritants like pollen, perfume, household chemicals or cleaners, room sprays, scented candles or plug-ins or even a sudden change in temperature

Rarely, there can be a respiratory infection or chronic post-nasal drip that causes the condition.

How to Help a Dog With Reverse Sneezing

Reverse sneezing rarely requires any type of treatment. As soon as the episode passes, the situation is resolved. But because reverse sneezing can make your dog quite anxious, it's important that you remain calm. Often the biggest issue I see as a veterinarian is a conditioned panic response in the dog that has been triggered by a pet parent who freaks out each time the dog reverse sneezes. It's important to remember that most dogs are quite sensitive to human emotions.

If you feel the need to do something for your dog during a reverse sneezing episode, you can gently massage her throat to help the spasm. You can also try gently covering her nostrils very briefly with your fingers. This will cause her to swallow, which can help clear the irritation and stop the sneezing.

If the episode doesn't end quickly and you're sure your dog won't bite you, you can try putting your fingers gently on her tongue and pressing down. This will cause her to open her mouth wide and help move air through the nose effectively, which should stop the reverse sneezing. The truth is, these types of interventions are usually unnecessary and can even add to your dog's stress (and yours).

Identifying Triggers

I recommend you pay attention to when the reverse sneezing occurs, where your dog is and what he's doing right before or as it begins. If you can identify the triggers for his reverse sneezing episodes, you can work to reduce or resolve the problem.

For example, my dog Rosco used to reverse sneeze every time I opened the front door on cold winter days. Another of my dogs reverse sneezes when she's awakened suddenly during the night, so I take care not to disturb her when she's sleeping. If she hears a noise or I touch her, she'll stand up and start reverse sneezing.

It scares her, so I just remain calm and tell her everything's okay. The episode passes in a few seconds and she's fine. I also have a client who has a 6-pound dog who tends to get very excited when he's going outside for a walk. He pulls against the leash, which is attached to his collar. Because he's prone to reverse sneezing, this can trigger an episode. The solution for this dog is obviously a harness, which takes stress off the neck, and some additional training on how to walk calmly on a leash.

When to Involve Your Veterinarian

If your pet's reverse sneezing becomes a chronic problem, or episodes are becoming more frequent or longer in duration, I recommend you make an appointment with your veterinarian. He or she will want to rule out things like a potential foreign body — for instance, a foxtail — in the nose or respiratory tract; nasal cancers, polyps or tumors; nasal mites; a collapsing trachea; kennel cough or a respiratory infection.

If you're able to videotape your dog during an episode, it can help your veterinarian determine whether it's reverse sneezing or perhaps something else. If your dog is experiencing prolonged episodes of reverse sneezing, discharge from the nose or other respiratory problems, it's time to make an appointment with your veterinarian.

If you happen to have a kitty who seems to be experiencing episodes of reverse sneezing, since the condition is so rare in cats, it's important to investigate the possibility of feline asthma or an upper respiratory infection.

Just as dogs sneeze intermittently throughout their lives, most have at least an episode or two of reverse sneezing as well. In the vast majority of cases, the episodes resolve on their own, and there's nothing to fear. Once you understand what's going on, you can relax and help your dog through it.