The first time an owner witnesses their dog having a reverse sneeze episode, they will often mistake it for a seizure or think the pet is dying. But within a minute or two, the dog returns completely to normal. A reverse sneeze is actually a NORMAL nasopharyngeal (nose and throat) gag-reflex that may cause a FALSE perception of suffocation in its most severe form. The dog will extend its neck forward and snort air violently through its nose in an attempt to get air into the lungs. It will not suffocate; the dog will recover completely as it relaxes. There may be a honking sound associated with the episode. Smaller breeds and brachycephalics (pug-nosed breeds) experience this condition more so than large breed dogs. Rarely does it require medical treatment unless the episodes last unusually long or occur very frequently.
Many things can trigger a reverse sneeze. Allergies and inhalant irritants like air pollution and cigarette smoke are common contributors. An episode may occur after exercise, excitement, or even eating and drinking. Dogs which are prone to the reflex will often experience a reverse sneeze episode while recovering from anesthesia. The irritation caused by an endotracheal tube (artificial airway used during anesthesia) can exacerbate this. Pulling on a leash will often cause a reverse sneeze in susceptible dogs.
Some dogs will experience occasional reverse sneezing all of their lives, and others will seem to out grow the problem. As long as the episodes are short and relatively infrequent, treatment is usually unnecessary. In the case that a reverse sneeze causes extreme exhaustion afterward, the veterinarian may prescribe oral antihistamines or low-dose corticosteroids. Antihistamines are used to treat an underlying allergic component that may be triggering the reverse sneeze. They also possess a mild sedative effect that may help to reduce the anxiety experienced during an episode. Steroids are usually reserved for more serious cases to avoid potential side effects. For brachycephalic dogs, which inherently have excess tissue in the pharyngeal (throat) area, a surgical procedure called a soft palate resection may help to reduce the recurrence of episodes.
At home, the owner can help to alleviate a reverse sneeze by blowing in the nose and gently stroking the throat. This may cause the dog to swallow which will correct the gag-reflex. An owner should NEVER attempt to grab the tongue or place fingers in the gagging dog’s mouth, for risk of being bitten by even the sweetest dog. As long as the episodes are infrequent and mild, there should be no fear of leaving the dog at home alone. As frightening as the reverse sneeze appears, it will almost always resolve on its own.
Exposure to irritants like smoke should be avoided in susceptible dogs. A persistent allergy may require medical treatment. It may also help to walk smaller dogs using a harness instead of a collar, especially for dogs that are prone to collapsed tracheas (a more serious problem requiring medical attention). Elevating the food and water bowls may also help reduce reverse sneezing.
Reverse sneezing should be distinguished from more serious conditions that involve coughing, vomiting, and wheezing. These are not symptoms of a reverse sneeze and would warrant further investigation and treatment.
Cats are less likely to experience a reverse sneeze. Although this is a possibility, any symptomatic cat should be assessed for feline asthma, a much more serious condition that requires medical treatment.