Sneezing in dogs – causes, reverse sneezing and tests

Overview

Ordinary sneezing, reverse sneezing and coughing differ

In an ordinary sneeze, air is expelled through the nasal passages. Reverse sneezing is a series of sudden, forceful inhalations. Associated irritation often lies in the nasopharynx. Coughing, by contrast, is forceful expulsion of air from the lungs.

A single sign does not establish a disease, as sneezing occurs with many nasal and respiratory conditions. Reverse sneezing can also occur in an otherwise healthy dog. In most dogs, episodes are infrequent and mild and stop quickly by themselves.

A case series investigating recurrent reverse sneezing included 30 dogs. It included dogs whose airways had been examined endoscopically. Findings therefore describe patients selected for investigation, rather than all dogs that sometimes sneeze.

Causes

Dust, inflammation and nasal cavity diseases

Dust or another particle entering the nose can trigger an ordinary sneeze. Smoke and irritating gases can inflame the nasal lining. Viral or bacterial respiratory infection can cause sneezing, nasal discharge and coughing.

Sudden one-sided discharge and facial pawing raise suspicion of a foreign body. The nose may contain plant material, for example. A polyp or tumour can also cause sneezing and nasal discharge.

An oronasal connection caused by dental disease can lead to sneezing. Fungal nasal inflammation is another possible cause. Allergic rhinitis is rare in dogs. Pollen-related signs may occur mainly in a particular season.

Nasal mites and reverse sneezing triggers

Nasal mites live in a dog's nasal passages and sinuses. They can cause sneezing, nasal discharge and nosebleeds. Nasal mites can also cause inward snorting, or reverse sneezing.

Reverse sneezing can be triggered by excitement, pulling against the lead and eating or drinking quickly. An elongated soft palate and other structural airway problems can also be associated with episodes. Pharyngeal irritation related to vomiting or reflux can be part of the picture. However, no precise trigger is found in many dogs.

Risk factors

Reverse sneezing occurs at all ages and in both sexes. It has been described more often in dogs weighing under 15 kilograms. It is also more common in short-muzzled breeds. Dogs in the reverse sneezing study had a mean age of 5.1 years, ranging from 5 months to 12 years. Mean weight was 9.9 kilograms, ranging from 1.1–36 kilograms. Ordinary sneezing risk, meanwhile, depends on its cause, such as an inhaled irritant or foreign body.

Nasal mites have been found in different breeds and age groups. Infection can pass through direct contact between dogs. Walking through long grass can expose your dog to plant material attaching to the coat and skin. Describing exposure helps investigate a new nasal sign.

Typical symptoms

Alongside sneezing, nasal discharge, breathing sounds and general condition are monitored. At home, you may notice:

• Repeated ordinary outward sneezing.
• Bouts of drawing air noisily and rapidly inwards.
• Clear, mucus-like, pus-filled or bloody nasal discharge.
• Muzzle rubbing or facial scratching.
• Head shaking or an itchy muzzle.
• Coughing or snuffling breathing.

During reverse sneezing, your dog often stands with the neck extended and elbows turned out. The mouth is generally closed and nostrils flared. An episode can last seconds to minutes. Your dog generally returns quickly to normal afterwards.

Nasal mites can involve reduced sense of smell. A change in a hunting or tracking dog's work may be noticeable to you. This observation still does not identify the cause without other investigation.

Complications and consequences

Significance depends on the underlying cause

Infrequent, mild reverse sneezing needs no treatment in most dogs. More frequent or severe episodes can instead suggest nasopharyngeal disease. Significance is therefore also assessed using your dog's condition between episodes.

Severe nasal inflammation and secretions can narrow the passages and cause oxygen deficiency. The inflamed nasal lining may be red and swollen. A plant foreign body can cause inflammation or an abscess and migrate through tissues.

Among the 30 investigated dogs with reverse sneezing, inflammatory airway disease was found in 17/30, or 56.7%. A structural or functional disorder was found in 8/30, or 26.7%. A foreign body was found in 3, or 10%. No explanatory diagnosis was established in 2 dogs. A causal link between findings and reverse sneezing was uncertain in some cases.

Diagnosis at the vet

Identifying the sign starts with describing the event

Your vet distinguishes ordinary sneezing, reverse sneezing and coughing using the description. A home video can help confirm the episode type. Duration, frequency and associated signs are also reviewed. An episode may not recur at the practice.

Clinical examination can be normal: this occurred in 19/30 dogs, or 63.3%, in the reverse sneezing study. However, this did not remove the need for other investigations in the selected cases. The mouth is also examined with nasal signs to look for a dental cause.

Imaging, endoscopy and samples depend on findings

CT can show nasal cavity and sinus structures. Imaging is performed before nasal sampling, as procedure-related changes can complicate interpretation. Plain X-rays do not always show plant foreign bodies.

Nasal endoscopy can examine the nasopharynx as well as the nasal passages. It is performed under general anaesthesia. Tissue samples can be taken to investigate inflammation, a tumour or infection. A foreign body can also be removed during the examination.

Nasal mites are confirmed by seeing a mite on endoscopy or in a lavage sample. A negative lavage result does not exclude infestation. Another upper airway disease can nevertheless underlie the sign.

Blood tests may investigate systemic disease. Nosebleeding may also prompt clotting tests and platelet counts. Pus-filled nasal discharge can contain inflammatory cells called neutrophils. Bloody discharge can also involve a clotting disorder or low platelets. In the reverse sneezing study, blood counts and biochemistry were normal in 23/30 dogs, or 76.7%. Nasal discharge alone therefore does not confine investigation to the nose.

Treatment

Distinguishing occasional reverse sneezing from disease needing treatment

Brief, mild, infrequent reverse sneezing can stop by itself without medication. Calming and comforting your dog may help during an episode. This is appropriate for a recognised mild episode. Signs of breathing difficulty need urgent help.

If a foreign body is found, treatment aims to remove it. Nasal mite infestation is treated with a veterinary-prescribed antiparasitic medicine. In dental disease, the oronasal connection and its cause are investigated. Fungal disease needs antifungal treatment.

Antibiotics do not treat every cause of sneezing. Most cases within the kennel cough complex are viral and generally need no antimicrobial. Signs can disappear by themselves within 10 days without antimicrobials. This time concerns kennel cough, rather than a foreign body, tumour or every sneezing cause.

For persistent inflammation, your vet may consider anti-inflammatory medication. An airway problem related to an elongated soft palate may benefit from surgical correction. Treatment depends on your dog's diagnosis.

Response and recovery after investigation

Follow-up was available for 23/30 dogs in the reverse sneezing study. Episodes stopped in 9/23, or 39.1%. Signs persisted despite treatment in 14/23. This selected investigation group does not describe the outlook for an occasional harmless episode.

Fluid from nasal investigation can rarely enter the airways. A breathing tube and active suction during the procedure help prevent this. Mild sneezing and small amounts of blood-tinged discharge can occur after rhinoscopy. Mild throat irritation or appetite changes can last 24–48 hours. Persistent or heavy nosebleeding and difficulty breathing require prompt contact with the treating practice.

Prevention

Reducing environmental dust, smoke and irritating gases limits irritant exposure of the nasal lining. If reverse sneezing relates to pulling against the lead or eating too quickly, these situations are addressed in daily routines. There is no single home measure to prevent every cause of sneezing.

Check your dog for grass seeds after walking in long grass. Running through long grass can be reduced for a dog with repeated seed problems.

Other dogs in the household are also considered with nasal mite infestation. Your vet decides whether they need treatment and plans coordinated care. This concerns confirmed or strongly suspected infestation, rather than starting antiparasitic medication for every occasional sneeze.

Important for dog owners

A video and symptom diary help at the consultation

Film an episode if safe and without delaying help. Home videos were also used to confirm signs in the reverse sneezing study. Record duration, frequency, whether the mouth is open or closed, inward snorting or outward sneezing, and whether your dog returns fully to normal.

Also note discharge side and type, coughing, appetite, altered sense of smell, vomiting and any connection with walks or meals. Report medication and known nasal, dental and respiratory diseases. These observations create a useful timeline for the consultation.

During a recognised mild reverse sneezing episode, you can comfort your dog. If breathing does not recover or a bluish colour, weakness or collapse develops, treat it as a breathing emergency. Calm handling and a cool car can ease breathing effort during transport.

After investigation, establish which changes are expected and when results or response will be discussed. Heavy or persistent bleeding and breathing difficulty after rhinoscopy warrant immediate contact. Keep reports and agreed monitoring instructions.

Frequently asked questions

How do ordinary and reverse sneezing differ?

In an ordinary sneeze, air moves outwards through the nose. In reverse sneezing, your dog draws air in with sudden, forceful inhalations. They may stand with the neck extended and mouth closed. A home video helps your vet identify the sign.

Is reverse sneezing dangerous?

In most dogs, occasional episodes are mild and need no treatment. Your dog generally returns quickly to normal after a mild episode. However, increasing frequency or severity can indicate nasopharyngeal disease. A bluish colour, marked breathing effort or collapse requires urgent veterinary help.

Does sneezing always mean nasal mites?

No. Nasal mites are one possible cause of sneezing, nasal discharge and nosebleeding. Nasal inflammation, a foreign body, dental disease or a tumour can cause the same signs. Signs alone therefore do not establish the cause. Infestation can be confirmed by finding a mite on endoscopy or in a lavage sample.

Does a sneezing dog always need an antibiotic?

No. Sneezing can involve an irritant or foreign body, for example. Many kennel cough cases are viral and generally need no antimicrobial. Treatment depends on the confirmed or strongly suspected cause; the sign alone does not establish a need for medicine.

Why does the vet ask for a video?

Sneezing, reverse sneezing and coughing can sound similar to you, but airflow direction and movement differ. A home video can help identify the sign. Alongside it, record episode duration, frequency and your dog's condition afterwards.