Reverse Sneezing

Patty Khuly

Summary

Reverse sneezing, also referred to as “backwards sneezing,” “pharyngeal gag reflex” or “inspiratory paroxysmal respiration” is a very common observation in dogs and, while not nearly as widespread, may occur in cats as well. Though it’s not a disease, per se, this episodic disorder is frightening and frustrating enough to merit its own discussion.

Pets who suffer this paroxysmal condition make characteristic gagging and honking sounds that, while decidedly unpleasant, are actually completely innocuous.

The cause of reverse sneezing is commonly believed to be an irritation of the soft palate which results in a hiccup-like sort of spasm. Any irritant can cause it, including excitement, eating or drinking, exercise, leash-pulling, inhalation of pollen, foreign bodies caught in the nose or throat region, strong odors, viruses and bacteria, household chemicals, allergic rhinitis or allergic pharyngitis, and post-nasal drip, among others.

Symptoms and Identification

Reverse sneezing appears as a spasmodic, rhythmic combination of a cough, sneeze or snort that’s hard to describe (but easy to imitate).

Diagnosis is most often achieved by visual inspection of the event. Owners are asked to either obtain video footage of the event for veterinary review or compare the signs they observe to video footage available online.

Persistent, atypical or violent bouts of reverse sneezing-type behavior may warrant additional investigation to rule out the following disorders, as these may elicit signs consistent with reverse sneezing:

  • Laryngeal paralysis is the most common cause of respiratory stridor in older dogs
  • Foreign body lodged in the nose, throat or nearby structures
  • Cancers of the nose, throat or nearby structures, and
  • Collapsing trachea, a condition common to small dogs

In cats, the possibility of feline asthma should be explored.

Affected Breeds

Breed predisposition has not been established for reverse sneezing. Anecdotally, dogs of brachycephalic (short-headed) breeds where over-long soft palates are common may experience these signs more often than others. In all reality, however, any pet predisposed to soft palate irritation of any kind is theoretically more likely to experience episodes of reverse sneezing.

Treatment

As a benign condition, treatment of reverse sneezing isn’t considered necessary. However, owners sometimes find that relaxing their pet –– either by massaging their throat, hugging them or providing some other type of soothing stimulus –– may be sufficient to end the episode. Alternatively, eliciting a swallow reflex by briefly occluding the pet’s nostrils may help clear any irritant from the region around the soft palate.

Veterinary Cost

The cost of veterinary care for reverse sneezing is relegated strictly to the initial examination and any diagnostic tests required to rule out any other conditions.

Prevention

Prevention of reverse sneezing is generally considered an unfruitful endeavor. In certain cases, removing any specific causes known to incite the reflex may be possible.


References

Holt DE: Upper airway obstruction, stertor, and stridor. In, King LG (ed). Textbook of Respiratory Disease in Dogs and Cats. Elsevier, St. Louis, pp. 35-42, 2004.

Parnell NK. Diseases of the throat. In Ettinger SJ and Feldman EC (eds): Textbook of Veterinary Internal Medicine. 6th Ed. Saunders-Elsevier, St. Louis. pp. 1196-1204, 2006.

Venker-van Haagen AJ. Diseases of the nose and nasal sinuses. In Ettinger SJ and Feldman EC (eds): Textbook of Veterinary Internal Medicine. 6th Ed. Saunders-Elsevier, St. Louis. pp. 1186-1196, 2006.