Sneezing and Reverse Sneezing in Dogs

In this article, we will tell you about sneezing and reverse sneezing in dogs. Sneezing is a regular occurrence in the canine species. They refer to a sudden and violent release of air from the lungs through the mouth and nasal cavities.

It is a reflex system which eliminates any irritation (mechanical, chemical, etc.) from the nasal cavity. These sneezes are often accompanied by a unilateral or bilateral nasal discharge (nasal discharge) (involvement of one or both nasal cavities): this discharge can be clear or purulent, liquid or thick, sometimes hemorrhagic (blood: we speak of epistaxis).

Sneezing and nasal discharge are usually signs of nasal, and / or sinus, and / or nasopharyngeal involvement; they are, in rare cases, secondary to a deeper or more general attack (see paragraphs on the causes below).

Reverse Sneezing

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Reverse sneezing is an inspiratory respiratory noise evolving in paroxysmal seizures and is secondary to nasal and / or pharyngeal irritation. The objective of this reverse sneezing (translated by sneezing upside down) and to change secretions or foreign material that interfere, from the nasopharynx * to the oropharynx ** (that is to say towards the bottom of the mouth) where they can be swallowed. 

Concretely, the reverse sneezing looks a bit like the noises that a pig would make when it was difficult to breathe in its air, as if the latter could not pass to the pulmonary level: the dog can have his neck outstretched, “snores brutally and paroxysmal ”, seems to be choking, makes a lot of noise and sometimes has his ribs widening. Sneezing and reverse sneezing must be clearly distinguished from coughing, choking,vomiting . Failure to distinguish between all of these symptoms can lead to a misdiagnosis. This is all the more important as these symptoms cannot always be viewed and objectified by the veterinarian in consultation: the production of videos with a camera or smart phone can be a valuable diagnostic aid for the veterinarian and can help him to check whether the clinical signs observed in an animal are compatible with reverse sneezing,

* and ** : the nasopharynx is the region that separates the back of the nasal cavities and the pharynx; the oropharynx is the area that connects the oral cavity to the pharynx.

Most of the time, reverse-sneezing is idiopathic. It appears (and sometimes disappears) without an underlying cause, with no clear explanation.

Causes of sneezing in dogs

There are several conditions that can cause sneezing in dogs.

We will distinguish them in:

  • “Nasal” causes of which the primary anomaly affects the nasal cavities or the nasopharynx:
    • Congenital (cleft palate, choanic atresia, nasopharyngeal stenosis)
    • “Allergic”
    • Secondary to the presence of polyps
    • Mycotic (fungi): aspergillosis for example
    • Parasitic (rare): Pneumonyssus caninum
    • Tumors (cancerous)
    • Foreign body
    • Traumatic (fractures)
    • Secondary to dental damage (large tartar, dental abscess, dental fracture, etc.)

It is important to note that primary bacterial rhinitis is exceptional in dogs. Most of the time, there is a primary cause to which is added a bacterial superinfection worsening the symptoms. This means that treating only with antibiotic therapy is often insufficient until the primary cause has been identified and possibly treated.

  • “General” causes which do not have a starting point at the level of the nasal cavities. But which can result secondarily in nasal discharge and sneezing:
    • Coagulation problem (intoxication, abnormality of blood platelets, haemophilia, etc.) which may lead to haemorrhagic discharge,
    • Infectious diseases (Ehrlichiosis, Leishmaniasis, …)
    • Certain leukaemias, …

Diagnostic

The age of the animal, the speed of onset and progression of symptoms, the appearance of the nasal discharge (if present), the general examination of the animal and in particular of the sphere nasal / sinus / buccal make it possible to direct the veterinarian towards diagnostic hypotheses.

However, the limited accessibility of the nasal cavities and the pharynx makes their exploration difficult or even impossible on a vigilant animal. Thus, the veterinarian may possibly offer anesthesia in order to explore these areas on the dog:

  • either without material
  • or with equipment for performing a rhinoscopy.

Rhinoscopy is an examination allowing, using a small camera that is made to penetrate through the nostrils and through the mouth, to objectify an anomaly within the nasal cavities and pharynx. This examination is non-invasive and painless. During the rhinoscopy, the veterinarian can take biopsies or various samples to submit to analysis laboratories in order to obtain a definite diagnosis. For instance, a foreign body can possibly be removed if it is present.

Sneezing and Reverse Sneezing in Dogs

Rhinoscopy may be difficult to perform

In some cases, rhinoscopy may be difficult to perform or insufficient:

  • in certain miniature breeds or of the brachycephalic type (Pug, Bulldog, etc.) the nasal cavities are too small to be able to introduce the rhinoscopy material
  • when the nasal discharge is too much, it prevents correct visualization
  • dental damage is not visualized by rhinoscopy
  • the sinuses, all the bones of the nasal cavity and the lymph nodes cannot be visualized by rhinoscopy.

In these situations, another medical imaging examination is of interest: the tomodensitometric examination (or scanner). It is also done under general anesthesia (possibly before or after a rhinoscopy). It has the advantage of allowing visualization of all the bone structures, sinuses, ganglia and this regardless of the size of the dog. However, it does not allow taking samples or removing foreign bodies.

Rhinoscopy and CT can therefore be examinations to combine to find the causes of sneezing and runny nose in dogs. The veterinarian will adapt the type of examination to the diagnostic hypotheses.

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Treatment and prognosis

The management and prognosis will depend on the cause of the dog’s sneezing.

A foreign body can be easily removed and the dog healed.

In cancerous phenomena, treatment can be surgical, medical (chemotherapy) or radiotherapy: it depends on the type of tumor present (biopsy required). The prognosis depends both on the tumor, its aggressiveness (that is to say its multiplication) and its extension.

In the event of a mycotic attack (Aspergillosis for example), the treatment requires the use of antimycotics by local application (in the nasal cavities and / or in the sinuses) more or less associated with oral treatment.

In the event of dental damage, tooth extraction and antibiotic therapy are necessary.

During idiopathic reverse sneezing, the use of corticosteroids or antihistamines may be considered.

Conclusion

In conclusion, sneezing and reverse sneezing in dogs most often testify to abnormalities concerning the nasal cavities or the nasopharynx.

The exploration of these symptoms sometimes requires the use of examinations, certainly under general anesthesia, but not very invasive and not painful for the dog: rhinoscopy and / or scanner, associated with samples.

Treatment then depends on the cause identified. It is important to note that primary bacterial infections (with no underlying cause) of the nasal cavities are rare in dogs.