Anything that looks this terrifying must be an emergency. The poor dog is standing with her legs braced and head thrust forward, and the corners of her mouth are pulled taught in a frightening grimace. Her belly contracts and her ribcage tenses in powerful bursts, and a thundering snort marks each strained breath. She’s distressed, and it feels like it’s gone on far too long. You reach for the phone and before you can dial your vet, it’s over. She wags her tail and goes about her day.
Alarming as it might appear at the time, this describes a typical bout of reverse sneezing, and it is simply an attempt to alleviate some kind of discomfort in the rear of the nasal cavity. In much the same way that a regular sneeze tries to blow an irritant out of the nose with an explosive burst of air, reverse sneezing attempts to suck an irritant back into the throat so it can be swallowed or spit out.
In most cases, the cause of irritation is minor and temporary. Perhaps a bit of dust or a blade of grass from the yard got stuck in the wrong place. If so, you may see a few episodes before it clears up for good. If allergies are responsible, you might see a pattern of symptoms occurring only in certain months. But so long as symptoms are sporadic, there isn’t any cause for alarm.
If reverse sneezing is observed frequently over a long period, however, it could indicate that more is going on. Brachycephalic breeds (like pugs, bulldogs and others with scrunched-up faces) can develop reverse sneezing because their soft palate is too long and hangs in the way. Nasal mites (yeah, that’s really a thing) are another potential cause and stubborn cases of reverse sneezing might be treated just to see what happens. And rarely, tumors and polyps in the nasal passageway can be responsible, but these may require advanced imaging like CT scans to locate.
Regardless of the cause, there isn’t much to do during a bout of reverse sneezing. It will stop on its own once the irritation is cleared. I’ve seen all sorts of suggested remedies. Some people recommend covering one or both nostrils, blowing gently in the dog’s nose or stroking the throat. I don’t know of any evidence that these methods help, but since the problem is self-limiting, I suspect that nearly any action can be misinterpreted as effective. Most episodes are finished in a few minutes no matter what you decide to do. My preference is to leave them alone. Getting in the dog’s face may add a new irritation while they try to manage the first one.
Thankfully, reverse sneezing is one of those things that looks far worse than it is. While some cases eventually warrant a deeper look, most of them blow over in a hurry, and you and your dog can both breathe a sigh of relief.
Dr. Mike Fietz is a small animal veterinarian at Georgetown Veterinary Hospital. He received his veterinary degree from Cornell University in 2003 and has lived in Charlottesville since.