Surprise! Some sneezes go backward

Definitely no need here for a 3 a.m. ER visit

Published: June 24, 2013

Emergency rooms are magical places of brown smells, buzzing fluorescent lights, long wait times and stale coffee, so I can see why people would really want to spend large quantities of time there with their pets. Some of the more obtuse conditions that I have observed that cause folks to traipse in with their companions over the years include:

  • Eye boogers – no kidding, someone once brought a pug in for an eye booger, at 3 a.m.
  • Trembling – again and again, at midnight, and always a little white dog. My favorite explanation for this one is either that their dog can sense an impending earthquake or that their house is haunted.
  • …and the dreaded reverse sneeze.

It sounds like some sort of fancy basketball move that Michael Jordan might pull off against the Lakers, but a reverse sneeze is actually fairly aptly named. Most people think the dog is choking on something or has something stuck in his nose/mouth. They also think the dog cannot breathe.

While a forward sneeze is a forceful expulsion of air out the nose to blow mucous and whatnot into the world, a reverse sneeze is that noisy phenomenon that happens when dogs inhale forcefully to try and suck that same mucus into their pharynx, or throat. Their tonsils and tongue set up such a rattle when it happens that some owners are certain that their dog is choking and they scoop them up and head into the ER in a panic. Usually when they arrive, both parties are looking sheepish as the episode has passed and no one is really sure any more why they are there.

You can hear this cute little Italian greyhound having an episode.

It can be set off by allergies, dusty environments – who knows, maybe even ghosts and earthquakes. It is not a serious event and definitely doesn’t warrant a trip to the ER. In some cases, though, it can be enough of a persistent or annoying problem for either the dog or the owners that it does need addressing. In some cases, antihistamines or other medications can help blunt the effects of allergies, so opening up a conversation with your trusted family veterinarian can be helpful. I have had many owners tell me that they think gently massaging their dog’s throat just under the angle of the jaw can help shorten the episode; the key word here is gently.

This problem can be especially pernicious in those snub-nosed breeds like Pugs, Bulldogs and Boxers – they are prone to a whole constellation of upper airway malformations (known as brachycephalic airway syndrome) that ends up with them having yards of extra tissue in their throat that just flap around like flags in the breeze. Severe cases may need surgery, but milder cases can sometimes be managed with medication, weight loss or lifestyle changes.

So, if you see your dog performing a maneuver that looks like our little Italian greyhound friend, spare yourself a trip to the ER and spend the $100 on something nice for yourself – maybe earthquake insurance, basketball tickets or that Ghostbuster DVD box set you’ve had your eye on.


December 12, 2014

This message is for Kate (post Nov 27, 2014).  We are experiencing a very similar situation with our 7 year old we adopted a few months ago.  Tried a course of antibiotics and then also tried the ivermectin (just gave the last does about 2 weeks ago).  Reverse sneezing has decreased but not totally gone.  It was so bad at one point that he did it every 5 mins for four hours in the middle of the night.  I wanted to see how your dog was doing as we are sort of at a loss.  Does your dog also have a lot of snot coming out of her nose?  Were you able to see the specialist yet?

November 27, 2014

I adopted my 10 year old mixed breed in June.  She has reverse sneezing.  This maybe the craziest observation resulting in the following question. Today, I noticed when she was drinking, she has a very long tongue.  She is  possibly a corgi,jack russell and deer head chihuahua mix .  She is smaller than a beagle.  However, her tongue looks like it belongs to larger dog like a spaniel.  Could the length of her tongue be contributing to her revers sneezing and sometimes forward sneezing afterwards?  I have tried antihistamines, vet put her on antibiotics because of the color. She recently went through 3 weeks of oral Ivermectin incase she was dealing with nose mites. I have a friend whose dog did the reverse sneezing and it turns out it was nose mites. Please be advised, dogs in the "Collie family of breeds, can not be giving ivermectin! I saw a huge reduction in both types of sneezing. Last dose was this past tuesday.  However, it still continues. Next step will be a trip to a specialist to have her nose and head looked at.  I was just curios about the tongue issue, possibly blocking the back of her throat.  She sometimes gags on the mucous. Thanks for any help.

July 13, 2013

Thank you! My little toy poodle, who has many problems due to being rescued from a puppy mill, has this issue as well. I was worried but he never seemed to shaken by the episodes, so I wasn't worried either, Now I know!

June 26, 2013

My little MinPin, Buddy, gets these.  But yesterday he had a really long episode right as we were driving home from his checkup and shots at the vet.  I wouldn't have worried except that afterwards, he held his head crooked and his left ear drooped.  Ended up going back to the vet today to check out this new situation and came home with Benadryl and ear drops!

June 26, 2013

My IG had this a few years ago when we were visiting my grandmother in West Virginia. After a couple days of her waking me up in fits in the middle of the night , I took her to see the vet to find out she was allergic to grass (we live in Arizona). It was rather disconcerting.
I did feel slightly dumb that all she needed was a Benadryl, but better knowing it was nothing major and helping her through the visit.

June 26, 2013

I have had dogs that do this and the first time you see it, it is frightening.  Once you find out what it is, it's easier to stay calm about it.  But sometimes you can't win for losing.  If you bring your dog in and there's nothing wrong, you feel foolish, if you wait to make sure there's something wrong, you feel neglectful.  Sometimes it's hard to tell.

June 26, 2013

My Jack Russell this several years ago and I was one of those who took her in to the emergency room.  The thing that scared me was that she did it for so long that she was passing out.  Now I just massage her throat and it eventually calms down.

Dr. Tony Johnson 
June 26, 2013

Thanks to everyone for the comments and insights into their experiences with reverse sneezing! Who knew that an topics about sneezing could go viral? I think viruses usually cause the sneezing, not the other way around!
I would like to sound a note of caution regarding the comments to temporarily obstruct the nostrils - just make sure you don't get bitten while doing this; don't surprise your dog and don't take any chances.

June 25, 2013

If you hold your finger over the nostrils, it stops the backward sneezes. I've done this little trick for years with many different dogs.  DO NOT restrict their breatheing thru their mouth.  Thanks to Dr. Leland Confer who told me to try this years ago.

June 25, 2013

I have Boston Terriers and this is so common with them.  I did panic the first time and I have to admit it still scares me a bit.  I have learned to cover their nose for a few seconds which forces them to breath thru their mouth and it stops immediately.

Melissa Tracy 
June 25, 2013

Thanks for this article. It is nice to have validation of what my chihuahua is going through. I have been told by my vet he is ok, and it is just a reverse sneeze, but still... Nice to hear more opinions! LOL, My baby sounds like a duck when he has his episodes. I had never heard another dog do it until seeing this article, thanks again!!

Sandra Kimpfbeck 
June 25, 2013

I had a Shar Pei once that never had a reverse sneeze in her life until she was vaccinated intranasally at age 6 for kennel cough. Sudden onset. It then became chronic for the rest of her life with some episodes being very severe.

June 25, 2013

How do you differentiate a reverse sneeze from an airway restriction- clear chest & time limitation? I have shih tzus and have seen it a couple of times.  But never in my dogs with longer snouts.

June 25, 2013

My puggle gets these.  One time it got so bad he developed a bloody nose and it was a bit unnerving.  I have learned that I can sometimes stop his reverse sneezing by reaching from behind him and pinching his mouth open with my thumb and forefinger while using his gums to cushion my fingers from his teeth. Keeping his mouth open prevents the reverse sneezing and it goes away in 30 seconds or less.  If that does not work I will feed him.  The idea is to get him swallowing which may act like a "massage" of sorts.  Using those techniques I can stop cure his reverse sneezing in minutes.  No drugs necessary.

Leslie Johnston 
June 25, 2013

I can see how a "reverse sneeze" can be scary.

Virginia Roberts 
June 25, 2013

Genie is right. It looks exactly like a cat hacking up a hairball.

Carol Sanderson 
June 25, 2013

Thanks for this article.  My room mate has a pug who often does this...She never did figure out what it was until I told her about this article!!!
Thank you again!!

June 25, 2013

I have had 5 Boston terriers and they are famous for the "reverse sneeze".  When this happens, I gently rub their throats and it seems to help.  It does, at least, comfort them while having the attack.

Sharon Palmer 
June 25, 2013

My Chi does this when she gets excited or when it's really windy, here lately she has been snezzing  when ever she get out & sniffing in the grass, am hoping she's just allergic to the grass.

June 25, 2013

The reverse sneeze yes I have experienced this, I explained this to my vet, he told me what it was. I hold the mouth gently together they stop. My cocker did that, my Maltese did once. It sounds like they are taking their last breath.

Lanny Harder 
June 25, 2013

Thank you so very much for the information. This is something I have witnessed but never knew exactly what it was.
I would also like you to know that there was absolutely nothing wrong with anything you said and that in no way did you ever indicate a lack of caring for anyone who has come in to your facility.
Some people want to be offended so they are.

June 25, 2013

My Dear old farm vet said he puts a bit of apple cider vinager in his dogs water to take care ofthe reverse sneeze.

June 25, 2013

Thanks for such a helpful article!  Though I have seen this in my pups before, I never knew it was a reverse sneeze.  Now I have a name for it.  And I feel much better knowing they are not choking on anything, especially since I tend to panic and start running in circles and trembling when it occurs...  :)

Kathy F 
June 25, 2013

Try putting your fingertips over the dog's nostrils for a few seconds, until the dog swallows. By swallowing, he'll usually break that rattling/gasping/inhalation sequence. I have two ex-racing greyhounds, and one periodically does the reverse sneezing when the grass pollen is high.

Kate Stuart 
June 25, 2013

I've got a standard poodle who does this quite frequently.  My daughter was over one day when he did this and she told me about reverse sneezing.  Thankfully she's a certified Vet Tech so I knew she knew what it was and told me not to worry.

June 25, 2013

My poor dog has a compromised immune system and is battling Valley Fever.  We are constantly walking the tightrope between treatment to suppress the fungus and no treatment to give his renal system a rest as the titers go up and down.  There is apparently no way to tell if there is a connection, but it is my gut feeling that when he starts reverse sneezing a lot, it means that the spores have started to win again.

Tony Johnson 
June 25, 2013

Hi Martha:  Thanks very much for sharing your views and commenting. I never want to imply that we take a patient's problem less seriously than it needs to be - we all care and want to help. We just need some laughter to blow off steam and stave off burnout at times. It can get pretty depressing in the ER at times and a little gallows humor can help heal wounded psyches. It should not come at the expense of the client, though - I agree with you. -- Dr. Tony Johnson

Martha Harvey 
June 25, 2013

Just be grateful they cared enough to bring them in. Instead of putting them down or making fun or light of it. So many don't and won't spend a dime on their pets. I had to bring my dog in for an erection that wouldn't go down and it was painful (for him.)It got a lot of laughs and they gossiped a lot as well as charge me a lot only to find out it was caused from extreme anxiety from being jealous of a needy female dog I brought in to foster and he felt so worried he got him self sick. It would have been nice if someone took it a little more serious.

Jane Yount 
June 25, 2013

I don't panic - Harvey does!  My third shih tzu, I know EXACTLY what they are.  He, however, starts racing madly around the room as though he thinks the second flood is coming and Noah is going to leave him behind!  I catch him and gently stroke his throat.  During high allergy season here in St. Louis, he gets Hydroxyzine to make him more comfortable.

Christy Corp-Minamiji 
June 25, 2013

Hi Genie, I double-checked with both Dr. Teri Oursler and Dr. Tony Johnson.  Neither of them has seen reverse sneezing in a cat, and both of them said that if a cat is displaying a similar noise, they would recommend having your veterinarian examine it.  Thanks for checking in!

June 24, 2013

reverse sneeze - I've had CATS who sound and act the same way - is this, in felines, the one and the same or something else?  Thanks for a reply!

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