Your dog suddenly freezes. Their neck stretches forward, their elbows move away from their chest, and they begin making loud snorting or gasping sounds.
It looks as though they cannot breathe.
Then, just as suddenly, it stops. Your dog shakes it off and walks away as if nothing happened.
This strange and often frightening event is called reverse sneezing. Most occasional episodes are brief and harmless. However, reverse sneezing is a respiratory reflex, not a diagnosis. When episodes become frequent, begin suddenly, or occur with other symptoms, something may be irritating or obstructing the back of your dog’s nose or throat.
What Is Reverse Sneezing in Dogs?
The medical term for reverse sneezing is paroxysmal respiration or inspiratory paroxysmal respiration.
During a regular sneeze, air is pushed forcefully out through the nose. During a reverse sneeze, the dog repeatedly and forcefully pulls air in through the nose. The reflex is usually triggered by irritation in the nasopharynx, which is the area behind the nasal passages and above the soft palate.
Despite its name, a reverse sneeze is not simply a normal sneeze played backwards. It is a separate upper-airway reflex.
During a typical episode, a dog may:
- Stop moving and stand still
- Stretch the head and neck forward or slightly upward
- Hold the elbows away from the body
- Keep the mouth mostly closed
- Flare the nostrils
- Make repeated snorting, honking or gasping sounds
- Move the chest and abdomen rapidly with each inward breath
Most dogs remain conscious and responsive throughout the episode. They are generally normal immediately before and after it. Episodes often last only a few seconds, although some continue for a minute or occasionally longer.
How Common Is Reverse Sneezing?
Reverse sneezing appears to be quite common, although we do not yet have reliable prevalence estimates for dogs worldwide.
In one questionnaire-based study of 779 dogs in southeastern Spain, owners reported reverse sneezing in 52.9% of the dogs. Most affected dogs had a long history of occasional episodes without other clinical signs. Because the study involved one geographic area and depended on owner recognition of the behaviour, that number should not be assumed to apply to every dog population.
Any dog can reverse sneeze. It has been reported more frequently in small dogs and short-faced, or brachycephalic, breeds. However, medium and large dogs can experience it too.
What Causes Reverse Sneezing in Dogs?
A reverse sneeze happens when something stimulates the tissues in or around the nasopharynx. Sometimes the trigger is temporary and harmless. In other dogs, repeated episodes are connected to an underlying airway problem.
Temporary irritation
An occasional reverse sneeze may be triggered by:
- Dust or pollen
- Smoke, perfume or aerosol sprays
- Excitement
- Pulling against a collar
- Eating or drinking too quickly
- Mucus or secretions at the back of the throat
- A small amount of plant material or another inhaled irritant
These triggers can briefly irritate the upper airway and activate the reflex. In many cases, no specific trigger is identified.
Inflammation of the nose or throat
Inflammation involving the nasal passages, sinuses, pharynx or nasopharynx can cause repeated reverse sneezing. Possible causes include inflammatory rhinitis, infections, inhaled irritants and immune-mediated disease.
Environmental allergies are often blamed for reverse sneezing, but this explanation should be used cautiously. Pollen and other airborne material may act as irritants, but true allergic rhinitis is considered uncommon in dogs. Frequent reverse sneezing should not automatically be dismissed as “just allergies” without considering other causes.
Foreign material
Grass awns, seeds, food particles and other material can become lodged in the nasal passages or at the back of the nose.
A foreign body is more concerning when reverse sneezing begins suddenly and is accompanied by regular sneezing, nasal discharge, head shaking or pawing at the face. Persistent sneezing after exposure to foxtails or similar grasses warrants prompt veterinary attention because plant material may migrate deeper into surrounding tissues.
Nasal mites
Canine nasal mites, Pneumonyssoides caninum, live in the nasal passages and sinuses. They can cause sneezing, reverse sneezing, nasal discharge, nosebleeds, facial itching and head shaking.
Nasal mites occur in Canada and many other parts of the world. They can be difficult to confirm without rhinoscopy, nasal flushing or direct visualization.
Airway anatomy
SomeStructural or functional airway problems may sometimes contribute to repeated reverse sneezing. Reported associations include an elongated or flaccid soft palate, pharyngeal collapse, congenital narrowing at the back of the nasal passages, and brachycephalic obstructive airway syndrome.
Tracheal or laryngeal abnormalities may also be found in affected dogs, although they are not always proven to be the direct cause of the reverse sneezing.
These dogs may also have snoring, noisy breathing, coughing, exercise intolerance or difficulty coping with heat.
Polyps, growths and nasal tumours
A mass in or near the nasopharynx could potentially trigger reverse sneezing by causing irritation or obstructing airflow. However, tumours are an uncommon explanation for reverse sneezing, and reverse sneezing alone is not considered a typical sign of a nasal tumour.
Digestive tract problems
Vomiting, regurgitation, difficulty swallowing and irritation related to gastrointestinal disease may sometimes contribute to inflammation around the pharynx and upper airway. Gastrointestinal signs were reported in some dogs evaluated for persistent reverse sneezing, although the connection is not fully understood.
Is Reverse Sneezing Dangerous?
A brief, occasional episode in a dog that is otherwise completely normal is generally not dangerous. Most dogs recover immediately and experience no lasting effects.
That does not mean every case should be ignored.
In one retrospective study of 30 dogs referred for investigation of reverse sneezing, inflammatory airway disorders were diagnosed in 57%, anatomical or functional disorders in 27%, and nasal or nasopharyngeal foreign bodies in 10%. However, this was a small, highly selected referral population in which every included dog had undergone extensive diagnostic testing. These percentages should not be applied to dogs that experience rare, mild episodes and are otherwise healthy.
The practical message is simple:
An isolated reverse sneeze is usually not an emergency. A new pattern, a worsening pattern or additional symptoms should be investigated.
What Should You Do During a Reverse-Sneezing Episode?
First, stay calm. Your dog may become more anxious if you panic or restrain them forcefully.
Most episodes stop without any intervention. You can:
- Stop exercise or play and allow your dog to stand quietly.
- Move away from smoke, fragrances, cleaning sprays or dusty areas.
- Loosen pressure from the collar.
- Speak calmly and gently stroke your dog’s neck or chest.
- Lightly massage the throat to encourage swallowing.
- Record a short video if you can do so safely.
Swallowing may help interrupt the reflex. Some veterinary sources also suggest briefly covering one of the nostrils or gently blowing toward the face to encourage swallowing. These techniques are not necessary for most dogs and should never be used if the dog becomes frightened, resists handling or appears to be in genuine respiratory distress.
Do not put your fingers into the back of your dog’s mouth unless you can clearly see a loose object that can be removed safely. A frightened dog may bite, and blindly sweeping the throat can push an object deeper.
Do not give human antihistamines, decongestants, cough medicines or other medications unless your veterinarian has recommended a specific product and dose for your dog.
Why a video is so helpful
Reverse sneezing often stops before a dog reaches the veterinary clinic. A clear video lets your veterinarian see the posture, breathing pattern, mouth position and sounds.
Try to record:
- The dog’s whole body
- The face and mouth
- The chest and abdomen
- The beginning and end of the episode
- How the dog behaves immediately afterward
Also note what happened just before it started, such as eating, drinking, pulling on the leash, running through long grass or exposure to smoke or sprays.
Reverse Sneezing or Something More Serious?
Several medical problems can sound similar.
Reverse sneezing
Air is pulled rapidly inward through the nose. The dog usually stands still with the neck extended and mouth closed. The episode ends abruptly, and the dog returns to normal.
Coughing
A cough pushes air outward from the lungs or airways. It may sound dry, wet, harsh or honking. Some dogs gag or retch after coughing. A persistent “goose-honk” cough is often associated with tracheal irritation, tracheal collapse or infectious tracheobronchitis rather than a simple reverse sneeze.
Gagging or retching
Gagging may involve opening the mouth, swallowing repeatedly, drooling or attempting to vomit. Problems involving the mouth, throat or esophagus can cause repeated gagging and difficulty swallowing.
Choking
A choking dog may panic, paw at the mouth, drool, struggle to move air or become weak. The gums may turn pale, gray or blue. Choking is an emergency.
Respiratory distress
A typical reverse sneeze ends abruptly, with the dog returning to normal breathing and behaviour. Respiratory distress is more likely to involve continued or recurring abnormal breathing, open-mouth breathing, marked abdominal effort, weakness, collapse or abnormal gum colour.
When Should You Call Your Veterinarian?
Arrange a veterinary examination when:
- This is your dog’s first episode and you are unsure what you saw.
- Episodes have started suddenly or are becoming more frequent.
- The episodes are becoming noticeably more frequent, lasting longer, changing in character or occurring with other symptoms.
- The episodes are becoming longer or harder to interrupt.
- Your dog does not return completely to normal afterward.
- There is regular sneezing, coughing or gagging.
- There is nasal discharge, especially from only one nostril.
- You see blood from the nose.
- Your dog paws at the face or shakes the head repeatedly.
- There is noisy breathing between episodes.
- Your dog has trouble eating or swallowing.
- Vomiting or regurgitation is also occurring.
- Your dog tires easily or struggles during exercise.
- A senior dog develops reverse sneezing for the first time.
- A short-faced dog has chronic snoring, heat intolerance or difficult breathing.
A sudden onset after running through long grass deserves particular attention because a nasal foreign body may need to be removed.
When Is It an Emergency?
Go to an emergency veterinary clinic immediately if your dog has:
- Blue, purple, gray or very pale gums
- Persistent open-mouth breathing
- Severe or continuous breathing effort
- Weakness or collapse
- An inability to move air
- Suspected choking
- Facial swelling with breathing difficulty
- An episode that does not resolve and is clearly worsening
- Continued distress after the snorting sounds stop
Keep your dog cool and calm during transport. Call the clinic while you are on the way when possible. Respiratory distress can deteriorate quickly and should not be watched at home.
How Do Veterinarians Diagnose Frequent Reverse Sneezing?
The first step is confirming that the event is actually reverse sneezing. Your veterinarian will review the video, ask about the timing and frequency, and perform a physical examination.
The examination may include:
- Listening to the heart and lungs
- Checking airflow from each nostril
- Examining the teeth, mouth and throat
- Feeling the neck and trachea
- Looking for nasal discharge or facial asymmetry
- Assessing the soft palate and upper airway
- Reviewing any coughing, vomiting or swallowing problems
A healthy dog with rare, mild episodes may not need testing.
When reverse sneezing is persistent or accompanied by other symptoms, testing may include bloodwork, chest or neck radiographs, dental imaging, computed tomography, examination of the larynx, rhinoscopy or retroflex nasopharyngoscopy. Samples may be collected for cytology, biopsy, fungal testing or culture.
CT and endoscopy are particularly useful when a veterinarian suspects a foreign body, nasal disease, structural abnormality or mass. These tests usually require sedation or general anesthesia and are not necessary for every dog.
How Is Reverse Sneezing Treated?
The reverse sneeze itself usually does not require treatment. Treatment depends on what is causing the irritation.
Possible treatments may include:
- Removing a nasal or nasopharyngeal foreign body
- Reducing exposure to smoke, sprays or other irritants
- Treating nasal mites with an appropriate antiparasitic medication
- Managing inflammatory nasal or airway disease
- Treating a confirmed infection
- Addressing dental disease
- Managing vomiting, regurgitation or swallowing disorders
- Treating tracheal or pharyngeal collapse
- Correcting significant brachycephalic airway abnormalities
- Investigating and treating a polyp or tumour
Antibiotics, antihistamines or anti-inflammatory medications are not automatically appropriate for every dog that reverse sneezes. Medication should be chosen according to the suspected or confirmed cause.
Can Reverse Sneezing Be Prevented?
Not every episode can be prevented, particularly when no trigger is identified.
You may be able to reduce episodes by:
- Using a harness if your dog pulls against a neck collar
- Slowing down dogs that gulp food or water
- Avoiding smoke, scented sprays and strong cleaning products
- Keeping your dog away from dusty areas when possible
- Checking the face and coat after walks through long grass
- Managing known airway or gastrointestinal conditions
- Maintaining a healthy body weight, especially in short-faced dogs
Keep a simple record if the episodes become frequent. Note the date, duration, activity, location and any possible trigger. Patterns that are difficult to notice day to day may become clearer over several weeks.
Frequently Asked Questions
Can a dog suffocate during a reverse sneeze?
A typical brief reverse sneeze does not usually prevent a dog from getting enough oxygen and is not expected to cause suffocation. A dog with blue gums, collapse, open-mouth breathing or continued respiratory effort is not having a routine episode and needs emergency care.
Does reverse sneezing hurt?
Most uncomplicated episodes do not appear painful, although they may be startling or uncomfortable. Pain, facial sensitivity or persistent distress suggests that another problem may be present.
Is reverse sneezing contagious?
The reflex itself is not contagious. However, an infection that irritates the respiratory tract may be transmissible to other dogs.
Can allergies cause reverse sneezing?
Airborne allergens and irritants may trigger episodes in some dogs. However, true allergic rhinitis is uncommon, and frequent reverse sneezing should not be assumed to be an allergy without considering other causes.
Why does my dog reverse sneeze after eating or drinking?
Eating or drinking quickly may irritate the area around the soft palate and nasopharynx or briefly stimulate the reflex. Occasional episodes may be harmless. Repeated episodes with coughing, choking, regurgitation or difficulty swallowing should be evaluated.
Why does my dog reverse sneeze at night?
Reverse sneezing can occur at any time, including while a dog is resting or sleeping. There is currently no well-established medical explanation for episodes that occur mainly at night. Record a video and speak with your veterinarian if nighttime episodes are frequent, worsening, disturbing your dog’s sleep or accompanied by coughing, nasal discharge or abnormal breathing.
The Bottom Line
Reverse sneezing can sound dramatic, but most isolated episodes are over quickly and cause no harm.
Pay attention to the pattern. A dog that has one brief episode and immediately returns to normal can usually be monitored. A dog with frequent episodes, a sudden change, nasal discharge, bleeding, coughing, swallowing problems or abnormal breathing between episodes should see a veterinarian.
And when you are unsure, record the episode. A 20-second video may give your veterinarian the clue needed to separate a harmless respiratory reflex from a problem that needs treatment.
Medical disclaimer: This article provides general educational information and is not a substitute for an examination or advice from your veterinarian.
