Reverse Sneezing

This is a misnomer, for it has nothing to do with actual sneezing. However, it is a popular term for something that appears to be worse than it actually is. When this occurs, your dog will appear to be snorting or choking. The posture will be one of the neck extended with the chest expanded, as the dog struggles to take in air. The actual physiology is that the trachea has narrowed and the normal amount of air is not able to enter the lungs. The triggering mechanisms are usually excitement or stress. If this is happening to your dog, do not panic. You can help your dog by soothingly stroking the upper throat area to encourage relaxation and dilation of the trachea. If things do not resolve soon, and the dog is really having a continued hard time, you can try depressing the tongue to open up the oral cavity for the passage of much needed air into the lungs. The predisposition to this is thought to be hereditary, particularly in smaller breeds because of the decreased diameter of their tracheas. If your dog occasionally has this, do not worry that you need to be there to help each time it happens. A dog is able to come out of an attack of reverse sneezing without help and will not suffer permanent damage.

Reverse sneeze in pets

"My dog makes really loud noises and seems to have a hard time breathing. She is usually fine before and after her attacks. It seems as if she is in pain and choking. I never see anything that she is choking on. The sounds are very loud and she seems in pain or distress. What is going on and what can I do about it?"

This pet owner is describing what is called a reverse sneeze. Reverse sneeze syndrome is characterized by a series of loud, forced inhalations through the nostrils, lasting anywhere from 10 seconds to several minutes. This forces air in the opposite direction from a sneeze, which is forced exhalation of air through the nostrils.

They occur on a sporadic, unpredictable basis. They usually only occur in dogs and not other pets. Dogs usually stand still and have their head stretched or extended forward during an attack. Dogs appear perfectly normal before and after an attack. Their is no loss of consciousness or collapse. It is usually the loudness of the spells and the appearance of the dog that can be upsetting to their owners.

The exact cause of the syndrome is not known. One theory is that affected dogs are consciously removing mucus from the nasal passages. Dogs with allergies or sensitivities to odors may do this to clear their nose. Many dogs can be seen swallowing at the end of an attack. Another possible cause is a sinus or other respiratory disorder. Most of the time the condition is not serious.

If the condition appears suddenly in an older dog, or if the episodes become more frequent and severe the nasal passages should be examined. If the nose starts to bleed or develop a thick mucus discharge the nose should be examined. Treatment is not necessary when the episodes occur infrequently on a random basis. Home treatments that have been reported to be successful include massaging the throat, blowing into the nose, and rapidly and lightly compressing the chest. Usually these pets will not have an attack when brought to a veterinarian. If a tape recorder or video camera is available the attack can be recorded. The recording can be looked at or listened to by a veterinarian. They can then determine if any treatment is needed.

Honking, hacking, snorting sounds (reverse sneezing)

A day does not go by when someone doesn't ask about why their Maltese makes these sounds like they can't breathe. In most cases this is usually caused by what I call reverse sneezing. I've seen it happen primarily when excited. I have heard of others Maltese that will do this after drinking or eating, after running around, or while pulling on the leash.

It seems to me what is happening here is that the pharynx goes into spasms. Usually, by gently rubbing the throat of your Maltese, the spasms will stop after they swallow a couple of times and thats the end of it. On others, taking them outside for some fresh air will quickly cause the wheezing, snorting and honking to cease within less than a minute.

From the many Maltese people I speak to, I have found it to be extremely common in the Maltese breed and after speaking to several vets, have come to the conclusion that it is a harmless condition and medical attention is not necessary for reverse sneezing. It is very important though not to confuse reverse sneezing with a collasping trachea.

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Collapsed Trachea and Reverse Sneezing

The trachea, also known as the windpipe, is an important structure which connects the throat to the lungs. It is composed of 35- 45 C-shaped rings of cartilage that are joined by muscle and ligaments to create a tube-like structure. It serves the purpose of directing air into the respiratory tract.

When the cartilage rings are flattened from the top to the bottom, the trachea is said to be collapsed. Rapid inhalation of air can cause the trachea to flatten and make it difficult for air to enter the lungs, much like a soda straw being drawn on too vigorously.

Why does it happen?

We do not completely understand how this condition develops. However, we know that these dogs have an abnormality in the chemical makeup of their tracheal rings. The rings loose their stiffness so they are not able to retain their circular shape.

What are the signs?

Collapsing trachea or Reverse sneezing

With reverse sneezing the pharynx (back of the throat) goes into spasms. The dog finds it difficult to draw in air through the spasms, so it stands still, stretches out her neck, and thrusts its elbows out (like a bowlegged bulldog) as it honks, wheezes, or snorts. Often eyes open wide. The spasms will stop if she swallows a couple of times.

•Close off her nostrils with your fingers so it has to breathe through its mouth for a few seconds.

•Gently rub its throat. This works for some.

•Distract it by carrying the dog outside into the fresh air.

Young puppies can reverse sneeze, but the first episode typically occurs in late adolescence. Stay calm and get it to swallow with one of the methods described above. In a few seconds to a minute, it will run off to play. Reverse sneezing is a harmless phenomenon which needs no vet consultation and no medical treatment whatsoever. It is very common in toy breeds.

Other signs, however, will help you distinguish the two conditions:

If it makes these sounds when excited or after eating or drinking, or turns her elbows outward and extends its neck and gasps inward with a rhythmic snork! snork! snork!, this is reverse sneezing.

If it breathes through the mouth sometimes, or breathes with a raspy sound, or coughs reflexively when you simply rub its throat, it could have a collapsing trachea. If the cough is one or two expulsive outward bursts (forcing air through the trachea to open it), typically with a gag or empty retch at the end, she could have a collapsing trachea.

The most common clinical sign of collapsing trachea is a chronic cough. It is often described as dry and harsh and can become quite pronounced. The term "goose honk" is often used to describe it. Coughing is often worse in the daytime and much less at night. The cough may also begin due to excitement, pressure on the trachea (from a leash), or from drinking water or eating.

How is collapsed trachea diagnosed?

Many times, very light pressure placed on the trachea during the physical examination can raise a suspicion of collapsed trachea in a small dog with a persistent dry cough. While the information gained from the physical examination is helpful, other tests are needed to confirm this condition.

X-rays of the chest can identify the trachea and its shape. However, a collapsed trachea changes its diameter during the respiratory cycle. It is usually collapsed during inhalation and normal during exhalation. Therefore, attempts to make radiographs during both phases of respiration should be made.

Endoscopy is another way to see the trachea. An endoscope is a tube that is small enough to be inserted into the trachea. By watching the trachea during inspiration and expiration, abnormal collapsing can be seen. Unfortunately, tracheal endoscopes are expensive and not available at every veterinary hospital.

How is it treated?

Collapsed trachea can be treated medically or surgically. Some dogs respond well to:

• bronchodilators and various types of anti-inflammatory drugs.

•chemical cough suppressants

•a bronchodilator (typically the drug aminophylline) to keep the bronchial tubes open in extreme cases that are affecting the lungs

•The trachea of these dogs is easily infected, so antibiotics are usually part of the treatment.

•If obesity is present, weight loss is often beneficial.

•Excitement and vigorous exercise are likely to cause a relapse, so they should be avoided as much as possible.

Because medical therapy only treats the symptoms and not the problem, these dogs are always subject to recurrences of coughing and breathing difficulty.

•surgery. The above tests are used to determine how much of the trachea is collapsed. If the only abnormal part is that segment between the throat and the point where the trachea enters the chest (the thoracic inlet), surgery may be curative. However, if the segment of the trachea that is within the chest cavity is abnormal, surgery is not likely to be helpful because that part is not accessible to the surgeon. There are several surgical approaches that have been used. Each approach implants an artificial support device that is secured around or within the trachea. The purpose of the support device is to hold the tracheal rings in their normal, open position. Although some dogs have excellent results and are truly cured of the disease, the outcome is not uniformly successful.

Natural ways to treat your Yorkie:

•Fresh foods, keeping the amounts low for weight reduction. Fat dogs have a much harder time breathing.

•Vitamin C

•Vitamin E

•Exercise reduction. Don't stop exercise completely -- just don't let get to the point where the dog is panting heavily, especially when older. Remove all pressure from the throat. No collars, and use a harness that wraps around the chest and stomach, never around the throat. Tell visitors not to rub the throat.

•A cool-mist humidifer to keep the air moist and easy to breathe.

•Glyco-flex and Glucosamine are nutritional products packed with minerals, amino acids, enzymes, and lubricating agents. They build cartilege and help heal damaged connective tissue. These are natural products with no side effects. They are inexpensive and last a very long time, so you have absolutely nothing to lose by trying them.

•Herbal cough remedies, if coughing is really bad.