Q. I have a 5-year-old German Shepherd Dog-Terrier mix, Andy, who has frequent bouts of inverted sneezing. It actually sounds like he's having an asthma attack. They seem to come out of nowhere and usually last no longer than 15 to 20 seconds. He's totally fine afterward. I've been told by my vet there's no need to worry, but I'm so curious as to what causes this and what's actually going on when this happens to him.
A. Reverse sneezing can be very alarming for dog owners because it may seem that your dog is in respiratory distress. It is best described as a series of vigorous intakes of breath through the nose, often accompanied by your dog's head bobbing up and down.
If I had a live audio-video feed, I could demonstrate it (I have gotten good at doing so in the exam room).
As your veterinarian told you, most reverse sneezing is nothing to worry about. It is the result of irritation of the nasal passages, often with dust. It is not life-threatening, and usually does not indicate any underlying disease.
Interestingly, some dogs do it for attention. They discover by accident that their owners immediately jump to their rescue, and they receive unexpected offerings of affection and concern. If your dog is a drama queen (or king), consider this possibility and react accordingly.
However, there is one medical condition that was discovered rather recently with the advent of endoscopes, which allow veterinarians to look up inside dogs' noses. Occasionally, microscopic parasites known as nasal mites are discovered running around inside these serpentine passageways, undoubtedly having a grand old time. You can imagine their delight in setting up shop inside a Collie's nose, for example. (How spacious compared to their neighbors, who may only have a Bulldog's compact acreage in which to set up their household.)
In any event, nasal mites are mostly an annoyance to your dog (and indirectly to you). If the reverse sneezing continues or worsens, you might discuss having your dog's airways "scoped." This does require general anesthesia. Never ignore chronic nasal discharge or bleeding because these could be signs of a nasal tumor.
In some cases, if nasal mites are suspected, dogs are treated with ivermectin without doing endoscopy. Ivermectin is a powerful antiparasitic medication that will kill nasal mites, but some dogs are sensitive to it, so it should only be used after discussing it with your veterinarian.
Best,
Jon Geller, DVM
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