Those Startling Reverse Sneezes?

They aren’t life threatening, and a few quick, easy steps like rubbing the throat can shorten an episode

A reverse sneeze looks alarming. The cat may stand still with his elbows out and eyes open wide while rapidly snorting inward and extending his neck. An owner might panic, thinking the cat is suffocating.
A reverse sneeze also sounds alarming. “I do not know exactly how to describe it,” says Andrea N. Johnston, DVM, DACVIM, a specialist in internal medicine and instructor in small animal internal medicine at the Cornell University College of Veterinary Medicine. “It is a cross between a sneeze and a gag.”

Sudden Onset. Adding to the puzzle, the cat, who was normal one moment and suddenly appeared to be choking, returns to normal immediately afterward. In the case of reverse sneezing, however, sounds and appearance usually deceive. The sneezing isn’t life threatening, and owners can take some easy steps to shorten an episode.

Reverse sneezing, though common in dogs, is rare in cats. However, veterinarians encourage owners to take their pets for an exam to determine whether the episode really is reverse sneezing or a serious yet treatable condition.

An episode lasting from a few seconds to a minute or two can occur at any time in any breed. “There are many potential causes: intra-nasal foreign bodies, rhinitis and nasal neoplasia (tumors),” Dr. Johnston says. Reverse sneezing is also linked to nasal and bronchial infections and cleft palate in young cats. In older cats, causes include dental diseases. Other possible causes are inflammation, nasal drip, long-term vomiting, pneumonia and mites in the nasal cavities.

Record the Event. Ultimately, the exact cause is often not determined. What’s known for certain: Irritation in the nose, sinus or pharynx causes a throat spasm — a noisy reverse sneeze. At-home video, on your cell phone or alternate recording device, is a good tool to record the event and show your cat’s veterinarian, Dr. Johnston says.

One inexpensive, budget-friendly remedy: petting. Rub the cat’s sides and back, and scratch his throat. Some owners find that lightly covering the cat’s nostrils causes him to swallow. Swallowing helps stop the sneezing.
“Just try to relax your pet. Petting or gentle verbal soothing may be helpful,” Dr. Johnston says. “Changing environments may also benefit the cat – moving from an allergen-rich environment, such as outdoors, to a cool, calm environment, possibly indoors.”

Take note of the cat’s location and action immediately before the sneezing and its length. “The duration is very dependent on the cause,” Dr. Johnston says. “If the clinical signs are progressively worsening over minutes to hours, then veterinary assistance should be sought.

“Many clients describe an isolated episode of reverse sneezing,” she adds. “If this is an isolated or rare event, then I tell them not to worry about it, but if it is acute (sudden) in onset, increasing in severity or frequency, then I will recommend more advanced diagnostics such as nasal CT (imaging), rhinoscopy (a procedure in which a small camera is passed into the nasal passages) and possibly nasal biopsy.”

If the sneezing seems like a problem — if it happens daily or several times a day, or if it’s prolonged or accompanied by nasal discharge — visit the veterinarian.

He or she will consider the cat’s medical history and the description of the sneezing. A physical exam, blood tests, allergy tests or imaging may be used to rule out upper respiratory infection, nasal tumors, polyps or other underlying conditions.

When no underlying causes are found but the problem is ongoing, or the reverse sneezing is related to allergies, the veterinarian may prescribe an antihistamine or a steroid medication —
but medicine is not usually needed.

“If it is a once-in-a-while event, then I do not worry,” Dr. Johnston says. “Choking is a much more obvious and worrisome scenario. If a pet’s airway is blocked, then the gagging or coughing will escalate within minutes. The pet may display evidence of dyspnea (difficulty breathing) and potentially cyanosis (blue mucous membranes).”

For most cats, reverse sneezing sounds and looks scary, but it turns out that an event that may be eased by petting isn’t so scary after all. ❖