If you’ve ever seen your dog suddenly freeze, stretch their neck, and start making a racket that sounds like a cross between a goose and a malfunctioning vacuum cleaner, you’re not alone. While I work with animals every day, I also get a front-row seat to this spectacle at home—my own dog, Reggie, is a frequent performer when it comes to reverse sneezing.

So, what’s actually going on with this dramatic show?

What Actually Is a Reverse Sneeze?

A reverse sneeze (the technical term is “paroxysmal respiration”) is a reflex involving a sudden, involuntary spasm of the muscles in the throat and soft palate. Here’s what’s happening under the hood:

• The airway at the back of your dog’s throat (the nasopharynx) temporarily narrows or partially closes.
• This narrowing triggers your dog to forcefully and repeatedly inhale air through their nose, usually with their mouth closed.
• The classic snorting or honking noise is caused by air being sucked in past the narrowed airway, making the soft tissues of the throat vibrate.
• During an episode, dogs usually stop, stand still, and stretch their neck forward. You might see their chest and belly contract as they try to draw in air.
• The whole thing generally lasts a few seconds to a minute, then it’s over—Reggie acts like nothing happened, and so do most dogs.

It sounds dramatic (and frankly, a bit alarming), but your dog is still able to breathe. This is just their body’s way of clearing out irritants or mucus from the back of the nose and throat, much like how a regular sneeze clears the front part of the nose.

What Causes Reverse Sneezing? (And Who Gets It?)

A 2022 observational study of 30 dogs (Smith, 2022) found:

• 57% of cases were due to inflammatory airway disorders (e.g., nasopharyngitis, rhinitis)
• 27% were due to anatomical or functional disorders (such as tracheal collapse or elongated soft palate)
• 10% were caused by foreign bodies
• 7% had no identifiable cause (idiopathic)

Common secondary triggers include allergies, environmental irritants (dust, pollen, perfumes), nasal mites, excitement, sudden temperature changes, and possibly gastroesophageal reflux.

Breed and Population Predisposition

Small and toy breeds are more commonly affected, but there’s no clear link to sex, age, or neuter status (Smith, 2022). In my experience, dogs like Reggie—with her small-dog energy and penchant for drama—are classic examples. Her most consistent trigger is excitement, especially when her daddy arrives home.

What Does It Look and Sound Like?

Picture this: your dog stands still, stretches their neck, and starts making repeated, loud snorting noises. It can sound like they’re choking, but it’s not dangerous. Most episodes last less than a minute and resolve on their own. If you want to see what it looks and sounds like, this video by Dr. Leigh (an Australian vet) provides a clear, real-world example:

Should You Be Worried? Are They Going to Die?

This is the question I hear most often, and it’s a fair one. The good news: reverse sneezing is almost always harmless and doesn’t need treatment. It’s not the same as choking, coughing, or a true respiratory emergency.

That said, if episodes become frequent, last longer, or come with other symptoms (like coughing, nasal discharge, lethargy, or trouble breathing), it’s worth getting your dog checked out. Sometimes, new or severe cases need a bit more investigation to rule out infections, allergies, or foreign bodies.

How Do I Diagnose It (and What If It’s More Than a Reverse Sneeze)?

For most dogs, diagnosis is based on clinical exam and history. If you can manage it, getting a video of what your dog is doing during an episode is extremely valuable—being able to show your vet exactly what’s happening helps us see with our own eyes and make a much more confident diagnosis.

For frequent or severe cases, the 2022 study and current best practice recommend:

• Videofluoroscopic swallow studies
• Skull X-rays
• Endoscopy or CT imaging
• Nasal flush cytology
• Nasal swabs to rule out mites or infections

Key finding: 61% of dogs with follow-up data in the 2022 study had persistent reverse sneezing despite treatment, suggesting many cases have undiagnosed or inadequately treated underlying issues (Smith, 2022).

Medical & Surgical Management: What Does Treatment Involve?

Treatment depends on the underlying cause and may include:

• Corticosteroids (used in 77% of cases in the 2022 study)
• Antihistamines (67%)
• Antibiotics (60%)
• Antiparasitics (23%)
• Medications for reflux (e.g., omeprazole)
• Surgical interventions (for anatomical problems or foreign bodies)

However, it’s important to know that treatment success is limited: only 39% of treated dogs with follow-up in the study showed complete resolution of symptoms. Most dogs continued to have occasional episodes, even after therapy (Smith, 2022).

New Frontiers: What’s Emerging in Research?

Recent research is exploring links between reverse sneezing and aerodigestive diseases, particularly reflux disorders. Proteomic studies suggest silent reflux aspiration may play a significant role in some cases (Sykes et al., 2023). Acoustic monitoring technology is also emerging as a tool for objectively tracking episodes—potentially useful for both vets and owners.

What Can You Do?

There’s no clear antidote or quick fix for reverse sneezing. You may find lots of different tips and tricks online—everything from massaging the throat to briefly covering the nostrils—but in my experience, these practices are more likely acting as a distraction to the dog rather than actually stopping the process itself.

There’s really no need to intervene; just observe and try to spot any obvious triggers. Stay calm—your dog isn’t suffocating, and most episodes pass quickly.

If episodes increase in frequency, severity, or come with other symptoms, reach out to your vet or request a visit from me at www.personalisedmobilevet.com.au.

Removing potential irritants (dust, perfumes, cleaning products) from the environment can help. If you’re not sure whether it’s a reverse sneeze, take a video for your vet (I always appreciate a good home movie).

For a more detailed and visual explanation, check out these youtube vids:

References

• Smith, M. P., DVM. (2022). “Reverse Sneezing in Dogs: Clinical Findings and Outcomes.” Veterinary Sciences, 9(4), 185. 
• Sykes, J. E., BVSc, PhD, DACVIM. (2023). “Upper Airway Disorders in Dogs: A One Health Perspective.” Journal of Veterinary Internal Medicine, 37(2), 412–425. 
• Johnson, K. L., DVM, DACVIM. (2021). “Diagnostic Approach to Paroxysmal Respiratory Events in Dogs.” Proceedings of the American College of Veterinary Internal Medicine Forum.
• Dr. Lee. “Reverse Sneezing in Dogs.” YouTube, 2022. 
• Cornell University College of Veterinary Medicine. “Reverse Sneezing in Dogs.” 
• VCA Animal Hospitals. “Reverse Sneezing in Dogs.” 
• VIN (Veterinary Information Network). “Reverse Sneezing: What’s New?”