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Dr. B.
Dr. B., Veterinarian
Category: Dog Veterinary
Satisfied Customers: 21220
Experience:  Hello, I am a small animal veterinarian and am happy to discuss any concerns & questions you have on any species.
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My puppy just started reverse sneezing. He's never done it

Customer Question

My puppy just started reverse sneezing. He's never done it before and is having episodes every half hour. He is recovering from an ear infection and I'm nervous he might be allergic to the ear medication.
JA: I'm sorry to hear that. There are all sorts of infestations your puppy can pick up. I'll have you talk to the Veterinarian who'll sort out what is wrong and help you decide what to do about it. What is the puppy's name?
Customer: Arthur
JA: Is there anything else important you think the Veterinarian should know about Arthur?
Customer: hes 11 weeks old and a cockapoo
Submitted: 4 months ago.
Category: Dog Veterinary
Expert:  Dr. B. replied 4 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you today.

How long has he had these signs?

What ear medication is he on? How long has he been on it?

Did his vet confirm any damage to the ear drum?

Any nasal discharge? If so, what color and is it from one or both nostrils?

Any breathing changes or paling of his gums?

Customer: replied 4 months ago.
The "reverse sneezing" symptoms started last night after we put him to bed. He was diagnosed with the ear infection and started treatment on the Friday that just passed. He is having his ears cleaned with a cleaning solution every other day and is taking ear drops twice a day. The ear drops are Surolan. He also had his second set of shots on Friday that included an anti-parasite. No damage to the ear drum was confirmed. I don't see any nasal discharge. His breathing seems to be ok when he's not having a "reverse sneezing" episode. I don't think his gums are pale but I'm not 100% sure. I am concerned because yesterday I cleaned his ears for the first time. I squirted in the solution (perhaps with a little more force that I meant to because I'd never done it before) and he went a little crazy - got really upset and was rubbing his ear against the carpet and running away from us.
Expert:  Dr. B. replied 4 months ago.

Hello again,

Now if Arthur's gums are pale, do keep an eye on that. Its not really expected with this condition unless he was have difficulty breathing but if we see any more paling then we'd want him seen urgently. Now given when the medication was started, I'd not suspect it as a direct cause for this airway irritation That said, if you were to forceful when squeezing in the treatment, there is risk you have potentially injured the ear drum and if the products can then leak into the middle ear its possible they could play a role here. So I would suggest a 24-48 hour treatment break and just using salt water (1tbsp salt to a pint warm water) as a safe gently treatment to carefully flush into the ear.

Otherwise, when we see reverse sneezing, its usually due to irritation of the nasopharynx (where the throat and back of the nasal passages meet)/ Common cases are focal inflammation, bacterial or viral infection, low grade allergies, foreign bodies in the airwa) or we can also see this secondary to a polyp or growth (less likely here with Arthur).

With this in mind, further to giving that wee treatment rest, we can try some supportive care to see if we can reduce these signs. To start since he is congested at all, you can steam treat him. To do so, you can take him in the bathroom while you run a hot shower. The steam will help loosen any discharge but also moisten the airway. You can also use a baby nebulizer, but often they don’t like things held up to their faces. Therefore, we can often make little ‘steam tents’ with the him in a dog crate, a humidifier nearby, and a light bed sheet over both to make a little steam room for him. Or you could use a small room as well.

Furthermore, to try to flush out any irritants and soothe the tissues of this area, we can try using non-medicated saline nasal drops (like Ocean Mist or Little Noses). To administer, tilt the head back and drop two to three drops in one nostril. They hate this, but it helps. After the drops go down, you can let the head up and wipe away any discharge that gets loosened. Then repeat with the other nostril.

As well, to counter allergy concerns, we can trial him on an OTC antihistamine. Most commonly we use Benadryl/Diphenhydramine (More Info/Dose @ http://www.petplace.com/article/drug-library/library/over-the-counter/diphenhydramine-benadryl). A low dose (ie. 0.5-2 mg per pound of their body weight twice daily) can just be enough to reduce allergic irritation. We like to keep the dose low, as it can cause drowsiness (just like people). Of course, this medication shouldn't be used if your wee one has any pre-existing conditions or is on any other medication without speaking to your vet first.

Otherwise, if we use these but his signs persist, then we'd want your local vet to reassess him. They can check the ears for compromise and also the nasopharynx for the above concerns. Ideally, they can start a dog safe anti-inflammatory (ie Metacam, Rimadyl, Onsior, Previcox) +/- antibiotics if needed. These should address any allergies and reduce any inflammation triggering his signs as well as tackle any infection. If he settles, then we are happy. Though if we had a more chronic issue, then we may need his vet to flush the nasal passage to just make sure nothing is caught xray +/- scope his nasal passages (Hopefully, we'd not need that here but I just want to let you know our options just in case).

Overall, Arthur's signs do raise a few concerns and the medication may not be to blame. So, we can give it a break to make sure but otherwise would use the above now to see if we can settle any mild irritation present. Otherwise, we'd want his vet to check this and start the above treatment as needed to nip this in the bud.

Kind regards,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond.

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Customer: replied 4 months ago.
Thank you so much. This is very detailed. This morning Arthur is very lethargic (not like himself at all). I will start him on his treatment break. One thing that might be helpful to know is that he is very wiggly so I think since Friday we haven't given him an actual dose of his ear medicine (its more been a drop here and a drop there whenever we could get him to stay still for a second). Yesterday we wrapped him in a towel and gave him a proper dose. This is why it makes me think it could be an allergic reaction. The symptoms started about an hour after his second "proper dose" of it. The "reverse sneezing" episodes seem to be getting further apart in length which I think is a good sign. Thanks for all your help.
Expert:  Dr. B. replied 4 months ago.

You are very welcome, my dear.

Since it did start so soon after and wiggly pups are quite difficult to medicate, it is a concern that it could have gotten into the middle ear. So, do stop that medication and try the above to see if we can get him feeling better here. Since it sounds to be waning we'd hope that we can do so. Though again if it lingers then we'd want this checked just to be safe.

Best wishes,

Dr. B.

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If you have any other questions, please ask me – I’ll be happy to respond.

**Please rate me by clicking on the **stars** at the top of the page as this is the only way the site credits me for helping you!: )

Expert:  Dr. B. replied 4 months ago.
Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. B.
Customer: replied 4 months ago.
Hi Dr. B.Arthur was very lethargic and continued to "reverse sneeze" until about 9am that morning. Then he peeked up, ate, went out for a walk and stopped having "reverse sneezing" episodes. Since then he's been feeling much better. We haven't put anything in his ears at all since (no cleanser, no medication). He is still scratching his ears a bit - I wouldn't say incessantly but he is scratching. His ears look pink inside and aren't smelly. Not sure if I should try the ear drops again or maybe get a different kind of ear drop. Or maybe just give it a little more time and see if it solves itself. Also, yesterday and this morning he hasn't been reverse sneezing, but he has been a little sniffly.
Expert:  Dr. B. replied 4 months ago.

Good afternoon,

I am very glad to hear that he is feeling better.

In regards ***** ***** I'd be tempted to avoid those drops here. Instead, you can gently salt water flush the ears. Or if they are still irritating him, consider ringing his vet for an alternative drop to use just so we don't let this linger and possibly get worse for him.

Best wishes,

Dr. B.

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