E770
Sneezing and Nasal Discharge

Introduction: Sneezing and nasal discharge are common problems in dogs and tend to indicate an upper respiratory problem. Structures affected are often the nostrils, nasal passages, sinuses, mouth, teeth, pharynx (back of the mouth), and larynx ("voice box").

Causative Agents: Some of the causes of sneezing and nasal discharge include trauma, infection, dental disease, foreign bodies, allergies, tumors, toxin ingestion (i.e. rodenticide anticoagulant poisoning such as D-Con), or environmental irritation (i.e. cigarette smoke, dust).

Clinical Signs: A sneeze is an involuntary, forceful expiration of air through the nasal passages. Its function is a protective one, and serves to clear the nasal passages of foreign material and irritants. A common variation of sneezing observed in dogs is the reverse sneeze. Reverse sneezing is associated with violent, repeated inspirations of air into the nose, as opposed to true sneezing which is manifested as the forceful expiration of air. The distinction is important to make, because different problems tend to result in one or the other.

The nasal discharge may be clear, mucous-like, pus-like, true pus, blood-tinged, and/or straight blood. It may contain food particles, and may be unilateral (involving one nostril) or bilateral (involving both nostrils).

Diagnosis: A thorough history and physical examination are the first steps. Information which is important to collect includes the following:

  1. A detail of the environment in which the animal lives
  2. Previous medical history
  3. Presence or absence of sneezing or reverse sneezing
  4. Presence and character of any nasal discharge
  5. Odor of the breath
  6. Conformation of the nose and surrounding structures
  7. Body temperature
  8. Appearance of the teeth, gums, and eyes, including the retinas
  9. Any abnormal facial expressions or pain when the face is handled (palpated)
  10. Presence of air flow from the nostrils

Additional diagnostic testing may be necessary and can include bloodwork, urine analysis, skull radiographs, cytology and/or culture of nasal discharge, biopsy, and rhinoscopy (inserting a small, flexible tube with a camera at the end into the nasal passages). See Section D for information on these tests.

Treatment: Treatment of a patient with a sneezing or nasal discharge disorder centers around elimination of the underlying cause and depends on an accurate diagnosis. Antibiotics, antifungals, anti-inflammatory agents, analgesics or sedatives, nasal probes, surgery, radiation, and elimination of environmental irritants are specific treatments.