We humans all sneeze and cough from time to time, and we have our own sense of when we need to go to the doctor.
An occasional sneeze or cough is part of normal life, but if it starts to happen many times a day, for several days in a row, or if we feel unwell in ourselves generally, we know that we need to see a doctor to find out the cause.
In general, pets are no different. My rule of thumb for owners is that if your pet is sneezing or coughing more than you are, then you should take them to the vet.
What do vets do about sneezing and coughing pets? The answer is simple — a diagnosis of the cause of the sneeze or cough needs to be made. Once you know why it’s happening, you can give the appropriate treatment.
Simple, mild, causes are the most common. For some reason, dogs are more prone to coughing, while cats tend to sneeze more than cough.
Kennel cough (infectious tracheobronchitis) is the most common cause of coughing in dogs, while simple allergies and cat flu are the most common reason for cats to sneeze. Pets with these problems tend to remain bright and active, and with treatment, the problem can usually be quickly resolved.
Other, more serious conditions can be more challenging to diagnose and to treat.
The first task is taking a full and detailed history from the owner. How long has the problem been going on? How many times an hour is the pet sneezing or coughing? Is there any pattern? (for example, some conditions cause pets to cough first thing after rising in the morning, while others cause coughing after exertion).
This discussion can be surprisingly useful. One woman told the vet that her cat only had sneezing fits on Saturday evenings. On closer questioning, the cat used to sit behind her, watching while she prepared to go out for the night. It turned out that the hairspray she was using was irritating the cat’s airways.
After she started to put the cat in the next room while she got ready, the cat never sneezed again.
I often ask owners to take a video of the pet sneezing or coughing, so that I fully understand what’s happening.
This can sometimes provide enough information to make a specific diagnosis. Some dogs are prone to an issue called “reverse sneezing”.
This is literally like sneezing in reverse: They breathe out slowly through the nose, then inhale explosively. It can appear shocking and serious to owners, but it’s a common and normal behaviour in moderation. The easiest way to make the diagnosis is to watch a video of the dog doing it.
Vets will also ask about any discharges: It’s normal for pets to sneeze out little droplets of clear mucus, but if there are globs of yellow fluid, or drops of blood, then that’s a more serious sign. Again, it can help to take photos of anything that your pet coughs or sneezes out so that you can show the vet.
After the history has been taken, it’s time to examine the animal.
The aim of the body’s sneezing and coughing reflexes is to clear irritating debris from the airways. When the lining of the nose is irritated, sneezing follows — and, when the throat and airways are irritated, the result is a cough. So, for sneezing, this means the nose needs to be inspected, while for coughing, the throat and lower airways (the lungs) are the focus. None of these areas are easy to visually examine in detail, so this can be a challenge.
Vets often use handheld scopes to peer into noses. One of the classic causes of sneezing in cats is a blade of grass being stuck inside the nose.
Cats like chewing grass, and sometimes they swallow some, then regurgitate it. Occasionally, the grass enters the back of the nasal cavity instead of coming out through the mouth. This causes repeated sneezing, and when a vet looks into the nasal cavity, they can often see a tiny fleck of green. If this is grabbed with forceps, a long blade of grass can be pulled out. This is very satisfying: It reminds me of a magician pulling a white rabbit out of a hat, and it’s guaranteed to cure the sneezing cat.
For a detailed inspection of the inside of the nose, a special flexible fibreoptic scope may be needed (for a detailed inspection and biopsy collection), as well as x-rays and advanced imaging like CT scans.
IN severe, repetitive cases of sneezing, and especially if drops of blood have been seen, it’s important to check carefully for cancer of the lining of the nose using these methods.
In coughing pets, the throat and lungs need to be checked carefully.
Auscultation, the act of listening with a stethoscope, is the first step: sometimes extra rattles and crackles can be heard. X-rays are the next stage: vets know exactly what healthy lungs and hearts look like, and if a cough is caused by bronchitis, asthma, lungworm, heart disease, or (rarely) cancer, a characteristic pattern can be seen. To confirm a diagnosis, a sample of cells from the airways may be collected, but this requires full anaesthesia.
Understandably, conscious pets don’t take easily to having long thin tubes poked down their windpipes.
Treatment depends on the cause and can range from tablets for heart disease to spot-on products for lungworm, to inhaler masks for pets with asthma or bronchitis.
Your pet is telling you something when they cough or sneeze: it’s important that you don’t ignore it.