85 — Reverse Sneezes & Drama Queens: Is Your Dog Dying or Just Sneezing?

Reverse Sneezes & Drama Queens: Is Your Dog Dying or Just Sneezing?

Dr. Marty Greer and Laura Reeves break down the critical differences between upper and lower airway issues in dogs, outlining warning signs of serious respiratory diseases, breed-specific risks and essential diagnostic steps to protect your pet.

This discussion cuts through the noise to help pet owners distinguish between a minor reverse sneeze and a life-threatening emergency. From breed-specific vulnerabilities (like BOAS in pugs and LARPAR in Labradors) to the diagnostic tools vets use, this episode provides a vital roadmap for anyone wanting to keep their pet breathing easy.

1. Dogs vs. Cats: Who Tells You They’re Sick?

• Dogs are early communicators: Dogs are more than happy to show symptoms early on, including coughing, runny noses and loud respiratory distress.
• Cats mask symptoms: Cats hide respiratory issues until they are in severe distress—often down to their last functioning alveolus.

2. Upper Airway vs. Lower Airway Issues

Dr. Marty explains that respiratory disease is a broad spectrum, ranging from mild infections to fatal conditions:

• Upper Airway: Includes rhinitis (nasal inflammation), pharyngitis, laryngeal disease, tracheal disease and common infections like kennel cough.
• Lower Airway: Located past the rib cage, involving the lungs and pleural cavity, which houses the lungs and heart. This includes serious conditions like pneumonia, lung tumors and lung torsions.

3. The Warning Signs: Why the “Quiet Cough” is Scariest

• Loud Hacking Coughs: Often associated with conditions like kennel cough. While dramatic, they are often less immediately dangerous.
• Soft, Quiet Coughs: These are highly concerning as they are typically associated with deep lung issues (like pneumonia) or cardiac (heart) problems.

4. High-Risk Breeds & Severe Airway Syndromes

• Brachycephalic Breeds (Pugs, Frenchies, Bulldogs): Can be prone to BOAS (Brachycephalic Obstructive Airway Syndrome) and tracheal.
• Labradors (especially Black Labs): Prone to LARPAR (Laryngeal Paralysis), a severe condition that can cause acute, life-threatening respiratory distress on hot days
• Sighthounds & Deep-Chested Dogs: At a higher risk for lung torsions (twisting of a lung lobe)

5. Essential Veterinary Diagnostics

If a respiratory issue doesn’t resolve, vets rely on several critical diagnostic tools:

• X-Rays: Chest and upper airway x-rays to identify collapsing tracheas, lung tumors, pneumonia, or fluid in the chest.
• Echocardiograms & Bloodwork: Ultrasound of the heart and CBC (Complete Blood Count) tests.
• Urine Tests: A urine-based “blasto test” to screen for Blastomycosis (fungal infection).
• Chest Fluid Extraction: If the pleural cavity is full of fluid (such as chyle, pus, or blood), the fluid must be drawn out immediately to determine the underlying cause and help the pet breathe.

6. Critical Treatment Insights & Drug Safety Warnings

• Antibiotics vs. Antivirals: Antibiotics are effective against bacterial causes but won’t cure viral infections unless there is a secondary bacterial complication.
• OTC Cough Syrups: Dextromethorphan can be safe for dry, hacking coughs, but never suppress a soft, wet cough where the dog needs to clear fluid.
• 🚨 Lethal Tylenol Warning: Never give over-the-counter medications containing Tylenol (Acetaminophen). A single dose of Tylenol will kill a cat.
• Prescription Risks: Medications like Temaril-P (prednisone/antihistamine) must be used carefully, as steroids can be highly dangerous for conditions like blastomycosis or pyothorax.

Dr. Marty’s Pro-Tips for Pet Owners

1. Grab Your Phone and Record Video: Dogs and cats rarely perform their abnormal coughs or breathing patterns at the vet’s office. Having a quick video of the episode (including whether it occurs when breathing in or out) is invaluable for diagnostics.
2. Intranasal Bordetella Vaccines: For show dogs or active social dogs, opt for the intranasal vaccine rather than oral or injectable forms. It provides much stronger coverage against parainfluenza and adenovirus.
3. The Power of Vet Relationships: Having an established relationship of trust with your vet is critical when making fast, difficult, or expensive emergency medical decisions.