When should I take my cat to the vet for sneezing?

Sneezing is a useful bodily function in which the body forcefully expels irritants from the nose. A multitude of animal species sneeze, including dogs, chickens, elephants, certain lizards, and cats.

If your cat is sneezing, it may just be part of the normal process to clear their nose that usually isn’t concerning. However, if the sneezing is persistent, or if other symptoms are present, it may indicate an underlying disease.

Here’s what you need to know about cat sneezing—from the causes and concerns to how to help.

What Causes Cat Sneezing?

Cat sneezing can be surprisingly difficult to diagnose, for several reasons. First, your veterinarian will need to confirm that your cat is actually sneezing.

Coughing, gagging, reverse sneezing, hiccupping, retching, and wheezing can all be misidentified as a sneeze, and each of these symptoms come with a separate list of possible causes.

Take a video of your cat during an episode to help your vet confirm whether it really is a sneeze.

Another obstacle in diagnosing cat sneezing is the plethora of underlying causes. Infections, chronic inflammation, dental disease, cancer, and inhalation of foreign material can all cause a cat to sneeze.

Further complicating matters is the fact that in cats, more than one of these causes is usually going on at the same time.

Here are some of the possible causes for sneezing in cats.

Viral Respiratory Infections

In sneezing cats, viral upper respiratory infections are, as a general rule, the original problem. The most prevalent infection is feline herpesvirus. Some researchers have estimated that as many as 80-90% of cats are infected with herpesvirus.

Unlike people, herpesvirus in cats causes primarily upper respiratory signs, including sneezing and discharge from the eyes and nose. As in people, the symptoms of feline herpesvirus are exacerbated by stress.

Although there is emerging research to suggest that existing drugs could improve outcomes for cats infected with herpesvirus, there is currently no cure, and infections are lifelong.

Other viral infections that can contribute to cat sneezing include calicivirus (which the FVRCP combo vaccine provides protection against) and influenza.

Bacterial Infections

Bacterial infections almost always play a secondary role in upper respiratory symptoms in cats.

If you see yellow or green snot emerging from your cat’s nose or eyes, this abnormally colored discharge is a sure sign of a bacterial infection.

However, in cats, these bacterial infections almost never act alone; after a respiratory virus or other disease process causes damage to the nasal passages, bacteria seize the opportunity to take advantage of the diminished barriers that usually protect the cat from such attacks.

Bordetella, mycoplasma, and chlamydia are all common culprits of bacterial infections in a cat’s nose. Although these infections are rarely the sole issue, treatment with antibiotics such as doxycycline or azithromycin will dramatically reduce sneezing and other symptoms, allowing your cat to breathe more comfortably.

Research into the efficacy of newer antibiotics may allow your vet to more easily treat these infections in the future.

Inflammation and Irritation

A very broad category of disease that contributes to cat sneezing is one that creates inflammation and irritation in the nose.

The infections mentioned above can certainly cause inflammation, but so can almost all other causes of cat sneezing.

Making matters more complicated, inflammation itself can cause a cat to sneeze, creating a feedback loop where cats continue to sneeze long after the initial problem is eliminated or has been inactivated. This situation is typically referred to as chronic rhinitis.

There is no good test for diagnosing an inflammatory condition as the sole cause of sneezing in cats (short of a nasal biopsy, which must be done under anesthesia). So, typically, once the other causes are ruled out, inflammation is the last man standing, so to speak.

Reportedly effective treatments range from steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) to drugs typically used for nausea. Although in its infancy, there is evidence to suggest that immunotherapy could help sneezing cats in certain cases.  

Although allergies are inflammatory, allergic rhinitis (sneezing from allergies) is so rare as to be nonexistent in the domestic cat.

Foreign Material

Inhalation of foreign material, like blades of grass, foxtails, etc., can of course cause irritation to the nasal passages.

When these intruders are inhaled by a cat, the body’s response is to sneeze to expel the foreign debris. While this approach might work for smaller particles like dust, larger objects are difficult for a cat to remove by sneezing.

These situations can be diagnosed with either rhinoscopy, in which a camera is inserted into the nose of an anesthetized cat, or a nasal flush, in which sterile saline is forced through the nasal passages (again, under anesthesia) to remove the material that the cat was unable to sneeze away.

Dental Disease

Many pet owners are surprised to hear that dental disease could contribute to cat sneezing.

As with many species, the roots of the teeth on the upper jaw are located right next to the nasal passages. When teeth become infected, or when severe inflammation exists, the barrier between the tooth socket and the nose can be penetrated.

When the cat eats, food material can enter the nose, triggering the sneeze reflex.

Treating the dental disease, either by extraction of the affected tooth or closure of the abnormal hole, will typically alleviate the sneezing unless the issue has progressed to the feedback loop of chronic rhinitis.

This condition is generally painful, so if you suspect dental disease in your cat, a veterinary visit is strongly advised.

Neoplasia (Tumors)

As with most symptoms, tumors are always on the list of possible causes.

In older cats especially, tumors can grow inside the nasal passage, creating irritation and inflammation that causes the cat to sneeze. These tumors are typically detected visually via rhinoscopy or a nasal biopsy.

When they are present, the prognosis is unfortunately quite poor. Similar to dental disease, nasal tumors are thought to be painful.

Fungal Infections

Although less common than viral or bacterial infections, fungal infections are a known cause of sneezing in cats.

A fungus called Cryptococcus is the usual suspect.

Unlike viral infections, there are effective treatments for fungal infections in the feline nose. A physical exam alone will not be enough to distinguish a fungal infection from other causes of cat sneezing, so rhinoscopy or a biopsy are usually required to achieve a diagnosis.

Fungal infections in this location can be painful.

Other Causes

Although a handful of other causes can contribute to your cat’s sneezing—including polyps or abnormal formation of the nose and mouth—the causes listed above are vastly more common.

Is Cat Sneezing Serious?

It depends on whether the cause is environmental or a disease.

Sometimes the irritants that trigger the sneeze reflex are environmental—like dust, mold, or pollen—which the cat inhales, causing them to sneeze. In these cases, sneezing is usually not serious, especially if seen in an isolated episode.

More often, though, cat sneezing is caused by one or more disease processes.

Most commonly, a viral infection is the initial problem, with subsequent inflammation and bacterial infections causing damage to the architecture inside the nose, perpetuating the problem.

What If My Cat Keeps Sneezing?

It depends on the cause. If it is an isolated episode of cat sneezing, the issue is likely to go away and not return.

If your cat starts sneezing suddenly and it lasts several days, there is a possibility that the issue will resolve, but treatment will likely be needed.

If your cat suffers from chronic sneezing, however, they will likely be sneezing intermittently for the rest of their life. Persistence of sneezing to a chronic state substantially raises the odds that an underlying disease process is at play.

When Is It Time to See a Vet?

Since many of these conditions are uncomfortable or painful, it’s never a bad idea to take your cat to the vet as soon as you notice a problem, even if sneezing is the only symptom.

However, these signs are more serious and require a vet visit sooner rather than later:

• Loss of appetite

• Weight loss

• Nasal discharge

• Worsening of symptoms

• Persistence of symptoms beyond a few days

Cat Sneezing With Other Symptoms

Cat sneezing in conjunction with other signs is common but doesn’t always help us narrow down the cause.

Cat sneezing along with wheezing can suggest concurrent lower respiratory disease.

If a cat is coughing and sneezing, it typically means that it’s primarily an upper respiratory process with postnasal drip irritating the throat.

If you see nasal discharge, especially with blood or pus-colored mucus, make a note or take a picture before cleaning your cat’s face, as this can help narrow down the causes. Be sure to clean your cat’s face, as it causes discomfort for your cat.

Chronic nosebleeds raise the concern for cancer, especially in older cats, but this association is not definitive.

How Do Vets Determine the Cause of Cat Sneezing?

Although treatment for sneezing cats is typically not costly, achieving a diagnosis certainly can be expensive.

You would think that testing for bacteria or a virus would determine the cause. However, because the nasal cavity is not a sterile location, a culture that is positive for certain bacteria does not prove that the bacteria are the primary cause of the sneeze, or even that they are causing disease (there are normal bacteria that live on the surface of the skin).

Nor does testing positive for viruses confirm this as the underlying cause, since even asymptomatic cats will often test positive for either herpesvirus or calicivirus.

Here are some ways your vet can determine the cause of cat sneezing:

Physical Exam

Your vet may want to first run some baseline tests to evaluate the overall health status of your cat. A dental exam should be a part of the initial physical exam to investigate whether dental disease may be causing the sneezing.

Imaging 

Imaging can be useful to look for underlying causes and to evaluate the degree of damage to the inside of the nose in severe cases.

Your veterinarian can take X-rays of your cat’s head and chest, but the gold standard for imaging sneezing cats is a computerized tomography scan, which requires general anesthesia and is typically done in emergency or referral hospitals.

Rhinoscopy

Rhinoscopy, in which a camera is inserted into the nasal passages of an anesthetized cat, can be used to search for tumors or fungal plaques.

Biopsy

Biopsies of the walls of the nasal cavity may be taken during rhinoscopy to search for inflammatory, fungal, and cancerous causes of sneezing.

Nasal Lavage

Flushing the nasal passages while the cat is under anesthesia can sometimes reveal diagnostic information (e.g., dislodging a foreign body), and it is also a treatment.

How Do You Treat a Sneezing Cat?

Treatment for cat sneezing is typically targeted at the underlying cause where possible.

While a wide variety of treatments are available, owners should be aware that the goal in most cases, especially chronic cases, is to reduce the frequency and severity of symptoms, not to cure them.

More research is needed to fully understand the role that infections play in cat sneezing, but repeated or prolonged courses of antibiotics have proved to be effective in controlling clinical signs.

Antibiotics

Although bacterial infections are rarely the primary problem, antibiotics are often used for such cases, as these drugs make the cat feel better quite quickly.

Nasal Lavage 

Nasal lavage under general anesthesia can relieve clinical signs temporarily, regardless of the cause, and it can dislodge hidden foreign material.

Other Treatments

Other treatments, which have variable levels of effectiveness, include:

• Humidifiers or nebulizers

• L-Lysine to minimize flare-ups of herpesvirus

• Steroids

• Antihistamines (in cats, cetirizine is far better than diphenhydramine)

• NSAIDs

• Decongestants

• Antinausea medications

• Surgery (in rare cases)

Featured Image: iStock.com/gilotyna

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