Sneezing in cats

Just like us, cats will sneeze and the occasional sneeze is nothing to worry about. A sneeze is usually the result of something that has irritated the inside of the nose. However, frequent sneezing, or sneezing accompanied by a nasal discharge, can be a sign that something else may be occurring. 

Narrowing down the timing of sneezing can help identify the potential cause – does sneezing occur …

… after lighting candles or introducing diffusers in the home?

… after the cat leaves the litterbox?

… after you have used a cleaning product or other spray in the house?

Cats have very sensitive nasal passages and airborne particles can easily trigger an episode of sneezing. 

Common causes of sneezing in cats include:

• Environmental irritation – due to the presence of dust, cigarette smoke, perfume or cleaning products or sprays.
• Dental issues – infected tooth roots may affect the nasal sinuses and trigger sneezes.
• Upper respiratory tract infection (URTI) – due to bacteria, parasites, fungal organisms or viruses such as feline herpesvirus or calicivirus that cause cat flu*.
• Foreign body – grass or other small objects can become lodged in the nose or throat.
• Growths or tumours – such as nasopharyngeal polyps or neoplasia. 
• Other causes – such as cleft palate or nasopharyngeal stenosis
• Additionally, vomiting or regurgitation can lead to sneezing or nasal discharge if food material enters the nose via the nasopharynx.

Sneezing due to inhaled allergens (typical hayfever in humans) is less common in cats, as this type of allergy is usually accompanied by itchy skin rather than sneezing. 

*Cat flu is spread by coughing and sneezing of infected cats. The cats most likely to be more severely affected are young kittens, elderly cats and those with weakened immune systems. There is no specific treatment or cure for cat flu; however, the clinical signs can be treated and most cats will recover within one to two weeks. Vaccination is used to reduce the chance of infection and to prevent cats from being severely affected, if they do become infected.  

If sneezing is infrequent and your cat has no other signs of illness, there is usually nothing to worry about but if sneezing becomes more frequent, is accompanied by a nasal discharge, or if your cat show signs of feeling unwell, it is time to seek veterinary care to identify the cause.

Sneezing accompanied by nasal discharge

• Serous nasal discharge refers to a clear, thin, watery fluid that is characteristic of most acute diseases of the nasal cavity and may precede mucopurulent nasal discharge. A chronic serous nasal discharge is most commonly associated with viral and allergic causes.
• Mucopurulent nasal discharge refers to a thick, opaque, yellow or green mucus that is primarily a sign of immune activity in the nasal passages. It is a sign of inflammation and occurs in association with fungal disease, primary bacterial disease or overgrowth of normal bacterial flora secondary to chronic nasal disease (including viral URTIs).
• A blood-tinged or overtly bloody nasal discharge may be a sign of a more serious problem and should be investigated, especially if it is persistent or copious.

The following table may be helpful to some owners in understanding the common clinical signs of upper respiratory tract disease in cats.

General Diagnostic and Treatment Considerations

Signalment and lifestyle often help refine the differential diagnosis and direct a diagnostic workup. Brachycephalic breeds may be predisposed to nasal disorders due to physical conformation. Nasopharyngeal polyps are more common in younger cats while neoplasia is more likely in older cats. Outdoor cats are more likely to come across foreign bodies, sustain trauma or acquire an infectious disease. Cats in crowded housing conditions such as catteries, shelters or multi-cat households are more likely to develop acute or chronic viral or bacterial rhinitis. Obtaining a complete history is important for determining the duration of the clinical signs. Acute onset of clinical signs is common with viral agents, foreign bodies, and trauma. 

Treatment depends on the cause of the sneezing. In mild cases, your vet may suggest taking steps such as stopping exposure to environmental irritants or using a humidifier to simply make your cat more comfortable.

The diagnostic workup of sneezing and nasal discharge is commonly completed in stages:

1. Non-invasive tests including a complete physical examination with careful attention to the head and neck, especially the nose, ears, eyes and mouth to identify any abnormalities. Further testing may include cytology of any discharge to identify infectious organisms. A complete blood cell count (CBC), biochemical panel and urinalysis may be indicated to rule out other systemic diseases in cats with chronic disease. A therapeutic trial may be used in cats with mild disease and usually consist of antihistamines, antibiotics, antivirals or immunomodulators.
2. More aggressive diagnostic testing may be needed if the physical examination indicates the need, or if routine therapeutic trials fail. These diagnostic procedures often require anaesthesia and may include xrays, CT scans, rhinoscopy and possibly biopsy. Samples for further cytology and/or culture may also be taken.
3. Exploratory rhinotomy is a surgical procedure that allows direct visualisation of the nasal cavity to identify
4. Foreign objects, masses or fungal plaques. However, it is rarely performed in cats unless it is required to remove a chronically embedded foreign body or in chronic cases of sinus infections refractory to previous treatments.

One of the best things you can do to prevent sneezing and to keep your cat healthy and comfortable in your house is to avoid the use of anything that may irritate the nasal passages. Reduce your use of chemicals and perfumed products as much as possible. Clean fresh air is good for all of us!