Shih Tzu Sneezing, Reverse Sneezing, and Coughing: What’s Normal and When to Worry

How we researched this article: This guide draws on the American Veterinary Medical Association (AVMA), VCA Animal Hospitals, the American Kennel Club (AKC), and veterinary clinic guidance on reverse sneezing. Every source is listed at the end. Last reviewed: September 2026.

See a vet the same day if your Shih Tzu: has trouble breathing between episodes, blue or pale gums, a nosebleed, thick yellow or green nasal discharge, a wet cough with labored breathing, fever, or stops eating. See our breathing problems guide for emergency signs.

The Short Answer

Most sneezing is normal. Dogs sneeze to clear dust, pollen, or other irritants. Reverse sneezing, which sounds like loud snorting or honking, looks alarming but is usually harmless and stops on its own.

Coughing is different. A sudden, honking cough in a dog that has been around other dogs is often kennel cough, a contagious respiratory infection. Most cases are mild, but some need treatment.

What Is Reverse Sneezing?

In a regular sneeze, air is pushed out through the nose. In a reverse sneeze, the dog pulls air in rapidly through the nose, making loud snorting or honking sounds. The dog usually stands still, extends its neck, and may look like it is struggling. Episodes usually last seconds.

Veterinary clinics describe it as a reflex triggered by irritation of the soft palate and the back of the throat. Common triggers include excitement, dust, pollen, pulling on a collar, and eating or drinking quickly. Flat-faced breeds like the Shih Tzu, with their long soft palates, tend to have more episodes.

What to do during an episode

• Stay calm. Most episodes end on their own within seconds.
• Gently massage your dog’s throat or calmly talk to it.
• Film an episode on your phone so your vet can see it.
• Use a harness instead of a collar to reduce pressure on the throat.

When reverse sneezing needs a vet visit

• Episodes are becoming longer or much more frequent
• Your dog has nasal discharge, a nosebleed, or paws at its nose
• Your dog seems distressed or has trouble breathing between episodes
• Episodes started suddenly after a walk in long grass, which may mean something is stuck in the nose

Why Does My Shih Tzu Keep Sneezing?

Occasional sneezing is normal. Frequent sneezing can be caused by:

• Allergies to pollen, dust, or mold
• Irritants such as perfume, smoke, cleaning products, or dusty litter
• Something stuck in the nose, such as a grass seed
• Infections, including kennel cough
• Dental disease, since tooth roots sit close to the nasal passages
• Play sneezing, which some dogs do when excited

See your vet if sneezing comes with discharge, bleeding, pawing at the face, or loss of appetite.

Kennel Cough (Canine Infectious Respiratory Disease)

Kennel cough is not one disease. The AVMA explains that several bacteria and viruses can cause it, including Bordetella bronchiseptica, canine parainfluenza virus, and canine adenovirus type 2. Dogs catch it through close contact with infected dogs, cough and sneeze droplets, and shared toys, bowls, and bedding.

Signs of kennel cough

According to the AVMA, the classic sign is a frequent, honking cough that comes on suddenly. It can sound like gagging or retching and may bring up froth that looks like vomit. The cough often gets worse with activity. Some dogs also sneeze or have a runny nose or eyes.

What to do

• Keep your dog away from other dogs until it has fully recovered, to avoid spreading it.
• Let your dog rest and avoid exercise that triggers coughing.
• Use a harness rather than a collar.
• Call your vet if your dog has a fever, stops eating, seems very tired, or has a wet cough or labored breathing. VCA notes that puppies with these signs need urgent care.

VCA notes that kennel cough usually resolves on its own in about two weeks.

Prevention

Vaccines are available against several of the organisms that cause kennel cough. The AKC notes that dogs who go to daycare, boarding, grooming, dog parks, shows, or dog sports benefit most from the Bordetella vaccine. Many boarding facilities and groomers in Canada and the US require it. Vaccines reduce the risk, but they do not fully prevent every respiratory infection.

Other Causes of Coughing and Gagging

• Tracheal irritation from pulling on a collar
• Airway problems linked to the Shih Tzu’s flat face
• Heart disease, especially in older dogs with a cough that is worse at night or after exercise
• Something stuck in the throat, which is an emergency if your dog cannot breathe

A cough that lasts more than a week or two, or any cough in a senior dog, should be checked by a vet.

Frequently Asked Questions

Sources

• American Veterinary Medical Association. Canine Infectious Respiratory Disease Complex (Kennel Cough).
• VCA Animal Hospitals. Kennel Cough in Puppies.
• American Kennel Club. Bordetella Vaccine: What to Know. 2026.
• Kingsdale Animal Hospital. Reverse Sneeze in Dogs.

This article is for general information. It is not a substitute for advice from your veterinarian. Read our medical disclaimer.