Reverse sneezing as a clinical manifestation of nasopharyngeal-oropharyngeal fistula in a dog.

A 6-year-old spayed female Labrador retriever was evaluated for a 3-month history of intermittent reverse sneezing and gagging episodes. Pertinent findings at evaluation included frequent reverse sneezing and non-productive retching. No pathology was visible on sedated oral examination. Contrast-enhanced computed tomography of the skull revealed a gas-filled defect within the left ventral aspect of the soft palate. A non-eroded defect was present in the left caudoventral nasopharyngeal wall on nasopharyngoscopy. Surgical exploration revealed a nasopharyngeal-oropharyngeal fistula within the left palatine tonsillar fossa. The dog had a witnessed oropharyngeal stick injury (OSI) 3 months previous in the location of the fistula. The OSI had been allowed to heal by secondary intention and was treated with an oral antibiotic and NSAID. However, the dog lacked characteristic signs of a chronic OSI such as nasal discharge or abscess formation. The defect in the soft palate was surgically debrided and closed, and the left palatine tonsil was excised. The dog recovered completely with cessation of reverse sneezing and retching episodes.