Last Updated on February 19, 2022 by Allison Price
Espophageal obstruction (or “choke”) is a common equine emergency. Choking in horses is different from choking in humans. In human medicine, choking refers only to a tracheal or windpipe obstruction. But choke in horses refers instead to an obstruction to the esophagus (the muscular tube that transports food from the mouth into the stomach). Horse owners most often notice feed material coming out of the nostrils. However, they may also notice hypersalivating horses, retching or not eating, colicky behavior, or coughing. Chokes can cause serious problems so make sure your veterinarian examines your horse immediately.
Choking occurs most often when horses consume concentrated feed too fast without properly chewing it. The feed is not softened by saliva, and forms a bolus which gets stuck in the esophagus. Esophageal obstruction can also be caused by straw, hard treats or carrots. A horse may also be susceptible to choking due to anatomical issues such as poor dentition or abnormal esophagus anatomy.
It is vital that your horse not eat while you wait for the veterinarian. Continued feed intake can be prevented by hand-walking and muzzling. Oral medications should not be administered. It is an old wives’ story that you can resolve a choke by sticking a gardenhose in the horse’s mouth. This increases the chance of serious complications, including aspiration pneumonia.
Your veterinarian will perform a physical examination upon arrival. Choking horses can be sensitive to esophageal pain. In minor chokes, the obstruction may be visible on the left side. If a horse continues to eat after choking it can cause distention of the entire stomach and not just focal swelling. Both veterinarians and horse owners can see a bad choke, but mild chokes could indicate an upper respiratory tract infection.
There are two main approaches to treating horse esophageal blockage. First, the most common treatment is to put the horse to sleep and then to pass a nasogastric tub to clear the obstruction. The veterinarian will flush the obstruction with water in small quantities and then slowly take out the feed material. To prevent esophageal leakage, it is important to gently do this. This can take up to an hour if the choke is severe. This second approach is based upon the idea that most chokes will eventually self-cure. Therefore, veterinarians may administer multiple rounds of sedation to the horse, as well as medications to relax the esophageal muscles and intravenous fluids in order to keep them hydrated.
Very rarely, a veterinarian is able to remove a choke with nasogastric Intubation. You might have to refer your horse to an emergency center to receive further diagnostics such as an endoscopic exam. The endoscope, a small camera that is passed down the esophagus, can be used by the veterinarian to determine the cause of the obstruction. This is particularly important if the object is not easily flushable, such as a foreign object or a piece carrot. The veterinarian can use endoscopy to diagnose any anatomical abnormalities in the esophagus.
The horse will require continued care after the obstruction is cleared. Choking can lead to pneumonia in horses. This is due to feed material getting down the trachea into the lungs. Horses can develop secondary bacterial infections from foreign material in their lungs. Many veterinarians give antibiotics to horses after choking. This is to prevent the possibility. Because a fever could be a sign of pneumonia, it is important to keep the horse’s temperature up for several days after choking. You might also notice a cough, nasal discharge, or increased effort and respiratory rate. A veterinarian may also give sucralfate (a medication to treat ulceration of the esophagus) or a non-steroidal, anti-inflammatory drug (NSAID), such as flunixin (Banamine). Before administering NSAIDs to horses, make sure they are not feverish.
You might have to stop feeding certain feeds for several days depending on how severe the choke is. Avoid dry feeds and hays, and give your horse a soupy mash with complete concentrate feed. Horses that choke repeatedly on certain feeds might be required to continue on soupy mashes for an indefinite period. Horses who eat too fast may benefit from large, smooth rocks in their feed tubs. Poor dentition can lead to poor chewing, which is a common reason for choke. Schedule a comprehensive dental exam after a choking episode.
Chokes can be a serious equine emergency. If you feel choked, contact your veterinarian immediately.