Esophageal Obstruction (Choke)

Choke, or more appropriately termed “esophageal choke” or “esophageal obstruction,” is something that can occur in any age of horse. It can be quite a dramatic and frightening scene, so here a few things you should know! When it comes to small animals or humans, we automatically think of choke referring to something being lodged in the trachea and therefore causing difficulty or inability to breathe. In horses, however, the obstruction is usually caused by feed material or sometimes a foreign body in the esophagus NOT the trachea – the good news is that your horse can still breathe! Often it will occur during a meal or shortly afterwards and signs you see will include saliva/feed material coming from nostrils and mouth, coughing, extending the neck outwards, retching, and agitation. There can be a combination of factors involved that can lead to or predispose a horse to a choke episode but most commonly include dentition problems, anatomical derangements such as esophageal strictures or diverticulums, grain bolters/situations where there is competition for feed, feeding dry/coarse feed material, or feeding material such as beet pulp that is inappropriately soaked.

If you suspect your horse is choking you should remove ALL feed (hay and grain) as well as water, try to keep your horse calm with their head low to the ground, and call your veterinarian! What will we do when we come out to the farm often includes giving your horse a sedative as well as passing a nasogastric tube (a tube designed to enter the esophagus and pass down to the stomach). Once the obstruction in the esophagus is located, we will gently lavage the area with copious amounts of water until the obstruction is resolved and we can easily pass the tube entirely to the stomach without any resistance. Occasionally, obstructions can be very large or difficult to resolve and we may recommend referral to clinic to evaluate the obstruction/esophagus with endoscopy. Due to the proximity of the openings of both the trachea and esophagus, there is risk of aspiration pneumonia secondary to a choke and often we will therefore recommend a course of antibiotics. Other frequent recommendations include keeping horses off feed for a short period of time then slowly introducing small amounts of soft, soaked feed material then gradually returning to their normal diet. In horses that have choked repeatedly we may recommend a diet change all together such as switching to a complete pelleted feed, chopped forage, or heavily soaking all feed. And remember it is VERY important to keep up with your horse’s dental care!

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