Do horses really choke?

By Molly Bellefeuille, DVM, MS

Just like humans, horses may choke. Choke is a condition in which the esophagus is blocked, usually by food material. Horses with dental problems that do not grind their food properly and horses that do not take adequate time to chew are at risk (fractious horses, and horses that have to fight for their food). Dry foods may cause choke especially if the horse does not have free access to water. Pelleted/cubed feed and beet pulp are among the most common feeds that horses choke on. The risk of choke associated with dry feeds can be reduced by soaking the ration prior to feeding. Foreign objects such as wood, large chunks of apple, and blanket/lead rope pieces may also cause choke.

In horses signs of choke are excessive salivation, coughing, constant chewing, difficulty swallowing, disinterest in food, and extending the neck and head out. Choke is a medical emergency, as horses are often not able to resolve it on their own. Resolving it promptly is important because secondary to choke, aspiration pneumonia may develop if food material and saliva accumulate in the pharynx and spill over into the trachea and lungs.

Treatment of choke entails passing a nasogastric tube up the nose/down into the esophagus. If the tube will not pass into the stomach and hits resistance, it indicates a complete obstruction of the esophagus, while difficulty passing the tube may represent a stenosis or narrowing of the esophagus. If resistance is hit, warm water is pumped into the esophagus down the tube. Water helps soften the obstructing matter so it can pass on down the esophagus. Heavy sedation is used during this procedure to keep the horse’s head low and prevent aspiration of fluid into the trachea.  If the choke is not resolved with the passing of a nasogastric tube a video endoscope is passed down into the esophagus to assess the obstruction and small biopsy forceps can be used to pick apart/break up the obstruction. In severe cases the horse may have to be anesthetized and an orotracheal tube placed to prevent aspiration and allow for more vigorous flushing. If all of these techniques do not work, an incision can be made into the esophagus to remove the obstruction; however, if surgery is performed the horse is at risk of scarring down the esophagus/stenosis, which increases the chance that the horse may choke again.

After a choke is resolved, it is important to provide the horse with anti-inflammatory (banamine or bute) to help prevent any scarring. Depending upon the duration of the choke, horses are often placed on broad-spectrum antibiotics to help prevent the onset of aspiration pneumonia. Horses should also be kept on a soft feed to allow time for the esophagus to heal.

As stated before, chokes are an emergency and to give your horse the best chance at recovering it is important that a veterinarian see your horse if you suspect they are choking.

This article was originally published in the January 2016 issue of Oklahoma Farm & Ranch.