Choke

Horses Advice

Fortunately choke in horses refers to an obstruction of their food pipe (oeseophagus), as opposed to the windpipe and therefore is very rarely life threatening. It is quite a common condition and occurs when food blocks the oesophagus, which is the pipe that connects the back of the mouth with the stomach.

Causes

Most commonly choke occurs because some food gets stuck in the oesophagus. This can be hay/haylage, hard feed, a solid item like apple or carrot or a foreign body (i.e. not food material). A horse can have a random single choke episode or can be prone to it recurrently. Issues which predispose to choke include dental disease reducing the chewing ability and physical abnormalities of the throat or oesophagus.

Symptoms

Refusing food
Lip curling
Head down, tensing neck muscles, looking as though they are trying to be sick
Possibly making a noise – squeak or grunt
Saliva and food coming from nostrils/mouth
Distress with possible sweating
Gulping and repeated swallowing
Coughing and gagging

These symptoms are the result of the blockage causing a backflow of food and saliva back up the oesophagus, discomfort, panic and the horse trying to clear it themselves.

What to do?

Remove all food and water. Most cases of choke resolve uneventfully when the horse relaxes. This will be associated with the discharge from the nose stopping and the horse will become more settled and relaxed. Massaging the left side of the neck may help to ease the discomfort and help to reduce spasm of the oesophagus. A gentle walk around can help too.

If the symptoms persist for over fifteen minutes then contact the practice on 01562 701334 to arrange a visit.

Treatment

In the first instance we will examine the horse and establish whether the choke has self-resolved prior to our arrival. If it has then the vet may choose to give a muscle relaxant and anti-inflammatory to help resolve the oesophageal spasms and reduce the risk of recurrence. All feed and hay should be soaked for 24 hours so as not to irritate the already inflamed oesophagus. If it sounds as though the horse inhaled any food material and saliva on checking the trachea and chest then antibiotics may be discussed although this is less likely in a self-resolving choke.

If the choke has not self-resolved by the time the vet arrives then initial treatment consists of sedation, muscle relaxants and anti-inflammatories to resolve the spasm and obstruction. If this fails to resolve the obstruction, we will sedate the horse more heavily and a stomach tube will be passed up the nose and down the oesophagus to the level of the obstruction. At this point water will be used to lavage the obstruction clear. Again an examination afterwards will prompt a discussion regarding risk of inhalation in this case and the use of antibiotics.

If this fails to resolve, then often the horse is given some time for its own saliva to continue softening the obstruction and a repeat visit in a couple of hours will be arranged to repeat the tubing process. Sometimes we will use the gastroscope (camera) to visualise the obstruction) to help assist in resolving it.

Following clearance of a larger obstruction we will often recommend starving the horse for a period of up to 12 hours, then continue with sloppy feeds or grass for several days to reduce any stress or pressure on the oesophagus.

Complications

Although the vast majority of cases of choke resolve either without treatment or with some simple help at home a small number of cases can result in complications. The most common complication being inhalation of foodstuff and saliva which can result in a respiratory tract infection or more seriously pneumonia. Much more rare and serious would-be damage to the oesophagus itself from tears up to rupture. In very rare cases the obstruction is not resolved with repeated treatments at home and referral to an equine hospital will be discussed for more intensive management or even surgery to prevent the above-mentioned complications.

Prevention

Ensure that all dried feed is soaked thoroughly as per the manufacturer’s instructions to ensure they are fully swollen before eating.
Regular dental care to ensure chewing is thorough and complete.
The placing of a large brick or rocks in a food bowl may slow rapid, greedy feeders from taking in large mouthfuls of feed.
Ensure continuous access to fresh water.