Horse Side Vet Guide ®

Equine Health Resource

Choke, Esophageal Feed or Foreign Body Obstruction

“Choke” is a term referring to obstruction of a horse’s esophagus, preventing them from swallowing. Horses normally produce and swallow large quantities (gallons) of saliva per hour. Saliva produced upstream of the blockage often accumulates together with feed material and exits out of the nostrils and mouth as foamy green discharge.

Horses with choke act distressed, often cough violently, and extend their neck forward, spewing material from the nose and mouth.

Choke occurs more commonly in older horses with poor teeth, in horses that “bolt” or eat their food quickly, and in horses that are fed pelleted feeds such as beet pulp that has not been properly soaked and softened.

The word “choke” conjures up thoughts of asphyxiation. In humans “choking” suggests an obstruction that blocks the airway, that prevents a person from breathing. In horses, “choke” is a blockage of the esophagus, not the airway. Generally, horses with choke LOOK WORSE than they are. Horses with choke are visibly distressed, but in most cases can still breathe fine.

Feed and saliva do, however, accumulate around the opening to the airway (larynx), and horses can inhale debris into their lungs that can cause pneumonia later.

In some horses obstruction resolves on its own. In that case, you might see the horse suddenly relax, the nasal discharge and coughing decrease over time, and their appetite return. That said, many cases DO require veterinary intervention.

Vets usually treat choke by passing a nasogastric tube down to the obstruction, gently trying to dislodge it through controlled pressure, and breaking up of the obstruction using flushing of water through the tube. Horses are usually sedated for this procedure. By farthe majority of these cases are resolved in the field using this method, and with a little patience. In some cases, esophageal relaxing drugs may be helpful.

Stubborn esophageal obstructions, unresponsive to field treatment, are best hospitalized and treated with nursing care, IV fluids and esophageal relaxants along with repeated attempts at removing the obstruction. Endoscopy can sometimes be helpful in unresponsive cases in order to visualize the nature of the blockage.

Prognosis & Relevant Factors

The prognosis for uncomplicated choke cases is usually very good, but ultimately depends on the cause.

The type of feed material may dictate the severity of an obstruction, as some feeds become more tightly impacted and thus more difficult to remove.

True foreign bodies like apples are rare (more common in foals) but can cause stubborn obstruction and might be difficult to remove.

Obstructions that have persisted for more than a few hours may be more difficult to remove, especially as horses become more dehydrated.

Long-standing esophageal obstruction might damage the esophagus, causing scar formation and a stricture, leading to inability to swallow or recurrent choke episodes.

Pneumonia can occasionally occur following choke because horses can inhale feed and debris that accumulat around their windpipe during the episode. Antibiotics are sometimes given after a choke episode to reduce the likelihood of pneumonia developing.

In some cases, narrowing of the esophagus (leading to choke) could result from an enlarged heart (heart failure) or mass (tumor) pushing into the esophagus from the outside.

QUESTIONS TO ASK MY VET

  • Why do you think this occurred?
  • Is there anything I should watch for after the choke is resolved?
  • When can I feed my horse again and what should I feed?
  • How should my horse be fed and managed in the future to reduce the likelihood that this happens again?
  • PREVENTION

    The most common esophageal obstructions I see are caused by pelleted feed for seniors, and beet pulp. Always ensure that beet pulp has been soaked in water and soft before giving it to your horse.

    By taking excellent care of your horse's teeth, you reduce the likelihood of this problem. Your vet should conduct a dental exam as part of your horse's routine preventative healthcare plan.

    It will be important to monitor your horse for a few days following resolution of choke to ensure that no complications develop.

    After a choke has been treated, your vet may suggest that you feed your horse a softened gruel for a day or two, especially if there has been damage to the lining of the esophagus.

    If your horse tends to bolt their food, you may need to slow their intake by spreading out feed, feeding smaller portions or using special feeders. Some advocate mixing fist-sized rocks in with pelleted rations for this purpose!

    For horses with poor teeth, soaking of pellets and other feeds may ultimately be the only way to prevent choke.

    Horses recently anesthetized or given sedative drugs have a reduced swallow reflex and could choke. That is why it's wise to wait for a specified time before feeding sedated horses again.

    Author: Doug Thal DVM Dipl. ABVP

    RELATED REFERENCES

    Higgins AJ, Snyder JR eds. The Equine Manual. 2nd Ed. Edinburgh: Elsevier Saunders 2006.

    CONTACT US

    We're not around right now. But you can send us an email and we'll get back to you, asap.

    Sending