What you see. The starting point for addressing any equine health related issue is your observation.


Cannot Swallow, Difficulty Swallowing


The swallowing reflex requires coordinated nerve and muscular function and involves the rear of the mouth, the tongue, the pharynx, epiglottis, larynx and esophagus. Difficulty swallowing may be a sign of dental disease, pain in the esophagus, pain in the back of the mouth or pharynx, or a neurological or muscular abnormality involving the swallowing reflex. Inability to swallow is easily confused with difficult chewing.

If a horse truly cannot swallow, saliva often pools in the esophagus and comes out of the nostrils, along with feed material. Foals that cannot swallow often salivate, and have milk return through their nostrils.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
    • If this problem seems severe and has come on suddenly.
    • If the horse seems to be in distress.
    • If the results of the Whole Horse Exam (WHE) in the resting horse indicate fever (Temp>101F/38.3C), or heart rate greater than 48 BPM.
  • Code Orange

    Call Your Vet at Their First Available Office Hours
    • If the problem is very mild and does not seem to be causing much harm to the horse.
    • If the results of the Whole Horse Exam (WHE) suggest the horse is otherwise normal.

your role


What To Do

Assess your horse's general health using the Whole Horse Exam (WHE), assess their mouth (wear gloves) looking for anything abnormal. Offer your horse a very small handful of feed and study their response. Watch the horse drink. Can you see a wave of contraction travel down the left side of the horse's neck? Share your findings and concerns with your vet.

your vet's role

Your vet will perform a physical exam. They may offer enough feed to observe the behavior for themselves, and at that point decide on additional diagnostics, such as passage of a nasogastric tube if there is a question about esophageal obstruction.
Questions Your Vet Might Ask:
  • Have you given your horse any oral medication recently, or changed hay?
  • When did you first notice this problem?
  • Have you changed your horse's feed or management lately?
  • Does the horse seem normal to you otherwise?
  • Is there any nasal discharge and if so, what is it's appearance?
  • Do you notice a cough?
  • Does the horse seem able to eat?
  • What are the results of the Whole Horse Exam (WHE)?

Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

Very Common
Less Common
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Treatments Your Vet May Recommend

A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)

Very Common
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Author: Doug Thal DVM Dipl. ABVP