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


Choking or Gagging, Fluid (Clear, Frothy, or Green) Coming Out of Nostrils &/or Mouth


You notice your horse gagging or having liquid or mucus coming out of the nostrils and/or mouth. This is usually a sign of a blockage in the esophagus (esophageal obstruction) or inability to swallow, especially when both nostrils are profusely discharging clear or frothy fluid and feed material. Saliva is being produced but cannot be swallowed and is being regurgitated. It is important to know that similar-appearing signs may also rarely be caused by other conditions.

  • Code Red

    Call Your Vet Immediately, Even Outside Business Hours
You also might be observing
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Less Common
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your role


What To Do

Remove all feed and water, keep your horse calm, and call your vet. Assess your horse's general health with the Whole Horse Exam (WHE) if possible, paying attention to rectal temperature, the amount of coughing, and looking for swelling of neck, under jaw or throat, and noting the appearance of the nasal discharge. Share your findings and concerns with your vet. If transporting horse, be sure to allow it to drop its head and clear material from its airway.

What Not To Do

Do not try to give anything orally or attempt to treat your horse in any way. If you do, you may cause your horse to breathe material into their lungs (aspirate).

Do not force a coughing horse or one with nasal discharge to stand with its head elevated. It may cause inhalation of material into the lungs and predispose to pneumonia.

Do not assume this problem will resolve on its own. Extensive esophageal damage can result if a horse is left choking for a significant period of time.

your vet's role

Your vet will determine the cause of this sign, starting with a careful history and physical examination. Other diagnostics that may be helpful include passage of a nasogastric tube and endoscopy, among others.
Questions Your Vet Might Ask:
  • What was the horse's most recent meal?
  • Does the horse seem able to eat or swallow now?
  • When did you first notice this?
  • What is the horse's age, sex, breed and history?
  • What signs are you seeing now?
  • Have you ever noticed this happen before?
  • How long ago was the horse's most recent dental exam?
  • Do you know if the horse has had any dental issues?
  • 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.

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Author: Doug Thal DVM Dipl. ABVP