The word “choke” for most people immediately puts an image of someone standing over a table, unable to talk or breath because a piece of food is lodged in their trachea or windpipe. In horses, “choke” is used to describe a condition that refers to an esophageal obstruction, not an airway (tracheal) obstruction. Since the horse can continue to breath with this condition, it is not an immediately life-threatening emergency. However, complications with choke include aspiration pneumonia, scarring within the esophagus and potential rupture of the esophagus. If the condition is not corrected it very well may kill the horse, because the obstruction prevents the horse from eating or drinking.

Choke is the most common esophageal disorder in horses. Many different substances can cause choke, most commonly grain or hay, but beet pulp, corncobs and apples can also cause this issue. Foals and small horses have been noted to suffer from choke following ingestion of shavings.

Why do horses choke on feed? Some feeds expand after they become moistened with saliva. Pelleted feed and beet pulp expand quite a bit after becomimg wet. Therefore, if a horse swallows a large amount of dry pellets or beet pulp, that material will mix with saliva and then expand. That expansion then becomes lodged in the esophagus.

Horses that are predisposed to choke include older horses, as they commonly are missing teeth or have other dental issues that may inhibit them from properly chewing their food. When caring for a senior horse, it is very important to have routine dental care by an experienced veterinary professional and making dietary changes to accommodate for such conditions.

The most common sign of choke is the inability to swallow food or water, called dysphagia. Horses suffering this condition will drool excessive amounts of saliva mixed with food and might make multiple attempts to swallow. This can lead to coughing, and often a lot of water or food runs out of their nostrils and mouth, resulting in thick nasal discharge, often containing food. Horses might also extend their head and neck repeatedly as they continue to try and swallow. This might cause them to breath in some of the secretions, which later develops into aspiration pneumonia. As the pneumonia continues to develop, the horse may have a fever. Signs of pneumonia usually appear within 24 to 48 hours after onset of choke.

If choke is suspected, a veterinarian should be called immediately. If the horse can’t drink, it can rapidly become dehydrated, so early treatment is very important. As the horse continues to drool, it will lose vital electrolytes as well as fluid, further hindering its acid-base balance. It is important to remove all food and water to prevent the horse from attempting to eat and drink. Bedding may also need to be removed. When your veterinarian arrives, a physical examination will help determine the extent of the obstruction and whether the horse has developed aspiration pneumonia. An endoscopy or radiographs of the neck may be performed to assess the severity of the obstruction.

If the condition is caught early, the patient may just need to be sedated, which gives the esophagus the opportunity to relax to allow the material to pass. If that does not work, a nasogastric tube may be passed to allow for lavage (washing) of the esophagus with warm water. After the obstruction is addressed, an endoscopy may be performed to evaluate for any damage or irritation to the esophagus. Over time, repeated insult to the esophagus may result in strictures, scar tissue formation. These areas of scar tissue can further exacerbate digestive issues.

It is important to have your horse evaluated as soon as you notice any abnormalities. After removing food, water and bedding, contact your veterinarian. Having an in-depth discussion with him/her will help develop a plan to address any husbandry issues or structural issues that may be causing choke in your horse.

[Contact Dr. D’Abbraccio at www.facebook.com/CatskillVeterinaryServices, www.catskillvetservices.com, or jdabbracciodvm@icloud.com.]