Choke in Horses

What Is Choke in Horses?

Choke is one of the most common emergencies seen in horses. Choke occurs when there is either a partial or complete obstruction of the esophagus. The esophagus is the tube that takes the food from the mouth to the stomach of the horse. This is different from “choking” humans, as horses are still able to breathe because their trachea (windpipe) is not affected. When horses are choked, they are unable to move food or water from their mouth to their stomach.

Symptoms of Choke in Horses

Horses experiencing choke may exhibit the following signs:

• Saliva/food material coming from the nostrils or mouth

• Hypersalivation

• Depression/lethargy

• Difficulty swallowing

• Anorexia (not eating or drinking) 

• Coughing/gagging

• Acting colicky

Causes of Choke in Horses

There are a variety of reasons that may cause a horse to choke. The most common reason is swallowing dry or coarse food eaten too quickly. Dry food, like pelleted grain, swells rapidly once mixed with saliva, chewed, and passed down the esophagus.

Choke occurs when a horse eats fast or has dental abnormalities resulting in food particles not being chewed properly before swallowing. Hay can also cause a similar issue as it is very coarse, and if it is not chewed well, it can become lodged in the esophagus. Another possible cause of choke includes eating hard food items such as carrots or certain treats.

Lastly, abnormal esophageal anatomy, some diseases (like botulism), and sedation can predispose a horse to choke because they affect the horse's ability to chew and swallow properly.

How Veterinarians Diagnose Choke in Horses

If you suspect your horse has choked, call your veterinarian right away and remove all access to food while you wait. Administration of any oral medication, eating, or drinking can all cause worsening of choke. Choke is always an emergency in horses.

The veterinarian will obtain a history, perform a physical exam, and run diagnostic tests to diagnose choke. On physical exam, the most common sign of choke is saliva and/or food draining from the horse’s nose. The veterinarian will be able to diagnose choke by passing a stomach tube down the horse via the nostril into the esophagus and then feeling for an obstruction before passing into the stomach.

In some rare instances, the veterinarian may not be able to resolve the choke on the farm and the horse may need to be referred to an equine hospital for further diagnostic testing such as an endoscopic exam. An endoscopic exam uses a camera to visualize the esophagus and obstruction.

Treatment of Choke in Horses

In order to clear the obstruction, the veterinarian will need to sedate the horse and may give an intravenous medication called buscopan (spasmolytic or anti-spasm medication) to help relax the esophageal muscle. Then, using the stomach tube, the veterinarian will gently use water therapy to flush or lavage the obstruction down into the stomach or out through the nose. Sedation is critical because the horse's head must be low to the ground to allow the obstructed material and water to come out through the nose and not into the horse's lungs. Depending on the severity of the choke, it may be relieved quickly or take longer to slowly remove the obstruction without damaging the esophagus.

Recovery and Management of Choke in Horses

After the choke has been relieved, it is common to keep a horse on a non-steroidal anti-inflammatory drug such as banamine for a couple of days to help with the esophageal inflammation and pain. Antibiotics are also important for the recovery of choke to minimize the risk of secondary bacterial infections and pneumonia.

Another essential part of recovering from choke is the gradual return to eating. Often this includes keeping the horse on a food restrictive diet for a few days to a week to allow the esophagus time to heal. Your veterinarian may advise food recommendations depending on the reason the horse choked and the severity.

Food restrictions may include:

• Feeding small amounts of forage at a time

• Providing a limited amount of grass via hand grazing

• Providing small quantities of hay soaked in water (to soften the hay) multiple times per day

• Feeding sloppy soup food or as mash (grain mixed with a high amount of water)

Normal exercise and lifestyle regimens can resume as the horse finishes any medications prescribed by your veterinarian and food restrictions lifted, usually within 1-2 weeks.

If you notice any of the following symptoms, call your veterinarian right away, as they can be signs of complications following choke:

• Coughing

• Nasal discharge

• Lethargy

• Increased respiratory rate

• Anorexia (not eating) 

• Fever/temperature (if you can safely check this)  

Possible complications from choke include esophageal rupture, pneumonia, and choke reoccurrence.

Prevention of Choke in Horses

Minimize your horse’s risk of choke by providing:

• Routine dental care by a veterinarian

• Access to fresh water at all times

• Slow feed systems (such as a slow hay feeder) if your horse is a fast eater

• Additional water to hay or grain to make it softer/easier to chew