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Let’s flush out facts about ‘choke’

By Daniel H. Grove, DVM - January 1st, 2018 - Ask the Vet

AskTheVetChoke in the horse is a common problem we see in equine practice. We were asked about choke and how to prevent it, so let’s discuss what it is, what you can do, what we as veterinarians can do and some tips on prevention and management.

Before we go any further, let’s define what choke is in horses. It is when the esophagus gets obstructed, usually with feed material. The esophagus is the tube that carries masticated (“chewed up”) food and saliva from the mouth to the stomach. When the esophagus is blocked, saliva and food material back up in the back of the oral cavity in the area called the pharynx. When this occurs, the common clinical signs are copious amounts of fluid mixed with feed draining from the nose, a desire to eat but not actually eating, cough, extending of the neck and lowering the head.

Well, now that we know what we have going on, what do we do about it? With choke, there are only a few things that a horse owner can do to try to alleviate the choke. The first thing is to give it a little time. A good portion of chokes will actually resolve themselves. As the saliva sits on the feed and softens it, it sometimes is able to be completely swallowed. Another thing that horse owners can do is to massage from the head down to the chest cavity on the left side of the neck in the jugular furrow. The esophagus normally travels in this area and the massaging can help break up and move the food bolus that is stuck. I would always recommend consulting your veterinarian at the first signs of choke, but these are a few things you can do while waiting.

Well, the choke has not resolved, so what does the veterinarian do? After I examine the horse, I usually give some sedation. This calms the horse if it is nervous about not being able to swallow and allows me to pass a nasogastric tube, just like with a colic, to see if we can push or flush down the obstruction. In a vast majority of chokes, veterinarians are able to resolve them this way. If not, then a trip to the equine hospital may be in your future. There, they usually will anesthetize the horse and use a hose to flush out the esophagus.

After the obstruction has been resolved, there is some aftercare that is necessary. Your veterinarian may or may not prescribe antibiotics. One of the biggest concerns with a choke is aspiration pneumonia. This is where feed material gets down the trachea and into the lungs to cause a nasty infection. If this occurs, you may be in for a long haul on antibiotics and maybe even a hospital stay. The next thing I have my clients do is to not feed any hay for a period of time, usually 8-12 hours to give the esophagus a little break before getting put back to work. The last thing I have my clients do is to monitor temperatures twice daily for at least a week after. This is in case we do get aspiration pneumonia, it will be a clinical sign that you can look for.

Preventing a choke is usually done in horses that have had multiple problems with it. The key to preventing it is knowing or having an idea as to why your individual is choking. Some horses eat too fast. We throw them feed twice a day and they gulp it down quickly. To prevent choke in these types, you may just need to feed your hay in a hay net or slow feeder. Some horses are old and have bad teeth. This allows for food to be swallowed that is not chewed properly. To aid these types, I usually recommend switching to a soaked pelletized or cubed diet. The feed is pre-chewed for the horse and the soaking breaks it up. Some horses on pelletized diets choke. Soaking the pellets prior to feed them allows them to soften up and do any swelling before being eaten.

Hopefully this gives you some insight into choke and the things you can do to prevent it. As you will be reading this in January, Happy New Year everyone!

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