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CHOKE by Howard Newitt BVetMed, CertEP, MRCVS

If this was your horse in the picture, would you know what was wrong and what to do…?

choke

 The horse in the picture is displaying signs of choke otherwise known as oesophageal obstruction which is usually caused by food becoming stuck in the oesophagus which is the tube that connect the back of the mouth with the stomach.

What causes choke?

Choke is usually caused by swallowing food or other material which becomes stuck in the oesophagus either because the horse takes in too much with one mouthful or that the food is too dry (e.g. unsoaked sugar beet). In the case of unsoaked sugar beet, this starts to expand upon contact with saliva as it passes down the oesophagus and swells to the point that it becomes stuck before reaching the stomach. Greedy or bullied horses that eat too quickly are at risk of choke because the food is improperly chewed before being swallowed and tends to ball up in the oesophagus as are horse with sharp teeth. Other conditions that affect swallowing including sedation, botulism & grass sickness can predispose to choke.

What are the symptoms of choke?

The most obvious signs of choke are a green/brown nasal discharge from both nostrils containing food material and saliva, repeated attempts at swallowing & pain if the left side of the neck is pressed. In most cases, the diagnosis is obvious and a stomach tube is often passed to determine the level of the obstruction. In cases that do not respond to initial treatment endoscopy and X-rays of the neck may be needed to determine the cause and site of the obstruction.

How is choke treated?

Many cases of choke will resolve spontaneously without any treatment over the course of 30 minutes or so but please contact the practice if you suspect your horse is choking so that we can advise on the best course of action. If the choke fails to clear then a muscle relaxing injection and/or sedative are often given to relax the oesophagus and allow the obstruction to be passed into the stomach. In some cases, the obstruction can be washed out using a stomach tube passed up the nose into the oesophagus under sedation. Small volumes of water are the pumped into the tube and allowed to drain out again bringing some of the food material with it. This can be a laborious process! In some cases, the horse may need to be hospitalised and given intravenous fluids to soften the obstruction.

What are the possible complications?

The most common problem is if food material or saliva becomes aspirated into the airways. The can set up a respiratory infection and lead to pneumonia. For this reason, many cases of choke are given antibiotics. The other serious complication is rupture of the oesophagus if the choke is left untreated which can be a very difficult condition to resolve.

How do I prevent choke?

  1. Take extra care to ensure that horses don’t have access to unsoaked sugar beet pulp.
  2. Regular dental care prevents sharp edges and encourages proper chewing.
  3. Greedy horses can have a large smooth flat rocks placed in the feed bowl to slow down their eating.
  4. Ensure that horse have sufficient room to eat individually to prevent “bolting” of food.
  5. Feed chaff or chopped alfalfa with nuts or mix to slow down chewing time.