Choke - A Relatively Common Condition

Choke is a relatively common condition in the horse that occurs when the horse’s oesophagus (the tube that takes food from the back of the mouth to the stomach) becomes blocked by food material or a foreign body.
Occasionally it may occur due to compressing masses or motility disorders of the oesophagus that prevent normal passage of feed eaten by the horse.

Clinical signs
The signs associated with obstruction of the oesophagus are as a result of the regurgitation of food, water and saliva caused by the inability to swallow effectively. Signs may include the following:
• Anxious expression or behaviour
• Drooling food and saliva from the horses mouth and/or nostrils
• Gagging/retching
• Repeated extension and fl exion of the neck
• Coughing
• Distension in the jugular furrow region (depending on the location of the obstruction) Aetiology
• Impacted food material/foreign body impeding the passage of material down the oesophagus
• Sedation or neurological disease affecting the normal motility of the oesophagus
• Tumours or other masses in/around the oesophagus wall
• Developmental abnormality of the oesophagus

Diagnosis
Most cases are diagnosed based on clinical signs and the results of further diagnostic tests. Diagnostic tests performed will depend on the clinical situation but may include one or more of the following:
• Passage of a nasogastric tube
• Endoscopy
• Ultrasonography
• Radiography

Treatment
In the majority of cases, saliva produced by the horse will lubricate the offending object obstructing the oesophagus, facilitating its passage to the stomach. Your veterinary surgeon may speed up resolution by administering a sedative and/or a
muscle relaxant to help relax the oesophageal wall. More severe cases will require the passage of a stomach tube to encourage the movement of the object into the stomach. This may include fl ushing with water to soften the offending obstruction
and may be a prolonged process and sometimes needs to be repeated. Rarely, more severe cases where the obstruction cannot be removed in the field may require the horse to be anaesthetized to allow safe removal of the obstructing object or the assessment of the underlying problem. Following resolution of a severe episode of choke the horse should be starved for 12-24 hours and offered only water. Sloppy feeds or grass should then be re-introduced gradually over the subsequent 24 hours to allow the oesphageal wall to heal. Further investigations may be needed if the horse becomes subsequently dull or notably unwell and/or suffers repeated episodes of choke.

Prognosis
Most cases of choke resolve spontaneously and prognosis is good in feed impactions that clear within 24 hours.
Loss of feed, water and saliva over a prolonged period can lead to the development of dehydration and electrolyte imbalances. Pneumonia caused by the aspiration of food material is a common concern and severe damage of the gullet wall may lead to the formation of strictures. Very rarely, severe, protracted cases may lead to rupture of the oesophagus and the development of a toxic state.

Prevention
Soak dried foodstuffs thoroughly to allow them to swell before being eaten. If your horse chokes on a particular feed stuff this should be avoided. Ensure your horse recieves regular dental care to allow them to chew feed thoroughly and effectively before being swallowed. Change feeds gradually. Cut “tit-bits” such as apples and carrots into small pieces. Ensure your horse has permanent access to fresh, clean water to encourage normal drinking. Strategies to slow food consumption in individuals that bolt their food include feeding horses separately, providing smaller feeds more frequently throughout the day , double netting haynets and putting a large object such as a salt block in a horses feed bucket to encourage “searching” for feed and slowing them down. It is always important to withhold feed following sedation.

Should your horse be suffering from choke…
• Remove any food and water for the next 15-20 minutes.
• Keep your horse quiet in a stable
• If the choke clears spontaneously offer the horse water but withhold feed for the next 1-2 hours.
• If signs of choke do not resolve within 15-20 minutes or if signs recur please give us a ring at the surgery on 01584 841 080

Related SEV Branch