Esophageal obstruction, or “choke,” is a common equine emergency. Unlike in human medicine, where choking refers to a tracheal (or windpipe) obstruction, choke in horses refers to an obstruction of the esophagus, the muscular tube that carries food from the mouth to the stomach. The most common sign horse owners recognize is feed material coming from the nostrils, although they might also notice choking horses hypersalivating, retching, not eating, acting colicky, or coughing. Chokes can have serious consequences, so it is important to have your veterinarian evaluate your horse as soon as possible.

Most commonly, chokes occur when horses eat concentrated feed too quickly without chewing it appropriately. The feed doesn’t get softened with saliva and forms a firm bolus that gets lodged in the esophagus. However, esophageal obstruction can also occur with hay or straw, hard treats, carrots, or nonfood objects. Anatomical problems, such as poor dentition and abnormal esophagus anatomy, can also predispose a horse to choking.

While waiting for the veterinarian, it is important that you keep your horse from eating. Hand-walking or muzzling can prevent continued feed intake. Also, do not administer oral medications. Finally, it is an old wives’ tale that you can and should resolve a choke by shoving a garden hose in your horse’s mouth— this only increases the risk of serious complications, especially aspiration pneumonia.

Upon arriving, your veterinarian will conduct a physical exam. Most choking horses are sensitive to esophageal palpation, and in minor chokes the obstruction could be visible on the left side of the horse’s neck. However, if a horse has continued to eat after choking, it can result in distension of the entire esophagus rather than apparent focal swelling. A bad choke is fairly obvious to both veterinarians and horse owners, but a mild choke could be confused with an upper respiratory tract infection or

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