b'AAEP FORUM LILLIAN M.B. HAYWOOD, VMD, CVMATheHorse.com/AAEP-ForumUnderstanding Choke in HorsesE sophageal obstruction, or choke, iswhich is especially important if it is a a common equine emergency. Unlikesolid object that will not readily dissolve in human medicine, where chokingwith flushing, such as a foreign body or a refers to a tracheal (or windpipe) obstruc- piece of carrot. Endoscopy can also help tion, choke in horses refers to an obstruc- the veterinarian diagnose any anatomical tion of the esophagus, the muscular tubeabnormalities of the esophagus. that carries food from the mouth to theFollowing resolution of the obstruction, stomach. The most common sign horsethe horse will need continued care. Most owners recognize is feed material comingimportantly, chokes predispose horses to from the nostrils, although they mightaspiration pneumonia, which is caused by DR. KEN SULLINSalso notice choking horses hypersalivat- feed material going down the trachea and ing, retching, not eating, acting colicky,into the lungs. This foreign material in or coughing. Chokes can have seriousthe lungs can cause the horse to develop a consequences, so it is important to havesecondary bacterial infection. To prevent The most common sign of choke is feed mate-your veterinarian evaluate your horse asrial coming from the horses notrils. this, many veterinarians place horses soon as possible.post-choke on antibiotics. It is important Most commonly, chokes occur whenis fairly obvious to both veterinarians andto monitor the horses temperature for horses eat concentrated feed too quicklyhorse owners, but a mild choke could beseveral days following a choking episode, without chewing it appropriately. Theconfused with an upper respiratory tractbecause a fever might be one of the first feed doesnt get softened with saliva andinfection or colic.signs of pneumonia. Other signs include forms a firm bolus that gets lodged in theThere are two main schools of thoughtcoughing, nasal discharge, and increased esophagus. However, esophageal obstruc- on treating equine esophageal obstruc- respiratory rate or effort. Your veterinar-tion can also occur with hay or straw,tion. The first and most common ap- ian might also administer sucralfate, a hard treats, carrots, or nonfood objects.proach is to sedate the horse and pass amedication to help treat ulceration of Anatomical problems, such as poor denti- nasogastric tube to clear the obstruction.the esophagus, or a non-steroidal anti-tion and abnormal esophagus anatomy,The veterinarian lavages (flushes) theinflammatory drug (NSAID) such as flu-can also predispose a horse to choking.obstruction with small volumes of waternixin meglumine (Banamine). Check the While waiting for the veterinarian, itand slowly removes the accumulated feedhorses temperature before administering is important that you keep your horsematerial. It is important to do this gentlyNSAIDs, as they will mask a fever. from eating. Hand-walking or muzzlingto prevent esophageal rupture. With aDepending on the severity of the choke, can prevent continued feed intake. Also,bad choke this can take upward of anyou might need to withhold certain feed do not administer oral medications.hour. The second approach is based ontypes for several days. Typically, avoid Finally, it is an old wives tale that you canthe theory that most chokes eventuallydry feeds and hays and offer the horse a and should resolve a choke by shovingself-cure, so veterinarians might adminis- soupy mash of complete concentrate feed. a garden hose in your horses mouth ter repeated rounds of sedation, medica- Repeat chokers on certain types of feed this only increases the risk of serioustions to relax the esophageal muscles,might need to remain on soupy mashescomplications, especially aspirationand intravenous fluids to keep the horseindefinitely, and horses that eat too pneumonia.hydrated.quickly sometimes benefit from having Upon arriving, your veterinarian willRarely, veterinarians are unable tolarge, smooth rocks placed in their feed conduct a physical exam. Most chokingresolve a choke using nasogastric intuba- tubs. Finally, a common cause of choke horses are sensitive to esophageal palpa- tion. In those cases you might need tois poor dentition leading to inadequate tion, and in minor chokes the obstructionsend your horse to a referral center forchewing; be sure to schedule a thorough could be visible on the left side of thefurther diagnostics, such as an endo- dental exam following a choking episode. horses neck. However, if a horse has con- scopic examination. The veterinarianChokes are common equine emergen-tinued to eat after choking, it can result incan use the endoscopea tiny cameracies with potentially serious consequenc-distension of the entire esophagus ratherpassed down the esophagusto identifyes. Call your veterinarian as soon as you than apparent focal swelling. A bad chokethe type of object causing the obstruction,notice signs of choke.hAmerican Association of Equine Practitioners, 4033 Iron Works Parkway, Lexington, KY40511859/233-0147www.aaep.org8August 2020The Horse|TheHorse.com'