choke in horses

Contrary to the name, choke does not refer to an obstruction in the trachea. It’s important to know the clinical signs of this condition, and what to do if it happens to your horse.

Your horse has green slime coming out of his nose. The alfalfa you fed him this morning is making a second appearance, dribbling out of his mouth. Is it time to call the vet? You recall that your horse is showing the symptoms of “choke”, but does that mean you have to give your 1,200-pound buddy the Heimlich? The following facts about choke will help you take care of your horse and prevent this problem in the future.

What exactly is “choke”?

Despite the term, “choke” in an equine refers to an obstruction of the esophagus – the tube between the mouth and the stomach – and not the trachea, the tube between the nose/mouth and the lungs. The obstruction is usually composed of feed material like hay, or large pieces of apple or carrot. While choke shouldn’t block the airway of your equine companion, breathing feed material into the lungs is a potential complication of the disease.

Clinical signs of choke

The common clinical signs or symptoms of choke include feed material coming out of the nose and mouth. It can look like hay-tinged mucus, or as if the horse’s morning hay ration has been put in a blender and is extruding out of his nose.  Horses will often stretch/extend their heads and necks. There may be coughing.  They will usually not be interested in eating or drinking during this process. As you might imagine, this can be very scary for a horse and he may become excited or panicked. His gums should remain a light bubble-gum pink; if they are turning purple, blue, brick red or white, call your vet immediately as these are signs of more severe disease.

What should you do?

Once you’ve recognized the clinical signs of choke (and his gums are a normal pink), the first thing to do is get your horse into a safe place and attempt to calm him down. A stall or small pen is a good location because it allows you to observe him closely. Encouraging your horse to keep his head low allows the feed material to drain out rather than back down into his lungs. Remove all food and water from the environment. Do not give anything to your horse by mouth. Remember, his esophagus is blocked. If you give him anything by mouth, the only place for it to go is down into his lungs. This could result in severe and even fatal pneumonia. (Try offering him lavender essential oil to inhale. Its calming effect may prevent any worsening of the situation.)

The first thing to do is get your horse into a safe place and attempt to calm him down.

The next thing to do is call your veterinarian. While the majority of chokes are self-limiting and resolve with basic veterinary care, this is not always the case.

Treating choke

Your veterinarian will use a combination of injectable drugs to calm your horse and relax his esophagus. Some cases of choke will resolve with this medical intervention alone. In more severe cases, a tube will be passed into your horse’s nose and down into the esophagus. Using a gentle lavaging technique, the veterinarian will attempt to wash out the obstruction using the tube and water.

In the most severe cases, an endoscope – an instrument with a camera on the end that can be passed into the esophagus – may be needed to visualize the obstruction and aid in resolving it. This may require referral to a surgical/advanced-care facility depending on the capabilities of your home veterinarian.

In severe cases of choke, or cases left untreated, the obstruction can damage the esophagus, causing it to stricture. Stricturing or scarring of the damaged tissue results in a significantly narrowed diameter of the esophagus. Horses with this problem become much more prone to choke in the future, and may not be able to eat a normal diet.

Your veterinarian will also evaluate your horse for signs of pneumonia. He or she will then develop a plan for pain, inflammation and infection management after the choke is resolved. He/she will also help modify your horse’s diet, both in the initial healing phase and long term. Usually, horses will receive mashes of pelleted feed in combination with soaked hay while they heal.

How to help prevent choke

Horses with severe dental disease are at a higher risk of choke. This means older horses are the most common victims. They are more likely to have teeth that are reaching the end of their lifespan, causing them to hurt and fall out. Because of the reduced number of healthy teeth, these horses are not chewing their forage as well as they should. They swallow coarser feed, increasing the likelihood that it will become stuck in the esophagus. Younger horses with severe points or hooks on their teeth, horses that have pain in the temporal mandibular joint (jaw), or those that bolt their feed are also a greater risk of choke.

Feeding a high quality diet appropriate for the life stage and workload of your horse can avert risk of choke. Have your veterinarian check your horse’s teeth yearly and perform dental floats as needed. Occasionally, underlying diseases will predispose a horse to choke. Scheduling regular checkups by your veterinarian helps catch these diseases early, or prevent them entirely.

Feeding a high quality diet appropriate for the life stage and workload of your horse can avert risk of choke.

For a horse that bolts his food, offer hay in a hay net (or even a double hay net or slow-feeder net) to slow him down and make him nibble his food. Large, smooth stones can be added to feed bins to prevent your food-motivated horse from bolting down his grain. Just make sure the stones are large enough that your horse can’t ingest or chew on them.

Certain pelleted feeds and cubes can pose a higher risk of choke. Also, cut carrots and apples into bite-sized pieces. Consult with your veterinarian if you have concerns about your feeding plan.

With good dental care, appropriate nutrition and consistent preventative medicine, choke is rare and usually carries a good prognosis.  Due to the potential for life-threatening pneumonia and severe damage to the esophagus, quick medical intervention is recommended as soon as clinical signs are recognized.