Choke in Horses
Bob Brusie, DVM


In horses, the term choke is used to describe esophageal
obstruction. Unlike choke in humans, it is usually not an extreme
medical emergency. It occurs in the esophagus, not the
windpipe. It blocks passage of food to the stomach, but it
doesn't cut off a horse's breathing.

Choke most commonly occurs when horses either eat too fast or
don't chew their food sufficiently. This is particularly
dangerous with pelleted grain and unsoaked beet pulp, both of
which expand when moistened (by saliva) and thus risk getting
caught in the esophagus. (Dry hay cubes can cause a similar
problem; wetting them before feeding solves it.)

In most cases, the horse stands still in his stall, neither
eating nor drinking, as large amounts of green, slimy discharge
with food particles mixed in (what didn't make it to his stomach
because of the obstruction) come out of his nose. Some choking
horses display obvious signs of pain, such as pawing and coughing
-- and may even appear panicked.

The most important thing to do is remove all food from his stall
(his water can stay, though) -- or put a muzzle on him. If he
continues to eat, the food will pile up, filling the esophagus
all the way up to his mouth. At this point, he risks aspirating
his feed (breathing it into his lungs), which can lead to a
secondary infection or pneumonia.

If you can feel a knot on the left side of his neck, below the
throatlatch, there's a small chance you can dislodge the
obstruction by massaging it. You can also try rinsing his mouth
with a garden hose, which will stimulate him to swallow and
possibly clear the obstruction. You'll know the problem's
resolved if he drinks water and nothing comes back out through
his nose. If, however, he displays symptoms for more than an
hour, call your veterinarian.

Very few choke cases require surgery. In most instances,
administering a tranquilizer relaxes the esophagus enough to
allow the obstruction to pass. Your veterinarian may also try
passing a stomach tube down the horse's throat and gently pumping
fluids into it to loosen segments of the impaction until it is
removed and the tube passes into the stomach freely. This must be
done carefully; if used too forcefully, the stomach tube can
damage the lining of the esophagus. (Trying to force the
obstruction down with a stomach tube doesn't work because the
esophagus spasms around the obstruction.)

After an episode of choke, there is a danger of a recurrence
within the next 72 hours. This is because the muscular layer of
the esophagus has been stretched and can't function normally
until the inflammation subsides -- so food passes slowly through
the area and may pile up to form a new obstruction. This risk is
temporary, however, and can be avoided by reducing the swelling
with anti-inflammatories and feeding an easy-to-swallow gruel.

Longterm effects occur only if the esophagus is damaged -- by the
obstruction being stuck for too long, or by efforts to remove the
obstruction (with a stomach tube, for instance). Very rarely, an
obstruction may irritate the esophageal lining to the point where
it forms an ulcer. When the ulcer heals, it causes irreparable
constriction of the esophagus.

If your horse has experienced any of the above traumas, or if
he's a voracious eater, you may be able to prevent repeat chokes
by changing his feed (to a non-pelleted grain, or by thoroughly
soaking beet pulp or hay cubes) and/or by putting a few
softball-sized rocks or pieces of brick in his feed tub to slow
his eating.

A Diplomate of the American College of Veterinary Surgeons
(ACVS), Dr. Bob Brusie graduated from Michigan State University
School of Veterinary Medicine, completed his internship at Auburn
University, and did his surgical residency at the Marion du Pont
Scott Equine Medical Center. He specializes in surgery and
lameness in hunters, jumpers, and dressage horses at the Palm
Beach Equine Clinic in Wellington, Florida.


This article first appeared in the September, 2000 issue of
Practical Horseman magazine.
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