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Sometimes it seems that the horse’s gastrointestinal tract is just looking for a way to cause problems for everyone. If it’s not impaction colic, it’s gastric ulcers. If it’s not colic, it’s choke. Most people know what “choke” is in horses, but it can be a little confusing. Afterall, when people are choking, they can’t breathe, right? So why don’t horses who are “choking” need the Heimlich?

The difference is, unlike people, horses very rarely inhale something suddenly and get it lodged in their trachea (windpipe). Instead, when a horse is “choked”, they have something stuck in their esophagus – the muscular tube that leads to the stomach. The obstruction doesn’t interfere with their breathing, at least not at first. The trouble is, a horse may continue to eat with this obstruction, and will certainly continue to produce saliva. This results in a saliva/food mix coming up the esophagus and either out the nostrils or down the trachea – usually both.

The symptoms of choke are classic and hard to miss. Many horses at the beginning of a choke episode are in a fair amount of distress. They may wretch, cough violently or even paw at their neck. Some will show colic-like signs, throwing themselves on the ground, pawing or rolling. And then there’s the mucoid saliva with feed material coming out of both nostrils (image, at right).

Sometimes, horses will seem to “get over” this initial episode of stress, and seem to settle down. This doesn’t necessarily mean they aren’t obstructed anymore – they may just have resigned themselves to it. If they are not eating, or if coughing or nasal discharge is still seen (especially while eating), consider them obstructed until proven otherwise.

Unlike colic, the causes of choke are numbered and usually easy to figure out. Generally, a problem with mastication (chewing) is to blame. Some horses who “bolt” their feed, meaning they eat it very quickly, may not take the time to chew pelleted feed. Pellets are notorious for causing choke because they swell when moistened. If not chewed properly before swallowing, saliva will mix with the pellets on the way down the esophagus, potentially swelling all at once and stopping things up. Alternatively, a tooth abnormality may be to blame – older horses are especially at risk here. As horses age, and their teeth are continuously ground down, they can develop dental abnormalities which decrease the grinding surface of their molars. Without good molars to grind their food, it sometimes doesn’t matter how long they spend chewing – it still gets swallowed pretty much “whole”. This is a recipe for an obstruction!

If you think your horse is choking, there are a few things you can do. First, remove all food or water from your horse’s area, and make sure he’s in a safe spot. If he seems to be in a lot of distress, and you can safely reach him to calm him (don’t get yourself injured, we need someone to operate the telephone!), get him walking to distract him. As with colic, walk to distract, not to exhaust them. Now, call your veterinarian – he or she will want to be aware of the situation. Some obstructions do pass without veterinary intervention, but many will require therapy. Keeping your vet in the loop at the beginning of the episode can really help prevent further issues. Even if the obstruction seems to have passed on its own, a quick vet check to verify this and evaluate for signs of aspiration can be very helpful. Aspiration pneumonia is a very serious potential complication of choke, and is the number one reason we lose horses to this condition. If your veterinarian is concerned that your horse may have aspirated feed material during the choke episode, heavy-duty antibiotics are indicated to ward off infection, and your horse should be rechecked in a few days.

As with everything, an ounce of prevention is worth a pound of cure – and this seems especially true of choke. The majority of choke episodes are preventable. Good dental care is essential for many reasons, including choke prevention. Every horse should have his teeth evaluated yearly by a veterinarian, to check for loose teeth, “cupped out” molars which are not grinding properly, or other abnormalities causing difficulty chewing. If your horse has lost some of his normal grinding surface, a diet change may be in order. Simple steps such as soaking pelleted grain or hay pellets until they are a soft mash can help prevent obstruction.

If your horse is a “bolter” of grain, you can try to slow their intake by adding large, flat rocks to their feed tub. There are a variety of specially designed feed tubs which help to prevent bolting grain; one in particular is the Pre-Vent Feeder (at left), which has lots of little depressions a the bottom of the bucket. These types of feeders prevent horses from taking large mouthfuls of grain. You can also try feeding smaller meals throughout the day, or feeding in wide shallow pans.

And finally, if you are feeding beet pulp, please take special care to soak it well. Beet pulp is an excellent addition to equine diets, but it is notorious for causing choke. Even if your beet pulp is in “shreds” and is labelled as safe to feed dry – soak it anyway! Beet pulp has a huge capacity to swell in water, and if the first water it hits is saliva, it will begin to swell upon entering the esophagus. Do yourself, your horse, and your vet a favor – soak!

Hopefully, with these preventative measures, you and your horses will never have to experience an episode of esophageal obstruction. But horses are still horses, and sometimes don’t read the book (or the blog!). Even with the best prevention, choke is possible. If you think your horse is choking, don’t panic! Follow the steps above, give your vet a call and get treatment underway quickly.