FAQ – Choke

My horse is choking – what do I do???
• Stay calm. Keep your horse quiet and calm.
• Remove all food. Offer water only from the ground.
• DO NOT PUT ANYTHING INTO THE HORSE’S MOUTH
• Massage the left side of the neck. If you feel a lump, concentrate there.
• If signs do not resolve in 30 minutes, call your veterinarian. Do not wait overnight thinking it
will pass.
• Aspiration pneumonia risk increases as time goes by – this can be fatal. Speak to your
veterinarian about antibiotics.

What is choke?
• Choke is an esophageal obstruction due to feed material – grain, hay, or, less commonly,
things like hedge apples, carrots, etc. Rarely, foreign objects like pieces of wood, rocks,
etc are found.

What are the signs?
• Signs include gagging, saliva and mucus from the nostrils and mouth, coughing, retching.
Some horses may roll or paw as if they are colicky.

What are the causes?
• Improper dentition – sharp points, missing teeth, loose teeth
• Eating too fast – not chewing enough prior to swallowing
• Not enough saliva
• Stricture in the esophagus from previous choke, tumor

How is choke resolved?
• If the choke does not resolve on its own, your veterinarian should be called
immediately.
• The horse will be evaluated – heart rate, temperature, respiratory rate, lung sounds.
• The horse will be sedated heavily to encourage the head to be low to the ground. This
services multiple purposes: pain management, relaxation of the esophagus, and
encourage gravity flow of all water instilled into the esophagus via the nasogastric tube.
• A nasogastric tube is passed into the esophagus to the level of the obstruction. Water is
flushed and the tube pressed against the obstruction to get it to move into the stomach.
• Sometimes, the obstruction is too extensive, too dry, or is not feed material. Some of
These cases require referral to a clinic for endoscopy, IV fluid therapy, and further care.

What are some complications?
• Dehydration and electrolyte loss. Since the horse cannot drink and is losing sometimes
large amounts of saliva, the horse can become dehydrated quickly if left unresolved.
Initially, the gut will dehydrate – as the body pulls water from the GI tract into the
circulation. If the situation continues to be unresolved, the horse will become
systemically dehydrated.
• Aspiration pneumonia is a real and significant risk. The risk increases as time goes by.
Pleuropneumonia (where the infection results in fluid within the chest) can occur as
quickly as 12 hours after a choke episode if left untreated. Antibiotics after a choke
episode are frequently required to prevent pneumonia. The type of antibiotic is based
on veterinarian preference, how long the choke had been going on, and the patient
status (age, other health concerns).
• Stricture at the obstruction site. This can occur if the obstruction is left or if the material
is damaging enough to cause a circumferential scar which shrinks down to cause a
stricture.

How is choke prevented?
• Regular dental exams and floats. Young and old horses should have exams twice a year,
middle aged horses once a year.
• If your horse has choked in the past, using a pelleted diet that is easily digested can be
helpful.
• Soaking the feed can help slow down eating and also help the feed pass through the
esophagus.
• Using large rocks or slow feeder pans can help reduce bolting of food. Feeding
separated can also help reduce speed-eating due to bullies.
• Feed from the ground – this has been shown to increase chewing, increase saliva
production, and slow the horse down when eating. By Dr. Karie Vander Werf