University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Esophageal Choke

Horse Owners Seminar

March 17, 2007

Carla Sommardahl

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

My horse is choking???

• Heimlich maneuver will not help!!• Esophagus = muscular tube

leading from throat to stomach• Horse can still breath• Esophagus blocked by a foreign

object most commonly– Tumors or scar tissue from previous

choke

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Normal Anatomy

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Common Sites of Obstruction

• Esophageal opening • Mid cervical region• Thoracic inlet• Terminal Esophagus = Cardia

• Esophageal opening • Mid cervical region• Thoracic inlet• Terminal Esophagus = Cardia

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Potential areasof obstruction!

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Common foreign objects

• Pellets, Grain, beet pulp

• Hay, grass clippings

• Pieces of fruit, commercial treats

• Hay or alfalfa cubes

• Baling twine, twigs, wood shavings

• Any improperly chewed feedstuff

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Signs of Choke

• Excess drooling of saliva with feed material or froth from mouth

• Heavy nasal discharge with feed material and froth

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Signs of Choke

• Extend head and neck

• Restless behavior

• Difficulty swallowing

• Cough, retching

• Colic

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

What can you do?

• Call your veterinarian = Medical emergency– Damage to esophagus can lead to

scar tissue– Aspiration of fluid into lungs =

pneumonia

• Remove all feed and water

• Put in unbedded stall

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

What will your veterinary do?

• Complete physical exam

• Sedation to relax horse and lower head

• Passage of a nasogastric tube to identify obstructed location

• Lavage of esophagus with head down

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Further Examination

• Endoscopy of the esophagus– Assess damage – Better view obstruction

• Radiographs of the neck area with and without contrast

• Radiographs of the lungs

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Complicated or Severe Choke

• Hospitalization for fluid therapy and monitoring

• Anesthesia to remove object more easily

• Surgery – Last resort if object cannot be removed

or is not digestible– Incision made into esophagus

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Prognosis• Good in most cases (< 24 hours

duration)

• Depends on:– Length of time obstructing material

remains in esophagus

– Damage to esophagus

– Previous episodes

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Complications of Choke

• Dehydration

• Electrolyte imbalances

• Aspiration pneumonia

• Upper airway irritation and inflammation

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Complications of Damage to Esophagus

• Esophagitis

• Motility disorders

• Esophageal ulcers and stricture (scar tissue)

• Esophageal diverticulum – Pocket formed from stretching of

esophagus, traps food

• Esophageal rupture or tear

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Aftercare

• Gruel diet until esophagus has healed– Senior or complete feed soaked in

warm water– Small frequent meals best

• No hay or grass

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Prevention• Proper dental care

– Yearly exams and floating– More frequent in older horses

• Rapid eaters – Feed separately to avoid competition– Place large rock or salt block in bucket

• Good quality hay• Avoid grass clippings

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

Prevention• Older horses or horses with previous

choke– Avoid dry pelleted feeds and beet pulp – Moisten prior to feeding.

• Avoid hay cubes or large fibrous horse treats if new to horse

University of

Tennessee College of Veterinary Medicine

Department of Large Animal Clinical Sciences

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