When a horse chokes repeatedly

Frequent episodes of esophageal blockage in horses merit a call to the veterinarian and a thorough investigation of possible causes.
Making sure a horse has a quiet place to eat, without being harassed by herdmates, can help prevent choke.

Question: My daughter’s 16-year-old Welsh pony has fairly recently become prone to choke. We’ve owned him for half his life and he never choked until this year. Now, however, it occurs frequently—he has choked four times this year. Twice the blockage cleared on its own, but twice we needed to call the veterinarian and have him flush the feed out with a tube and water.

We now make sure to soak the pony’s feed to the point of it being a sloppy mush, and he only gets chopped hay. But I’m worried there is something else going on. We’ve had his teeth checked by a veterinarian and they are fine for a pony his age. Is there anything else we should be looking into?

Answer: Choke is a scary thing to see. As you already know, when we say a horse or pony has choked, it is not the same as in people. Equine choke can be serious, but it does not pose an imminent risk of death: The problem is a blockage of the esophagus (the passage from throat to stomach) but the horse’s windpipe—and ability to breathe—is not affected. In contrast, choking in people refers to a blockage of the trachea (windpipe), a problem that quickly becomes fatal if not resolved.

The signs of equine choke are distinctive. The horse will look uncomfortable and may extend his neck and hold it at an awkward angle. A slimy discharge, mixing chewed feed and saliva, may also drain from his nostrils and mouth. If choke doesn’t resolve quickly on its own (many cases do), your veterinarian will need to come and flush the blockage out as you describe.

Now, what to do with a repeat of-fender? Having a veterinarian with dental training and experience examine a horse’s teeth is a vital first step. Then providing feed in a form less likely to accumulate into a blockage is good too. Since you have already covered those basics, I would next focus on two other considerations: behavior and physical condition.

On the behavioral side, step back and consider whether your pony’s mealtime is peaceful and predictable. Is he in a quiet stall without threatening neighbors? Is he fed often enough that he isn’t left hungry and anxious in between? Talk to your veterinarian about these vital aspects. Feed-time anxiety leads a horse to gulp the feed too fast, creating the conditions that make choke more likely.

As for the physical side, it may be time to literally look more deeply into the esophagus. This long, muscular tube is a strong, active organ critical to normal eating. Injury can cause the formation of strictures, a scar tissue that narrows a portion of the esophagus, preventing normal stretching and contraction. Clogs can form in this location. Conversely, in rare instances the portions of the esophagus wall can weaken, allowing a ballooning area to develop where feed accumulates. To diagnose these problems, a long endoscope—a flexible tube with a tiny camera on the end—will be used to examine the esophagus from the inside. Your veterinarian might do this exam on your farm or refer you to a specialist.

I do not recommend ignoring this problem. Choking is always abnormal, and it is obviously uncomfortable. Repeated choke episodes can cause or worsen damage to the esophagus, and that damage is most often irreversible. Each choke episode also carries the risk of aspiration pneumonia—a serious lung infection resulting from the inhalation of saliva, feed material and other contaminants.

Once you and your veterinarian have found the underlying cause, a plan for treatment or management can be created to help your pony stop this cycle of choking.

Melinda Freckleton, DVM
Firestar Veterinary Service
Catlett, Virginia


Melinda Freckleton, DVM, is founder and operator of Firestar Veterinary Services, LLC, in Catlett, Virginia. A graduate from the College of Veterinary Medicine at Cornell University, she served on the 2012 equine committee for the Virginia Veterinary Medical Association Conference as well as the AAEP Task Force on Referral Guidelines and Ethics. Freckleton enjoys riding and competing in dressage and taking care of her dogs, cats and horses on her small farm.

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