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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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