What the heck?! What is that sound out in the barn? The big horse Elvis is barking out enormous, intermittent coughs. Your pulse quickens--Elvis shouldn't be sick! Good grief, he hasn't been anywhere, hasn't had any of his horse friends over to visit, and he is fully vaccinated. So what is going on?

After rushing to his stall you find him looking very distressed with saliva pouring from his mouth. You check his stall to see if it is torn up the way it was when he had colic last year, and are relieved to note that everything appears to be in its usual order. Elvis is a neat horse. He is one of those tidy geldings who poops in one corner and pretty much leaves the rest of the place undisturbed.

Gee, could he have rabies? That's the only condition you know of where it is reported that an animal foams at the mouth. But Elvis has an annual vaccination to ward off rabies, and besides you haven't discovered any bite wounds. Really, he hasn't had any sort of wound in a very long time.

The big, bay warmblood lets out another "Whoomf!" of a cough. He sounds as if he is gagging. Saliva continues to stream from his mouth. Some bubbly spit is appearing in his nostrils as well.

What do you do?! Well, you do what every one of us does when one of our critters is in distress. You phone the vet in a panic and after describing the signs, you're informed that Elvis is likely experiencing an episode of choke and the vet is on the way.

Do horses choke? What the heck can he be choking on? Is he going to die? Will the vet have to perform some superhuman form of the Heimlich maneuver?

Before Doc rang off, he suggested that you take Elvis outside and trickle water from the hose across his tongue. Delighted to have something to do, you comply, yet wonder why.

You were instructed not to squirt the water down the horse's throat; rather, the vet made a point to say "across his tongue." And while you are doing this, the big fellow continues to stretch out his neck and heave these horrendous retching coughs. The situation is sickening. You hope the veterinarian can make good time.

After what feels like forever, you hear the vet's truck turn into the farm lane. The vet doesn't dally, but jumps right out, immediately assesses your horse, and says he thinks Elvis is, indeed, experiencing choke. The vet feels up and down Elvis' neck, mutters to himself, then dashes off to the truck to get equipment.

The first thing Doc does is give Elvis an IV injection of a sedative. And in only a matter of minutes, the big horse's anxiety starts to sputter and fade. His head begins to drop as his eyelids slide half-mast over his liquid brown eyes. With this you feel your own anxiety begin to abate. It always feels better, you think, when the solution to the problem has begun.

Your earnest veterinarian then explains that he will pass a nasogastric tube (stomach tube) and attempt to soften and flush down whatever is blocking the handsome Hanoverian's esophagus. The vet goes about the business of passing the tube and you watch, as you always do, in amazement as the seemingly endless tube disappears into your horse's nostril.

One end of the tube is in your vet's mouth, while the other end disappears south into uncharted territory...on it goes until its downward progress suddenly halts. And like he did during last year's colic, the vet takes a sniff down the tube. He then starts talking to you about the apple tree in the horse pasture. How in the world can this person know there is an apple tree in your pasture?

Doc then explains that Elvis has choked on an apple. The reason the vet knows this is that he can smell the fruit. The greedy horse has swallowed an apparently intact apple and it is stuck in his gullet.

Now what? The vet is going to send some mineral oil down the tube, then attempt to gently push the obstruction into the horse's stomach.

It takes a few minutes, but after some careful, patient persuasion, the apple slides home. Elvis is suddenly and greatly relieved, which he proves by burying his bay face in the grass and tearing up some of the last tender shoots of the season. Hallelujah!

Explaining Choke

When people choke, it is often because we've gotten some food stuck at the entrance to the windpipe. It is a terrifying situation, and people do die from obstructed airways. But have you ever swallowed a pill or large bite of food that seemed as though it wouldn't go down? What do you do? You drink something in order to "wash it down."

That is the sort of choke horses get. They get some foodstuff caught in the esophagus. And the reason saliva runs out of their mouths is that when they swallow, the saliva has no place to go, so out the mouth it comes. The horse coughs and stretches out his neck in an attempt to dislodge the offending food.

What do horses choke on? Aside from large things like apples, big carrots, and corncobs, horses can choke on hay, sweet feed, and feed pellets.

Why do they choke on these things? The reasons are varied. Your horse's teeth might need to be examined and floated; he might not be able to grind food the way he should. Or he could be old and simply not have enough remaining teeth to get the chewing job done sufficiently.

Some horses are greedy; they will bolt their food before it is properly chewed, and the result is that it globs up and forms an impaction in the esophagus. This is another good reason to have ample fresh water available to your horse at all times. However, sometimes it is the way the feed or pellets are milled. In those cases the fix is easy; simply change to another feed.

There are some anatomical conditions and rare diseases that can cause a horse to choke. One of the more common physical changes that leads to choke is a stricture (contracted spot) of the esophagus.

How can we keep horses from choking? Good and regular dentistry is an important tool for preventing choke. Please note that all veterinarians and equine dentists are not created equal when it comes to floating teeth. Find somebody experienced, with a solid reputation, to do the job. It will save on money and headaches in the long run.

Next, make certain that your feed is properly milled from a reputable dealer and is the appropriate feed for your horse.

If your horse bolts his feed, you can put several large smooth stones or salt blocks in his feed tub. This will slow him down as he will have to root around the stones in order to gather up his feed. Make certain the stones are potato sized or larger so that your horse doesn't swallow them.

Do horses choke more than once? Yes, some horses and ponies are chronic chokers. However, others might never experience a second choke. So, it is important to identify the source of the problem and correct it if possible. For example, in Elvis' case the owner needs to put him in a different field when the apples are ripe, and certainly he should have the horse's teeth floated. These two management efforts might prevent Elvis from ever experiencing another choke.

What happens if the veterinarian cannot clear the choke? In the rare case that the choke cannot be corrected on the farm, the horse will be referred to a surgical facility. There are times when the object causing the choke will have to be relieved under general anesthesia and possibly by surgical means.

Why was the owner told to dribble water across Elvis' tongue? Partly to give the anxious owner something to do while she waited for the vet to arrive, and to stimulate the swallow reflex while providing additional liquid, all of which could help relieve Elvis' distressing choke. Running water over the horse's tongue is a good way to see if the choking issue resolves itself; if saliva stops coming out of the horse's nose, most likely the problem is corrected.

Is there any special care Elvis must receive after experiencing choke? Yes, the owner will need to feed Elvis a soft, wet diet for several days because the muscular layer of the esophagus was stretched from the obstruction and cannot pass food normally until the inflammation decreases (about 72 hours). And he'll get an antibiotic to decrease the chances of respiratory infection due to inhaled food and saliva. Finally, in order to decrease the inflammation caused by the trauma, Elvis will be started on an anti-inflammatory drug such as phenylbutazone (Bute).

Take-Home Message

While you might never have a horse that experiences choke, taking precautions in your horse's environment and feed can help you in that goal. And, if your horse does become choked on something, remember that it can be a life-threatening situation that requires immediate veterinary attention.

About the Author

Laura Riley, DVM

Laura Riley, DVM, is a veterinarian who writes from her riverside cabin in Great Cacapon, W. Va.

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