🫧 Vet’s 2025 Guide to Equine Choke (Esophageal Obstruction)

By Dr Duncan Houston BVSc

1. What Is Equine Choke?

Choke—or esophageal obstruction—is when food or foreign material lodges in the esophagus, blocking the passage to the stomach. This is different from human choking: horses can still breathe, but can’t swallow, leading to drooling, nasal discharge, distress, and the risk of complications :contentReference[oaicite:3]{index=3}.

2. Why It’s an Emergency

• Dehydration and electrolyte imbalance from inability to drink.
• Esophageal trauma, swelling, or rupture if unresolved.
• Aspiration pneumonia from inhaled saliva or feed :contentReference[oaicite:4]{index=4}.
• Strictures or scarring lead to recurrence :contentReference[oaicite:5]{index=5}.

3. Common Causes

• Poor mastication due to dental issues.
• Bolting feed—eating too fast without chewing :contentReference[oaicite:6]{index=6}.
• Dry feed—pellets, cubes, beet pulp—especially if unsoaked and water is limited :contentReference[oaicite:7]{index=7}.
• Foreign materials like twine, paper, bedding :contentReference[oaicite:8]{index=8}.
• Esophageal strictures or abnormalities—especially after prior choke episodes :contentReference[oaicite:9]{index=9}.

4. Recognising the Signs

• Repeated swallowing attempts, drooling, and visible feed in saliva/nasal discharge :contentReference[oaicite:10]{index=10}.
• Coughing, neck stretching, open-mouthed breathing.
• Head lowering, anxiety, tachypnoea or tachycardia.
• Lump on neck (esophageal silhouette), especially left side :contentReference[oaicite:11]{index=11}.

5. What to Do While Waiting for the Vet

• Remove feed and water—preventing more material entering esophagus :contentReference[oaicite:12]{index=12}.
• Keep horse calm, ideally in a stall or dry lot with a companion :contentReference[oaicite:13]{index=13}.
• Lower the head to prevent aspiration; walking calmly may help saliva drainage :contentReference[oaicite:14]{index=14}.
• Gentle massage over left neck may help—only if guided by vet :contentReference[oaicite:15]{index=15}.
• Do not force feed or water; no home remedies like hoses or oils—they can worsen aspiration :contentReference[oaicite:16]{index=16}.

6. Veterinary Diagnosis

• Physical exam; visible discharge and aspiration signs :contentReference[oaicite:17]{index=17}.
• Nasogastric tube confirms blockage if resistance felt :contentReference[oaicite:18]{index=18}.
• Advanced tools—endoscopy, ultrasound or radiographs for recurrent or complex cases :contentReference[oaicite:19]{index=19}.

7. Common Veterinary Treatments

• Sedation and spasmolytics (e.g., butylscopolamine) to relax the esophagus :contentReference[oaicite:20]{index=20}.
• Nasogastric lavage with warm water to dissolve or push blockage :contentReference[oaicite:21]{index=21}.
• In persistent cases, reflux under general anesthesia or aided by endoscopy :contentReference[oaicite:22]{index=22}.
• Surgery (rare), for permanent obstruction or rupture :contentReference[oaicite:23]{index=23}.

8. Complications & Adjunct Treatments

• NSAIDs like flunixin to reduce pain and inflammation :contentReference[oaicite:24]{index=24}.
• Broad-spectrum antibiotics to prevent aspiration pneumonia :contentReference[oaicite:25]{index=25}.
• Monitor for pneumonia signs—coughing, fever, nasal discharge, lethargy.
• Assess the esophagus endoscopically post-treatment to identify damage or strictures :contentReference[oaicite:26]{index=26}.

9. Aftercare & Recovery

• Rest esophagus: no dry feed or hard forage for 12–24 hours :contentReference[oaicite:27]{index=27}.
• Transition gradually to soaked or pelleted diets over several days.
• Continue NSAIDs and antibiotics as needed :contentReference[oaicite:28]{index=28}.
• Monitor hydration, weight, and esophageal healing.
• Schedule follow-up exam if signs persist or recur.

10. Preventing Future Choke Events

• Ensure regular dental exams—every 6–12 months :contentReference[oaicite:29]{index=29}.
• Soak all dry feed—pellets, cubes, beet pulp—for at least 30 minutes :contentReference[oaicite:30]{index=30}.
• Encourage slower eating—spread feed, use large flat stones or salt blocks in tubs :contentReference[oaicite:31]{index=31}.
• Use hay nets or slow-feed feeders to limit bolt speed :contentReference[oaicite:32]{index=32}.
• Provide constant access to fresh water.
• Feed smaller, more frequent meals; monitor high-risk horses closely.
• Investigate esophageal strictures or neurologic issues if recurrent :contentReference[oaicite:33]{index=33}.

11. Ask A Vet Support 🩺

With Ask A Vet, you get:

• Photo/video assessments of drooling, nasal discharge, and neck involvement.
• Guidance on immediate steps while awaiting veterinary intervention.
• Recovery food plan support: soaking protocols, feeds, transition timing.
• Antibiotic and NSAID schedules to reduce pneumonia risk.
• Follow-up planning: endoscopy timing, monitoring, and chronic-case strategy.

Download the Ask A Vet app for instant expert guidance through choke emergencies and recovery care in 2025 and beyond! ❤️

12. Quick Reference Table

13. Final Thoughts

Esophageal choke is a serious but manageable veterinary emergency. Timely intervention, thoughtful aftercare, and prevention strategies allow horses to recover fully and avoid recurrence. With Ask A Vet at your side, you'll have expert support from crisis management to recovery planning throughout 2025 and beyond. 🐴💧