I was recently called out of hours to a suspected episode of ‘choke’. The clinical history behind the call was a geriatric mare showing signs of distress, coughing and, what was described as retching.

On examination it was quickly clear that the mare was not suffering with choke but in fact an acute asthmatic episode which we treated.

I thought it was important to review what ‘choke’ was and how the client might differentiate the two in the future.

‘Choke’ is a relatively common condition in horses where the oesophagus (the tube connecting the mouth to the stomach) becomes blocked. ‘Choke’ is typically caused by food material such as unsoaked beet or pieces of apple or carrot but it can be anything.

An important difference in comparison to humans is that the blockage is not in their trachea (windpipe) so does not pose an immediate risk to life.

Prompt diagnosis

The classic clinical presentation of ‘choke’ is a large amount of frothy discharge from both nostrils (a mixture of both feed material and saliva). This quickly becomes apparent soon after feeding concentrates, therefore taking a thorough history is important in making a prompt diagnosis. These horses often make repeated attempts to swallow, hold their necks out stretched and may cough. Thankfully these blockages will usually spontaneously resolve. If the blockage persists for more than 20 minutes veterinary intervention is recommended.

Treatment can vary based on size, severity and location of the blockage. Treatment usually involves sedation and an antispasmodic drug to relax the oesophagus and allow for passage of the blockage into the stomach. It can often be necessary to pass a stomach tube to confirm location of the obstruction and attempt to flush out the obstructed material causing the problem.