Choke in Horses

Choke is one of the most common conditions affecting the oesophagus of the horse. For a horse owner who might not have seen it before, it can be very frightening to witness.

Choke is essentially an obstruction in the oesophagus (gullet) caused by food material. Despite the name of the condition, a horse suffering from choke can still breath, and while it is distressing for both the horse and owner, the majority will fully recover in a short period of time.

However, there are several things a horse owner can and should do to help their horse recover quickly and to stop the condition from deteriorating. Luckily (or unluckily) I have had experience with a horse suffering from choke before and most recently my own three year old Irish Sports Horse gelding, Luca, suffered a bout of it, so these experiences will be used as a reference for this blog post.

Signs and Symptoms

The most obvious sign of choke is the presence of food debris and saliva running from the horse’s nostrils. The horse will stand with his head and neck braced and outstretched. They may also cough up saliva and food debris and appear to be trying to clear their throat. You may also see the oesophagus in spasm as it tries to dislodge the blockage.

In Luca’s case, he displayed all the tell tale signs – positioning of the neck and spasms, while also coughing up large volumes of saliva mixed with food debris through the mouth and nostrils.

A horse suffering from choke may also have an elevated respiration rate, which is a sign of distress. The normal respiratory rate for a horse at rest is 10 to 14 breaths per minute. Knowing your horse’s normal vital signs will help to eliminate any other suspicions. If your horse has an elevated temperature, there may be something more sinister at play, so all this information is key for your veterinarian to choose the correct course of action.

Relaying Information to Your Vet

While most episodes of choke will clear on their own, I personally believe it is worth at least consulting with your vet to confirm the diagnosis, for them to determine the severity of the case and whether a call out is necessary. Relaying the correct signs and symptoms to your vet will help immensely especially if you are unsure of what is wrong.

Look at the type of discharge from the nose – what does it look like? Is it thick like a mucus? Have you seen it before? Is there food debris present? A thick coloured mucus is more than likely a sign of infection and illness rather than choke.

What were the circumstances leading up to this? In Luca’s case, he had been fed at 2pm in the field and was noticed by 4pm when he was on his own and coughing up what was described to me as “yellow water” with “bits coming out of his nose.” His temperature was normal but his respiratory rate was elevated. The circumstances immediately led me to believe that he was suffering from choke, but as I was not there myself, a vet was called to see him.


Choke should resolve itself within a couple of hours. However, my vet reassures me that it can take some horses several days to come right.

Initially, no feed was offered to him and all hay was removed from his stable. This is important as you do not want to make the obstruction any worse.

I called the vet back as after 24 hours, as the symptoms had not yet resolved themselves and there was still debris coming from the nostrils.

In some instances, your vet may decide to insert a tube through the nostrils and into the oesophagus to help dislodge the obstruction. As the structures of the wind pipe and the oesophagus are very delicate this is must be done very carefully to avoid causing more damage than good.

As the vet is “flying blind” when inserting the tube, a simple test can determine whether the tube is in the correct position. Interestingly, by blowing into the tube the vet can tell if it is in the windpipe or the oesophagus by the level of resistance felt. If it is in the windpipe, there will be no resistance to blowing air into the pipe, however, when it is inserted into the oesophagus there will some resistance felt as the oesophagus contracts.

For me, this should only be done by a very experienced vet as the risk of placing the tube in the wrong place is too high.

Your vet may give your horse a muscle relaxant to help the oesophagus relax. They may also administer an antibiotic as there is a risk of aspiration of food debris and saliva into the windpipe, and also if the horse was tubed. Inhaling food debris or saliva could cause pneumonia.

By morning of the 3rd day Luca was attempting to eat and drink but was still unable to. After attempting to have a drink he was still displaying some symptoms, so I made the decision to call the vet, again.

He recieved a muscle relaxant, an antibiotic as well as an anti inflammatory pain killer to reduce any swelling caused by the blockage in the oesophagus. He was also placed on an IV drip as he had been unable to drink or eat for over 2 days.

Luckily, after this treatment he really came back to himself and was much brighter and eager to get something to eat.

After Care and Management

Under veterinary advice, I slowly began to reintroduce feed once the nostrils were clear and there was no coughing. I also notice Luca successfully drinking and he was looking for food. At this stage a very sloppy mash was offered to him which he successfully ate without any signs of difficulty.

I also began to hand graze him for 15 minutes at a time at hour – hour and a half intervals. As he was passing his droppings and not showing and signs of a relapse, I then soaked a very small haynet and offered to him for 10 minutes. He then had a couple of coughs and showed a little difficulty with the soaked hayledge so this was removed.

He is also on a course of antibiotics in case of any infection in the lungs.

From now on his feeds will all be heavily soaked as there is always the potential for relapse once a horse has had an episode of choke. Repeated relapses can lead to more serious complications in the long run so from now on it’s a case of prevention and management.

The most important thing now is to monitor the symptoms and to introduce feed and hayledge gradually.

I will be re evaluating his feed regime to make sure everything is soft and he is getting the right amount and the correct intervals.

You’ll be glad to know that despite being a little sore, he is perfectly fine. Eating sloppy mashes and enjoying this special treatment of hand grazing and hand picked grass until I’m sure he can take the hayledge. Hopefully that will be the end of the vet visits for another while – but always remember – if in doubt, call the vet!!


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