Choke in Horses: Symptoms, Causes, and When To Call the Vet

If your horse suddenly starts coughing, drooling, or has food coming from their nose, they may be experiencing choke. Although horses can typically still breathe during choke, the condition is a serious emergency that requires immediate veterinary care. Here’s what causes choke in horses, how it’s treated, and what you can do to help prevent it.

What Is Choke in Horses?

Equine choke occurs when there is either a partial or complete obstruction of a horse’s esophagus. The esophagus is the tube that takes the food from the mouth to the stomach of the horse.

Horse choke typically differs from human choke in that horses can usually still breath. This is because food tends to get stuck farther down in the esophagus in horses and doesn’t usually affect the pharynx (where the trachea and esophagus both enter the back of the throat). 

When horses are choked, they are unable to move food or water from their mouth to their stomach. Horse choking is one of the most common emergencies seen in horses and requires immediate veterinary assistance.

Signs of Choke in Horses

Horses experiencing choke may exhibit the following signs:

• Saliva/food material coming from the nostrils or mouth
• Hypersalivation
• Depression/lethargy
• Difficulty swallowing
• Anorexia (not eating or drinking)
• Coughing/gagging
• Acting colicky

If you notice any of these signs, contact your veterinarian immediately.

Causes of Choke in Horses

There are a variety of reasons that may cause a horse to choke. The most common reason is swallowing dry or coarse food eaten too quickly. Dry food, like pelleted grain or beet pulp, swells rapidly once mixed with saliva, chewed, and passed down the esophagus.

Choke occurs when a horse eats too fast or has dental abnormalities resulting in food particles not being chewed properly before swallowing. Hay can also cause a similar issue as it’s very coarse, and if it’s not chewed well, can become lodged in the esophagus.

Horses may also choke from eating hard food items such as carrots or certain treats if the pieces are too big.

Lastly, abnormal esophageal anatomy, some diseases (like botulism, EPM), and sedation can predispose a horse to choke because they affect the horse's ability to chew and swallow properly.

How Veterinarians Diagnose Choke in Horses

If you suspect your horse has choked, call your veterinarian right away and remove all access to food while you wait. Administration of any oral medication, eating, or drinking can all cause worsening of choke. 

Your veterinarian will obtain a history, perform a physical exam, and run tests to diagnose choke. On physical exam, the most common sign of choke is saliva and/or food draining from the horse’s nose.

Your vet will be able to fully diagnose choke by passing a stomach tube down the horse (under sedation) via the nostril into the esophagus and then feeling for an obstruction before passing into the stomach.

In some rare instances, a veterinarian may not be able to resolve the choke at your barn. In these cases, the horse may need to be referred to an equine hospital for further diagnostic testing such as an endoscopic exam, which uses a camera to visualize the esophagus and obstruction.

Horse Choke Treatment

In order to clear the obstruction, the veterinarian will need to sedate the horse and may give an intravenous medication called buscopan (spasmolytic or anti-spasm medication) to help relax the esophageal muscle.

Then, using the stomach tube, the veterinarian will gently use water therapy to flush or lavage the obstruction down into the stomach or out through the nose. Sedation is critical because the horse's head must be low to the ground to allow the obstructed material and water to come out through the nose and not into the horse's lungs.

Depending on the severity of the choke, the condition may be relieved quickly or take longer to slowly remove the obstruction without damaging the esophagus.

Recovery and Management of Choke in Horses

After the choke has been relieved, it’s common to keep a horse on a non-steroidal anti-inflammatory drug such as Banamine for a couple of days to help with the esophageal inflammation and pain.

Antibiotics may also be recommended for the recovery of choke to minimize the risk of secondary bacterial infections and pneumonia if your veterinarian suspects aspiration of the feed material.

What To Feed a Horse That Choked

Another essential part of recovering from choke is the gradual return to eating. Often this includes keeping the horse on a food restrictive diet for a few days to a week to allow the esophagus time to heal.

Your veterinarian may advise food recommendations depending on the reason the horse choked and the severity.

Food restrictions may include:

• Feeding small amounts of forage at a time
• Using chopped forages
• Providing a limited amount of grass via hand grazing
• Providing small quantities of hay soaked in water (to soften the hay) multiple times per day
• Feeding sloppy soup food or as mash (grain mixed with a high amount of water)

Returning to Exercise

Normal exercise and lifestyle regimens can resume as the horse finishes any medications prescribed by your veterinarian and food restrictions lifted, usually within one to two weeks.

If you notice any of the following symptoms, call your veterinarian right away, as they can be signs of complications following choke:

• Coughing
• Nasal discharge
• Lethargy
• Increased respiratory rate
• Anorexia (not eating)
• Fever

Possible complications from choke include esophageal rupture, pneumonia, and choke reoccurrence.

Prevention of Choke in Horses

Minimize your horse’s risk of choke by providing:

• Routine dental care by a veterinarian
• Access to fresh water at all times
• Slow feed systems (such as a slow hay feeder) if your horse is a fast eater

• Soaking hay or grain to make it softer/easier to chew