For most horses, it is reasonable to assume that feeding time is one of the highlights of their day. They often peer out of their stalls expectantly, nickering as they hear feed scoops being filled and grain rations being readied. The nickers of excitement increase as the feed cart is wheeled down the barn aisle. Those horses living on pasture might rattle their gates with excitement, and prance around their field before eagerly waiting at their feed buckets. These sights and sounds of feeding time are commonplace for horse people and may be one of our favorite parts of the day. Having your horse react positively to seeing you, feed scoop in hand or not, helps to reassure us that they are living a comfortable and fulfilled life. While those horses that are especially food motivated and enthusiastic about eating can make our lives easier and provide us some laughter, there is a risk horse owners need to be especially aware of around feeding time. No matter what form of feed your horse is consuming, there is always a risk of choke, the term used to describe an esophageal blockage in a horse. Horses can choke on commercial feeds or forage, as well as the treats we give them, and foreign materials that they might ingest by mistake, such as bailing twine.
Why is Choke such an issue?
Choke can be a medical emergency and may require veterinary intervention if the horse does not clear the blockage quickly. Horses are still able to breathe during a choke episode, as they are obligate nasal breathers, but horses experiencing choke often become very anxious and may become dehydrated, as they are unable to drink. If your veterinarian does need to attend, they may administer sedatives or muscle relaxants to try to calm the horse and allow them to clear the blockage themselves. Your vet may perform an endoscopy (the process of passing a tube with a camera down the esophagus) to visually see what the issues are and develop a plan for how to best manage them. Your veterinarian may also pass a nasogastric tube to enable them to carefully clear the blockage. They might also administer fluids to combat dehydration, as well as certain drugs to treat any possible infection and inflammation. The horse may need to be fasted for a length of time after the blockage has been cleared, followed by a grass-based or mash-only diet for a while, to allow the esophagus to heal. Possible complications from choke include aspiration of material into the lungs which may lead to pneumonia, or damage and scarring of the esophagus that may result in a persistent stricture and future episodes of choke. Some of these complications may not manifest for several days after an episode of choke, so it is very important to keep a close eye on your horse in the days and weeks following.
How can we recognize choke in our horses?
Horses may react differently, but often horses that are experiencing choke will step away from their feed, keep their head low and extend the neck, cough frequently, or make gagging and retching sounds. They often make repeated attempts to swallow, and sometimes you can see the blockage as a bulge on the left side of the neck. There may be nasal discharge associated with the choke as well. This is typically saliva mixed with feed material that drains out the nostrils, since it cannot be swallowed. This discharge can look foamy, clear, or take on the color of the feed material the horse is choking on. Horses experiencing choke can become anxious and act panicked, so it is important to keep yourself safe when trying to manage this situation. However, we do not always see such obvious, outward signs of choke, especially with those very stoic horses. In these scenarios, you may see a horse that seems very keen to eat, but only picks at their feed or forage. These horses may even quid (the act of chewing feed material and dropping it out of the mouth rather than swallowing) their feed material, and then walk away from the feed without swallowing anything. It is important that if you notice sudden changes in the way your horse approaches its food and eats, that you contact your veterinarian – in these cases they may need to pass an endoscope to see exactly what is going on, as it may not be obvious.
What should you do if you suspect your horse is suffering from choke?
Importantly, try not to panic, as this will likely make your horse more anxious. Take away any feed or bedding, as some horses may continue to try to eat and swallow, making the blockage worse. Try to keep your horse as calm as possible, as relaxing their muscles may help the blockage to pass. If the blockage does not clear within a few minutes (maximum 5-10 minutes) or if you are worried, it is best to call your veterinarian. It is not recommended to try and dislodge the blockage yourself or forcibly give the horse water (via a bottle, syringe or hosepipe) as this increases the risk of aspiration pneumonia if feed material is pushed into the trachea.
So how can you reduce the risk of your horse suffering from choke?
As previously mentioned, horses can choke on any feed material including apples, carrots, grass, hay, or commercial feeds. Those horses most at risk of experiencing choke seem to be those who do not chew their food fully due to dental issues or having pain in their mouth, those that are especially enthusiastic eaters, or ones that “bolt” their food. Some horses can have clinical conditions that make them more likely to suffer from repeated choke episodes, and these must be carefully managed once identified.
An important consideration for all horses regarding choke and general wellness is their dental status. Sharp points of teeth not recently floated can cause horses to chew less efficiently due to discomfort, and various other dental abnormalities may also contribute to inefficient or inadequate chewing. For example, aged horses with limited chewing surface left on their teeth can struggle to chew adequately, and when reaching this stage in life, may need alternative fiber sources to short and long stem forage. Ensuring that your horse gets regular dental evaluations and appropriate treatments, especially as your horse gets older, can help decrease their risk.
Trying to slow how quickly they eat their feed can also help decrease risk. How best to do this depends on your horse and the type of feed they are consuming. Feeding horses from troughs versus feed buckets can be effective for some, as they have to “chase” the feed around the bottom of the trough, thereby increasing the time between mouthfuls. More submissive horses might benefit from being fed in an area with no competition for food, as they often will eat slower and in turn, chew more thoroughly, when not feeling pressured by other horses. Horses who are aggressive or enthusiastic eaters might benefit from multiple smaller meals throughout the day, as this decreases the volume of feed they can bolt at one time, and soaking their feed would help further decrease risk. Slow feeders or puzzle feeders can be a good way to slow down consumption and increase chewing time as well. For those with adequate dentition, adding chopped fiber such as chaff to the feed can be helpful in slowing intake rate. Use caution when feeding treats such as fruits and vegetables, and be sure to cut them appropriately to avoid them becoming lodged (slice carrots lengthways, for example).
As mentioned, soaking feed is never a bad choice, regardless of feed type, age, breed, or previous choke history of the horse. The additional lubrication provided by water helps feedstuffs travel down the esophagus smoothly and may help to slow intake as well. Soaking is essential when feeding some feedstuffs (mashes, sugar beet pulp, etc.) as they rapidly swell when mixed with saliva. Always read feeding recommendations of the products your horses are consuming and, especially if your horse has had a previous choke episode, consider checking with your veterinarian or nutritional advisor about choke risk before introducing new products. It is always worth checking feed sources for unwanted foreign objects before feeding to your horse, and if any are found, notifying the feed producer. It is essential to ensure that your horse always has access to clean, fresh water.
While choke is a risk for all horses and something owners should be aware of, there are many ways we can work to mitigate this. Soaked feed, consistent dental care, and conversations with your veterinarian and nutritionist about choke are great places to start.