1. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Esophageal Choke Horse Owners Seminar March 17, 2007 Carla Sommardahl

2. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences My horse is choking??? Heimlich maneuver will not help!! Esophagus = muscular tube leading from throat to stomach Horse can still breath Esophagus blocked by a foreign object most commonly –Tumors or scar tissue from previous choke

3. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Normal Anatomy

4. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Common Sites of Obstruction Esophageal opening Mid cervical region Thoracic inlet Terminal Esophagus = Cardia Esophageal opening Mid cervical region Thoracic inlet Terminal Esophagus = Cardia

5. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Potential areas of obstruction!

6. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Common foreign objects Pellets, Grain, beet pulp Hay, grass clippings Pieces of fruit, commercial treats Hay or alfalfa cubes Baling twine, twigs, wood shavings Any improperly chewed feedstuff

7. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Signs of Choke Excess drooling of saliva with feed material or froth from mouth Heavy nasal discharge with feed material and froth

8. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Signs of Choke Extend head and neck Restless behavior Difficulty swallowing Cough, retching Colic

9. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences What can you do? Call your veterinarian = Medical emergency –Damage to esophagus can lead to scar tissue –Aspiration of fluid into lungs = pneumonia Remove all feed and water Put in unbedded stall

10. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences What will your veterinary do? Complete physical exam Sedation to relax horse and lower head Passage of a nasogastric tube to identify obstructed location Lavage of esophagus with head down

11. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Further Examination Endoscopy of the esophagus –Assess damage –Better view obstruction Radiographs of the neck area with and without contrast Radiographs of the lungs

12. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Complicated or Severe Choke Hospitalization for fluid therapy and monitoring Anesthesia to remove object more easily Surgery –Last resort if object cannot be removed or is not digestible –Incision made into esophagus

13. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences

14. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences

15. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences

16. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Prognosis Good in most cases (< 24 hours duration) Depends on: –Length of time obstructing material remains in esophagus –Damage to esophagus –Previous episodes

17. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Complications of Choke Dehydration Electrolyte imbalances Aspiration pneumonia Upper airway irritation and inflammation

18. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Complications of Damage to Esophagus Esophagitis Motility disorders Esophageal ulcers and stricture (scar tissue) Esophageal diverticulum –Pocket formed from stretching of esophagus, traps food Esophageal rupture or tear

19. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Aftercare Gruel diet until esophagus has healed –Senior or complete feed soaked in warm water –Small frequent meals best No hay or grass

20. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Prevention Proper dental care –Yearly exams and floating –More frequent in older horses Rapid eaters –Feed separately to avoid competition –Place large rock or salt block in bucket Good quality hay Avoid grass clippings

21. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences

22. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Prevention Older horses or horses with previous choke –Avoid dry pelleted feeds and beet pulp –Moisten prior to feeding. Avoid hay cubes or large fibrous horse treats if new to horse

23. University of Tennessee College of Veterinary Medicine Department of Large Animal Clinical Sciences Tennessee Lottery Winner