The entire barn felt sorry for poor little Missy today. The 44-year-old Shetland pony suffered from choke, and the veterinarian was just finishing up his evaluation as she was still under anesthesia.

Missy is at increased risk for choke because, at her age, she has few teeth left in her mouth. When a horse or pony suffers choke, the esophagus is blocked, usually by food. Unlike in people, choke in horses doesn’t block the windpipe, so the horse is still able to breathe, though he is unable to swallow. This inability to swallow creates some of the signs of choke: food and froth coming from the mouth and in some cases from the nostrils. Though chock conditions can resolve on their own, waiting too long for attention can lead to aspiration pneumonia if food travels up the nasal passages then down the trachea into the lungs.

Risk factors for choke include dental problems, such as Missy’s, and horses who do not chew their food well of who bolt their food down because of competition for food with other horses. Dry food, such as unsoaked beet pulp or pellets that expand with water, can also cause choke. Additionally, horses that eat foreign objects, like wood or dirt, or who crib, are at greater risk for developing choke.

Signs of choke include: discharge or drooling from mouth, discharge from nostrils, extended neck and head, coughing, difficulty swallowing, distress (elevated heart rate) or physical signs of pain. The blockage may also be visible on the side of the neck.

What you should do if you suspect choke: remove any food and water and call your veterinarian. In Missy’s case, her stablemate was also removed from the stall so she had a quiet place to be carefully watched. The veterinarian sedated her and gave her medication that helps the esophagus muscles to relax. Sometimes that’s enough to get the blockage to move further down the passage toward the stomach.  If not, the veterinarian may also send a stomach tube in through a nostril and down the esophagus to push the food down. The veterinarian may run warm water through the stomach tube to assist in passing it down. If all fails, surgery, though rare, may be the last option.

The veterinarian may determine a course of antibiotics and antiinflammatories may be necessary to prevent aspiration pneumonia and to reduce any inflammation that could lead to scarring and the increased risk of developing choke again.

Horses suffering choke will typically be fed softened food for a few days thereafter.

Though Missy’s case was clearly a lack of teeth issue, as she is normally fed soft food anyway, there are ways to prevent choke in horses. They include: ensuring 24/7 access to clean water, soaked beet pulp (if that’s what is fed), gradual change of feed when changing, spreading out feeders or place salt blocks in feed bins to slow food bolters down or feed several times a day smaller portions.

Thanks to sharp eyes of her observant owners, Missy is going to be fine.