Choke in Horses

What choke is, the signs to look for, and why you should phone your vet as soon as you suspect it.

Quick Answer

Choke is a blockage of the oesophagus (food pipe), not the windpipe, so a choking horse can usually still breathe but cannot swallow properly.
Contact your vet as soon as you suspect choke, and do not wait to see whether it clears.
While you wait, take away all food, and keep your horse calm and quiet.
Do not flush the blockage with a hose, bottle or syringe, or force liquids into the mouth, because liquid can be inhaled and cause pneumonia. Do not give medicine either.
Even if the choke clears quickly, tell your vet, because pneumonia can take days to appear.

Choke in horses happens when food or another object lodges in the oesophagus, the muscular tube that connects the mouth to the stomach. Unlike a person who chokes, a horse can still breathe, because the windpipe stays clear.

However, UK sources still treat choke as an emergency. The horse cannot swallow, and food and saliva can be inhaled into the lungs. The risk of complications also rises the longer the blockage lasts.

Many blockages do clear on their own, but internal damage can occur. For this reason, your vet should always be involved.

Chestnut horses with white blazes leaning over a feeding trough in a yard – choke in horses often happens when feed is eaten too fast

What Causes Choke in Horses?

Eating too fast

The most common cause is a horse eating too quickly, or "bolting" its feed. The food is not chewed or softened, so it forms a firm lump. Concentrated bucket feeds are more likely to cause this than hay or grass.

Feeds that swell

Sugar beet and pellets that are not soaked properly can swell in the oesophagus once they meet saliva, and then get stuck.

Teeth and age

Dental problems or mouth pain lead to poor chewing, and this can cause choke. Older horses are particularly vulnerable. See Dental Problems in Horses.

Row of bay and grey horses seen from behind eating along a wall in a farm yard – choke in horses can be reduced by slowing down fast eaters

Treats and foreign objects

Carrots, apples and other crunchy treats can cause choke. So can foreign objects such as baling twine or a potato. Inappropriate food fed by well-meaning passers-by has also caused cases.

Sedation and thirst

Eating too soon after sedation or anaesthesia can cause choke, because the horse may be unable to chew properly. Tired or dehydrated horses should drink before they eat, and they should be given sloppy, easy-to-swallow feed.

Narrowing and swallowing problems

Some horses have a narrowing (stricture) of the oesophagus, which makes choke more likely. Conditions that affect swallowing, such as grass sickness or neck injuries, also raise the risk.

Signs of Choke in Horses

Signs often appear soon after a feed. Horses cannot vomit, so that is not a sign to look for. Watch for:

Feed and saliva coming from the nostrils, and sometimes the mouth. It is often green, frothy or slimy, and it can be intermittent.
Excessive drooling.
Coughing, gagging or retching.
Repeated attempts to swallow, with the neck stretched out or arched.
Spasms of the neck muscles, and an anxious look.
A hard lump or bulge on the left side of the neck, where the oesophagus runs.
Colic-like discomfort, such as sweating or pawing.

Some horses keep trying to eat despite the blockage, which is hazardous. If the blockage does not shift, most horses lose their appetite and can become dehydrated. Colic-like signs can have other causes too, so see Signs of Colic in Horses.

Emergency: Contact a Vet Immediately If…

You suspect choke, for example feed or saliva is coming from the nose or mouth, or your horse is drooling, retching or stretching its neck.
Your horse is distressed, sweating or pawing, or you can see or feel a lump on the left side of the neck.
Your horse has had choke before and the signs are back.
After a choke, even one that cleared quickly, you notice coughing, a fever, nasal discharge or difficult breathing. These can be signs of aspiration pneumonia.

Call your vet or the nearest out-of-hours emergency vet straight away. Several UK sources give different waiting times, so do not wait to see whether it passes.

When to Contact Your Vet

As soon as choke is suspected, even if your horse seems to be coping.
After any episode that clears on its own, because aspiration pneumonia can take days to develop and your vet may want to act early.
If your horse has repeated or frequent episodes. Your vet will look for underlying causes, such as teeth, a narrowing, or a mass in the throat or oesophagus.
If your horse is prone to choke, so you can agree a plan with your vet in advance.

The vet may talk you through the next steps by phone, or come out to your horse.

What to Do While You Wait for Your Vet

Stay calm. A panicking handler can make the horse more anxious, and the neck muscles need to relax for a blockage to pass.
Take away all food straight away, including edible bedding. Several UK sources also say to remove water, so ask your vet on the phone.
If your horse is at pasture, bring it into a stable or shelter with no food. A muzzle can stop a horse grazing.
Keep the horse quiet, with its head low if possible, so saliva can drain. A companion nearby can help.

What Not to Do

Do not try to flush the blockage with a hosepipe, bottle or syringe. The horse may breathe in the water, which risks aspiration pneumonia.
Do not put a hose or anything else down the throat, and do not force liquid into the mouth.
Do not give oils, drenches or other liquids, or any oral medicine, while waiting for the vet.
Do not bang, hit or force any lump on the neck.
Do not offer food or water to a horse that may still be choking.

How Vets Treat Choke in Horses

Diagnosis is usually based on the signs. Your vet may pass a stomach tube to find the blockage, and may use an endoscope to see it or check for damage.

The vet will usually sedate your horse so that it relaxes and its head can drop, which reduces the inhaling of food and saliva. They may also give a medicine to relax the oesophagus. If the blockage stays put, a stomach tube is passed and water is used to soften and flush it. This can take a long time and needs patience.

Fluids may be given into a vein, and antibiotics may be needed if there is a risk of pneumonia. Most cases resolve with simple treatment on the farm. Some need referral hospital care, especially repeat episodes, and rarely a general anaesthetic is needed.

Complications and Recovery After Choke

The biggest practical danger is aspiration pneumonia, caused by food and saliva inhaled into the lungs. It may not show for a few days. Rupture of the oesophagus is rare but can be fatal. Some horses are left with a narrowing from scarring, which can make future choke more likely.

After an uncomplicated episode, the outlook is good. Your vet will tell you how to monitor your horse for several days, including checking its temperature, and what to watch for, such as coughing, fever, nasal discharge or difficult breathing.

Feeding advice after choke differs between sources. Some horses are advised to have a short period without feed, followed by soaked mashes and grass. Therefore, follow your vet's instructions exactly.

Almost every horse must have a passport, and its food-chain declaration decides which medicines may be used. Show it to your vet. In an emergency, vet practices will accept your horse without it, but you are advised to travel with it. If you compete, keep a record of any veterinary treatment and talk to your vet about it before competing, because competition medication rules apply.

Preventing Choke in Horses

Arrange regular dental checks. Senior horses should have dental care every six months.
Soak sugar beet and other expanding feeds thoroughly, following the feed manufacturer's soaking instructions.
Feed hay before concentrates, or add chaff to buckets, so hungry horses do not bolt their feed.
Slow fast eaters with large smooth rocks in the bowl, hay nets or slow feeders, and feed horses apart so they do not rush.
Cut carrots and apples lengthways, and avoid large chunks of solid vegetables.
Always provide clean, fresh water, and forage where possible.
Check feed for foreign objects such as baling twine.
Avoid any feed your horse has choked on before.

Turnout helps too, because it is very difficult to choke on grass.

How Pet Med Direct Can Help

Choke is a situation for your vet first. Please phone them straight away, and do not order or give anything while you wait.

Once your vet has advised, you can browse our equine range, or read how pet prescriptions work with us if a medicine has been prescribed.

Some pet medicines require a valid veterinary prescription. Pet Med Direct can only supply prescription medicines after the prescription has been checked. Always follow your vet's advice and the directions on the medicine label.

Frequently Asked Questions

Can a horse breathe during choke?

Usually yes, because the windpipe is separate from the food pipe. However, food and saliva can be inhaled, so urgent veterinary advice is still needed.

How long can I wait before calling the vet about choke in horses?

Do not wait. Contact your vet as soon as choke is suspected. UK sources give different waiting times, which is why the safest course is to phone straight away.

Can I give my horse something to ease choke?

No. Do not give medicines, oils or other liquids, and do not try to flush the blockage. Leave treatment to your vet, because liquids can be inhaled into the lungs.

Why can't a horse just be sick?

Horses cannot vomit. A horse with choke may retch, and feed and saliva may come out of its nostrils, but food and saliva can also be inhaled into the lungs, so the horse needs help from your vet.

Is choke the same as colic?

No, but some horses with choke show colic-like signs such as sweating and pawing. Either way, phone your vet. See Signs of Colic in Horses.

What happens after a horse has choked?

Your vet will explain how to monitor your horse and how to feed it. Watch for coughing, fever, nasal discharge or difficult breathing, as these can mean aspiration pneumonia, which may appear days later.

Can choke happen again?

Yes. Some horses are prone to repeat episodes, and damage to the oesophagus can make it more likely. If your horse has frequent episodes, ask your vet to look for underlying causes.

Related Equine Health Guides

Sources and Further Reading

This article was researched from the sources listed above. It is general information for horse owners and is not a substitute for advice from your own vet.

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This article is for informational purposes only and does not constitute veterinary advice.
If you are concerned about your horse’s health, please consult a qualified veterinarian.