Esophageal disorders in horses include choking and esophageal narrowing (strictures).
Obstruction of the Esophagus (Choke)
Esophageal obstruction (choke) is a condition in which the esophagus is obstructed by food masses or foreign objects. It is by far the most common esophageal disease in horses. Obstruction is most common when a horse quickly eats dried grains or hay. Diseased teeth can also limit the ability of a horse to chew forage.
The classic sign associated with choke is regurgitation of food through the nostrils. When saliva and food is discharged through the nasal openings, the materials often spill into the airway. This brings on coughing. The horse is anxious and may stretch and arch its neck but may still attempt to continue to either eat or drink. The horse should be moved away from any food or water, or food and water removed from its stall. Objects lodged in the upper esophagus may be felt by the veterinarian during examination. An endoscope may be used to confirm the diagnosis.
Many cases of obstruction caused by greedily eaten grain or hay improve on their own. The horse should be kept off feed and water as directed by a veterinarian. Mild sedatives, muscle relaxants, or smooth muscle stimulants may be prescribed. Horses should be monitored, because recovery may take from a few hours to several days. The longer the obstruction is present, the greater the danger of damage from pressure on the tissues of the esophagus and complications such as aspiration pneumonia (inflammation caused by inhalation of food particles into the lungs).
If the obstruction does not dislodge spontaneously and the horse resists the veterinarian's attempts to insert a feeding tube through the nose, general anesthesia may be necessary. Repeated pumping and siphoning of warm water by the veterinarian usually loosens the impacted food. After the mass has been removed, food should be introduced gradually, as directed. The horse will probably receive injected antibiotics and pain medications, and the esophagus may need to be examined again to monitor healing.
The main complication of choke is aspiration pneumonia caused by inhalation of food. Longterm obstruction can cause tissue death in the esophagus due to prolonged contact with the mass of food. Constrictions of the esophagus from scar tissue can also result.
Some cases of obstruction are not due to food blockage of the esophagus itself. In these other cases, the cause may be injury to the neck or surrounding tissues, leading to constriction of the esophagus. Such cases may be diagnosed from a history of recurrent choke or obstruction. The veterinarian may use x-rays (possibly including contrast material) to locate the site of the obstruction within the esophagus. If the problem is outside of the esophagus, surgery may be necessary to determine and correct it.
Esophageal Strictures (Narrowing)
Esophageal strictures of unknown cause are sometimes seen in foals. Diagnosis can be difficult because the signs are similar to those seen in foals with cleft palates or cysts in the throat. The diagnosis is confirmed by inserting an endoscope (a flexible tube with a tiny camera at the end) to examine the esophagus. If the esophagus is narrowed, the condition is treated either with dilation (stretching of the narrowed region) or with surgery.
Last full review/revision July 2011 by Peter D. Constable, BVSc (Hons), MS, PhD, DACVIM; Gordon J. Baker, BVSc, PhD, MRCVS, DACVS; Joseph A. DiPietro, DVM, MS; Walter Ingwersen, DVM, DVSc, DACVIM; John E. Madigan, DVM, MS; James N. Moore, DVM, PhD; Michael J. Murray, DVM, MS; Sofie Muylle, DVM, PhD; Stanley I. Rubin, DVM, MS, DACVIM; Susan D. Semrad, VMD, PhD, DACVIM; Josie L. Traub-Dargatz, DVM, MS, DACVIM