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Discussion on Plan of Care After Prolonged Choke

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Melissa
Member
Username: Melis

Post Number: 13
Registered: 8-2002
Posted on Wednesday, Jul 23, 2003 - 11:43 am:   Edit PostPrint Post

Hi, we are new to the area and my 11 yo TWH experienced a choking episode this past Monday night (7/21/03). I called the vet(s) that night but by the time they had called me back, he seemed much calmer. They didn't come out to check and I didn't know enough to insist that they do. Anyway, by the next day, Harley's temp was 103.6, he was dehydrated and his respirations were in the 50's.

I was able to contact another vet group and they came out to treat him. By the time the blockage was cleared it had been about 17 hours. The blockage was low, near the base of the neck. But the doc thinks that it started high and then got stuck lower in his throat so that's why he appeared to be ok initially.

I'm now treating him with Pencillin, Gent, and Flagyl along with bute. He's remained afebrile but his respirations are still a little high (35-40). He's to remain in his stall for 48 hours with only water and/or water with gatorade. I don't have any bare turn out areas. I can hand walk him, if I want to.

Since I don't know this vet very well and I have never had this problem, I would like a second opinion, please. My question is: what is the normal plan of care after prolonged choke? How soon would I see signs/symptoms of pneumonia and/or esophogeal damage?

Thank you.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 8815
Registered: 1-1997
Posted on Thursday, Jul 24, 2003 - 6:35 am:   Edit PostPrint Post

Melissa I often have the same thing happen: get called for a choke >> the horse is better by the time I call >> I advise to be sure the appetite has returned and keep an eye on them.

I come out if the horse does not eat or the profuse discharge starts up again when he eats. I have not had any problems managing chokes this way. Did your horse return to eating following the choke episode?

There is no special plan after 17 hours of choke. I think antiinflammatory therapy and antibiotics are sensible. You have already seen signs of pneumonia: high respiration and fever. The esophageal damage is hard to predict because it depends on how badly damaged it is but after a week off the antibiotics it is much less likely.
DrO
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Melissa
Member
Username: Melis

Post Number: 14
Registered: 8-2002
Posted on Thursday, Jul 24, 2003 - 9:29 am:   Edit PostPrint Post

Dr. O,
Thanks for the prompt reply. I've been feeling like a bad owner for not insisting the vets come out and check him. Yesterday (the day after they cleared the obstruction) Harley was not drinking or eating. I was instructed to offer him shedded carrots with applesauce. He would lick a little of the concoction off of my hand but wanted nothing to do with the mixture in his feed bin and his water and water with gatorade went untouched.

I did take him out for a walk and he acted normal. He even tried to eat some grass but I wouldn't let him since I was instructed not have him eat anything except the carrot mixture. I called the vet and left a message but she didn't return the call. I wasn't sure if not drinking was considered an emergency. His TPR were/are normal.

This morning I took him out of the stall and let him graze for 15 min. I wanted to make sure he would and could eat. He did well. I then offered him a little more of the carrot/apple stuff and he ate that.

Could the flagyl be the reason he's not drinking? I was giving him 12 500 mg tab every 6 hours for 24 hours and then I'm to give him 6 tabs every 6 hours. He weights about 825 lbs.

Maybe it still hurts to swallow? I am only giving him 1 gm of bute 2x/day so as not to mask a fever. I wish he could just tell me the problem!

The vet is supposed to do a follow up exam in the afternoon.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 8823
Registered: 1-1997
Posted on Thursday, Jul 24, 2003 - 5:26 pm:   Edit PostPrint Post

Was he eating between the initial incidence of choke and when he becamce obviously ill? Are you putting the flagyl in the water?
DrO
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Melissa
Member
Username: Melis

Post Number: 15
Registered: 8-2002
Posted on Thursday, Jul 24, 2003 - 10:56 pm:   Edit PostPrint Post

His appetite was good prior to the choke but has not been since. I didn't see him eat between the time he initially choked and the next morning when I found him in trouble. I'm mixing his flagyl with apple cider vinegar and giving it by syringe.

He's eating just a mouthful of soupy pellets here and there and is drinking a small amount. His TPR have been normal.

If I may just ask one more question, the vet says I need to keep him in the stall for 2-3 more days and to only feed him the pellet soup and water. I can take him out for walks. I understand the rationale for not wanting him to rechoke but I thought it was unusual to have horses choke on grass. I walked him this evening and he was acting a starving man looking at a steak dinner. He did manage to get a mouthful of grass here and there since I had to walk across the large pasture to get to the road. He didn't seem to have any problem swallowing the grass. I feel badly leaving him in the stall with the feed he's not eating when he's obviously hungry.

Thanks...I promise that was the last question.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 8826
Registered: 1-1997
Posted on Friday, Jul 25, 2003 - 7:10 am:   Edit PostPrint Post

Seeing him eat after the first episode and before you found him in distress puts the diagnosis of long term choke as a cause of the distress in question and at the very least indicates that he may have rechoked that night. I am not sure that your secondary problem was not aspiration pneumonia.

Though I agree with you assesment that he is unlikely to choke on pasture (I have seen horses choke on grass cuttings), I am unable to see your horse and you should follow your vets recommendation. Pneumonia's do best rested.
DrO
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Elizabeth Donahue
Member
Username: Paul303

Post Number: 366
Registered: 9-2002
Posted on Monday, Jul 28, 2003 - 10:02 pm:   Edit PostPrint Post

Melissa: Why are you mixing the flagyl with apple cider vinegar? That might be a bit rough on a traumatized esophagus.
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Tami Cascio
Member
Username: Tcascio

Post Number: 3
Registered: 6-2004
Posted on Sunday, Jul 3, 2005 - 12:09 pm:   Edit PostPrint Post

My horse chocked yesterday. I think it happened that morning or over night. He was foaming and drooling from the mouth. He tried to eat but chewed it and then spit it all out. He was opening his mouth wide and acting like he was chocking. The vet came out at night and cleared it with a tube. He immediately stopped drooling but he doesn't look like he feels very well. We gave him bute last night and again this morning. I went out and gave him some wet oats and his bute. He tried to eat a little but seemed in pain when he swollowed. He was pawing a little then he went and laid down. Any suggestions??? Do I call the vet out again? Is this normal behavior? I am going back out to see if he is eating any better after the bute had a chance to work.
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Vicki Zaneis
Member
Username: Vickiann

Post Number: 69
Registered: 3-2005
Posted on Sunday, Jul 3, 2005 - 1:29 pm:   Edit PostPrint Post

Over ten years ago a horse of mine had a "probable choke" (he was attacked by another horse while eating his grain) that lasted a few days. He never developed a fever or anything, so must not have aspirated anything into the lungs. When it was finally cleared (tubing by Vet. -- not done earlier because it was not realized it was choke), he was given an injection of some kind of steroid to reduce inflammation. After that he was perfectly fine, soon resumed eating and drinking, and he has never experienced another episode of choke.
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Sara Wolff
Member
Username: Mrose

Post Number: 764
Registered: 1-2000
Posted on Sunday, Jul 3, 2005 - 2:08 pm:   Edit PostPrint Post

After a severe case of choke one of our horses was off his feed for about a day. He was a little "droopy" but never ran a fever, and never laid down. He did drink. I suspect his throat was sore. He started eating again the second day after treatment. I started him on dampened grass hay and worked him back into his normal feeding routine.

If your horse doesn't eat after a while I'd check with your vet. He might need to see him again. If he has a fever, any wheezing or coughing, any nasal discharge, or looks ill at all, I'd call the vet and have him come back out. He might still have some choke, or might be getting pneumonia from aspirating some of the material he choked upon.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 13283
Registered: 1-1997
Posted on Monday, Jul 4, 2005 - 11:16 am:   Edit PostPrint Post

Tami if your horse is still in some distress I would have him checked again, perhaps something a bit stronger for the pain and inflammation or if there are signs of infection antibiotics.
DrO
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