Fact Sheet Fact Sheet Choke Choke is a relatively common conditionHeadshaking seen in and ponies and is typically caused by obstruction of the oesophagus (food pipe) with food; occasionally a foreign body can be involved e.g. wood or plastic.Syndrome Fortunately many cases of choke resolve quickly and spontaneously and only cases in which the obstructionHeadshaking lasts for longer sounds such an innocuous term but it can make the affected than 30 minutes are likely to require veterinaryhorse’s life assistance. a misery and render them un-rideable. It is important to noteHorses that thismay is shake not the their same heads as the for a variety of reasons: for example due to pain in the mouth life-threatening conditionor back. in Inhumans, some, itwhere may bethe a term response to stress or in anticipation of food or exercise. All of “choke” refers to blockagethese are of voluntarythe windpipe actions; rather the than the is choosing to toss his head. Headshaking syndrome is oesophagus. This differencedifferent, it means is an involuntary that unlike actionhumans, thought to be caused by pain in a nerve supplying the face. horses with choke can still breathe. Cause Clinical signs The condition is thought to be similar to trigeminal Typical headshaking behaviours include: neuralgia in people. The site of the pain (muzzle and • repetitive involuntary sudden violent vertical nose) is not the source of the pain which is within a downward flick of the nose; branch of the trigeminal nerve, deeper in the horse’s head. • rubbing nose and muzzle on foreleg; The trigeminal nerve is a sensory nerve receiving • usually worse during exercise; information from the head and sending messages Clinical signs: • sneezing, snorting; • difficulty/repeated attempts at to the brain. In headshaking syndrome this nerve swallowing is hypersensitive and fires at inappropriately low • runny eyes, runny nose; inputs. Nerve pain is described by people as • stretching/arching of the neck • seasonal; one third are affected during spring and itching, tingling, electric shock-like sensations, summer only; • coughing which could explain the sudden violent reflex actions exhibited by headshaking horses. • more common in ; • food & saliva discharging from the nose Keeping a diary can help identify trigger factors • photophobia (squinting in bright sunlight or drooling • such as sunlight, rain, wind, pollen, flies or less seeking shade), in some cases. • disinterest in food commonly eating or sound. Sunlight is a key trigger REGULAR DENTAL EXAMINATIONS AND There is a huge spectrum in the severity of signs in some horses and most of the others are also • occasionally a lump may be seen or felt TREATMENT CAN REDUCE THE RISK OF CHOKE shown, from the occasional twitch to horses who are more likely to be present in the spring and summer on the left side of the neck. obviously very distressed and can become dangerous which may contribute to the seasonal nature of the to ride or will rub the sides of their faces so hard they If you suspect your horse is suffering from KEY POINTScondition in some cases. will mutilate themselves. choke it is important to prevent your horse Some researchers have suggested a link to equine eating as this will make the blockage worse • Don’t herpespanic! Chokevirus (EHV) is rarely however life-threatening a study investigating and and more difficult to clear. Key pointS manythis cases found will no resolve evidence spontaneously. to support this theory. If the obstruction doesn’t clear quickly of its • Seek veterinary advice if the choke lasts more than • Headshaking is an involuntary action own accord then veterinary assistance must 30 minutes and while waiting for the vet remove all • Horses display a vertical flick of the head and be sought. There are a number of steps food to prevent your horse eating and worsening nasal irritation. your vet can take to help to confirm and treat the obstruction the problem. • Signs are usually worse during exercise and Following an episode of choke it is worth monitoring • may be seasonal. Horses and ponies with dental problems your horse’s respiratory rate (normal <16 breaths/ (that prevent them grinding their food min) and rectal temperature for several days. • The condition is thought to be due pain from properly), individuals that bolt their food too the nerve supplying the face. quickly and those fed dry pelleted or cubed • Arrange regular dental check-ups for your horse feeds are all at increased risk. to reduce the risk of choke as a result of a painful • Nose nets provide relief in some horses. mouth. • There is currently no reliable cure but the pHotopHobia (Squinting in SunligHt) condition can be successfully managed in some cases.

XLEquine - Better Together XLEquine - Better Together XLEquine Headshaking Syndrome Miscellaneous Fact Sheet M Diagnosis treatment/prevention: Your vet will take a careful history including how long • minimise known trigger factors; if light is a you have owned the horse,Choke when signs started and trigger avoid riding in bright sunlight or use a UV if there are any triggers.Choke is a relatively common conditionblocking seen face in horsesmask; A full clinical examinationand including ponies examinationand is typically of caused• byuse obstruction of a nose net of improves the symptoms in 75% of the ears, eyes and mouthoesophagus will be completed (food pipe)to rule with food; occasionallysufferers, this amay foreign act by reducing the contact out other possible causes.body If itcan is safe be involvedto do so, the e.g. wood or plastic.of irritants Fortunately with the nose, by warming and vet may want to see the horse ridden or exercised. slowing the air entering the nasal cavity and/or Further tests which canmany help rule cases out otherof choke causes resolve quicklydampening and spontaneously down the nerve response by the include endoscopic examinationand only of cases the nasal in which cavity the obstructioncontact lasts of the for material longer with skin. and x-rays of the head and sinuses. than 30 minutes are likely to requireOther treatmentsveterinary that assistance. may help in some cases The characteristics of theIt iscondition important means to thatnote the that this isinclude: not the same as the vet may make the diagnosislife-threatening from their examination condition in humans, where the term • magnesium supplements; alone however sometimes“choke” local anaesthetic refers to mayblockage be of the windpipe rather than the injected behind the eye tooesophagus. abolish sensation This from difference the means• ; that unlike humans, trigeminal nerve. If the headshaking signs improve • human drugs such as , tegretol in response to this nerve horsesblock, it addswith chokeweight tocan the still breathe. and ; diagnosis. • acupuncture; • surgery to insert a coil around the nerve; • electrical nerve stimulation; • pulsed steroid therapy. Some horses with the condition deteriorate and may have to be euthanased on humane grounds or Clinical signs: because they become difficult to handle. • difficulty/repeated attempts at swallowing • stretching/arching of the neck Dental exaMination anD treatMent will coughing • oFten ForM part oF tHe inveStigation oF • food & saliva discharging fromHea theD SH noseaKing SynDroMe • drooling • disinterest in food REGULAR DENTAL EXAMINATIONS AND • occasionally a lump may be seen or felt enDoTREATMENTSCopy CAN REDUCE THE RISK OF CHOKE on the left side of the neck. oF tHe naSal If you suspect your horse is suffering from KEYCavity POINTS Can choke it is important to prevent your horse Help rule eating as this will make the blockage worse • outDon’t ot panic!Her Choke is rarely life-threatening and and more difficult to clear. manyCauSeS cases will resolve spontaneously. tHe uSe oF noSe net iMprove SignS in a If the obstruction doesn’t clear quickly of its • Seek veterinary advice Sifigni the FiCchokeant lasts proportion more than oF SuFFererS own accord then veterinary assistance must 30 minutes and while waiting for the vet remove all be sought. There are a number of steps food to prevent your horse eating and worsening your vet can take to help to confirm and treat the obstruction the problem. For further information contact your local XLEquine practice: • Following an episode of choke it is worth monitoring Horses and ponies with dental problems your horse’s respiratory rate (normal <16 breaths/ (that prevent them grinding their food min) and rectal temperature for several days. properly), individuals that bolt their food too quickly and those fed dry pelleted or cubed • Arrange regular dental check-ups for your horse XLEquine is a novel and exciting initiative conceived from within feeds are all at increasedthe veterinary risk. profession made up of independently owned,to reduce the risk of choke as a result of a painful progressive veterinary practices located throughout the Unitedmouth. Kingdom, members of XLEquine are committed to working together for the benefit of all their clients. © XLVet UK Ltd. No part of this publication may be reproduced without www.xlequine.co.uk prior permission of the publisher. XLEquine - Better Together XLVetsXLEquine Equine - Better - Better Together. Together. Go Go to www.xlequine.co.ukto www.xlvets.co.uk XLVets Equine - Better Together. Go to www.xlvets.co.uk