Fact Sheet Fact sheet Chokeequine Metabolic Choke is a relatively common condition seen in and and is typically caused by obstruction of the oesophagus (food pipe) with food; occasionally a foreign body can be involveds e.g. yndromewood or plastic. Fortunately many cases of chokeEquine resolv eMetabolic quickly and Syndrome spontaneously (EMS) is a condition which has only and only cases in whichbecome the obst recognisedruction lasts in recent for longer years. EMS is usually seen in overweight than 30 minutes are horseslikely to and require ponies. vete Fatrina whichry assistanc is laid edown. around the body becomes It is important to notehormonally that this is active not the and same excretes as the hormone-like chemicals which interfere with life-threatening conditionnormal in sugarhuman ands, where metabolism. the term The result is an individual that continues to put on weight “choke” refers to bloandckage will, of eventually, the windpipe show rather signs than of laminitis.the It has similarities to in humans. oesophagus. This difference means that unlike humans, EMS in natural living, wild, native ponies is normal. It allows them to put on weight in the horses with choke can still breathe. summer and then use these fat reserves in the winter months when food is in shorter supply. Our domestication of and ponies – rugging up and liberal feeding all year round – interferes with this natural mechanism.

CliniCal signs: Diagnosis

Clinical signs: • overweight As well as the clinical signs, laboratory tests • firm and sensitive fat on neck crest can be helpful in confirming a diagnosis. A • difficulty/repeated attempts at raised resting blood glucose and/or level swallowing • stilted gait may be an indicator of EMS. • heat in feet • stretching/arching of the neck • increased digital pulses. A more sensitive test is the glucose tolerance • coughing test, which mimics the horse’s response to eating a sugary feedstuff (e.g. grass). The • food & saliva discharging from the nose patient is starved for 6 – 8 hours overnight, • drooling How does then given a fibre-based feed (e.g. chaff) with • disinterest in food a measured amount of glucose added, or REGULAR DENTAL EXAMINATIONS AND alternatively can be given corn syrup by syringe • occasionally a lump may be seen or felt TREATMENTEMS CAN causeREDUCE THE laminitis?RISK OF CHOKE into the mouth. A blood sample is taken at a on the left side of the neck. It is not fully understood exactly how EMS leads fixed interval afterwards. An excessively raised If you suspect your horse is suffering from KEY POINTSto laminitis. One of the features of EMS is insulin glucose/insulin level in this sample gives a very choke it is important to prevent your horse resistance. This shifts the metabolism away from strong indication of and EMS. breakdown and uptake into cells. Instead, the eating as this will make the blockage worse • Don’t panic! Choke is rarely life-threatening and and more difficult to clear. metabolism becomes physiologically “stressed” and many casesrelies will on resolcortisolve spontaneouslevels to drively .breakdown of fat into If the obstruction doesn’t clear quickly of its fatty acids. A side-effect of the high levels is • Seek veterinary advice if the choke lasts more than Key points: own accord then veterinary assistance must 30 minutesthought and tow hilebe anwaiting alteration for the in vtheet rembloodove flow all to the feet, be sought. There are a number of steps food to prin eturn,vent leadingyour ho rtose laminitis. eating and worsening your vet can take to help to confirm and treat the obstruction • EMS can affect all ages of horse / and the problem. mares / geldings / stallions; • Following an episode of choke it is worth monitoring Horses and ponies with dental problems • affected individuals are usually overweight; your horse’s respiratory rate (normal <16 breaeths/Ms in natural (that prevent them grinding their food min) and rectal temperature for several days. living native • affected individuals are more susceptible to properly), individuals that bolt their food too laminitis; Arrange regular dental check-ups for your horse ponies quickly and those fed dry pelleted or cubed • is a MeChanisM to to reduce the risk of choke as a result of a painful • laboratory tests are needed for accurate feeds are all at increased risk. Cope with FooD diagnosis; mouth. sCarCity in the winter Months • EMS can be successfully managed.

XLEquine - Better Together XLEquine - Better Together XLEquine equine Metabolic Medical Conditions Fsactyndrome Sheet MC

Our knowledge of laminitis prevention and control has treatment improved following the discovery of EMS. This has led us to understand that it is not the grass that causes the laminitis, but & preventionChokemore the individual’s hormonal / metabolic response to eating As with managementCho ofk typee is 2a relatively commonthe grass condition that causes seen the in problem.horses diabetes in humans,and the ponies key to and is typicallyFor caused those that by suffer obst r/uction have suffered of the EMS, dietary restriction controlling EMS is dietaryoesophagus control (food pipe) withand exercisefood; occasionally should be a permanenta foreign feature in their and exercise. The dietbody must can be be involved e.gfuture. wood management. or plastic. Fortunately reduced so that the maindividualny cases is of choke resolve quickly and spontaneously being fed a fibre based diet of the correct amount. It isand very onlyuseful cases to in which the obstruction lasts for longer have weigh scales tothan measure 30 mi thenutes are likely to require veterinary assistance. amount of hay / haylageIt is beingimpo rfed.tant to note that this is not the same as the A weigh tape or accesslife-threatening to weigh condition in humans, where the term scales can be extremely“cho usefulke” re inf ers to blockage of the windpipe rather than the monitoring the horse/pony and allow fine tuning of the dietoesophagu if required. s. This difference means that unlike humans, horses with choke can still breathe. Exercise is very beneficial, as it improves the body’s sensitivity to insulin. It can be difficult to implement exercise initially if the individual is suffering from laminitis. In these cases, exercise should not be forced, since the complications of a worsening laminitis are much more detrimental to the patient. Dietary ManageMent anD exerCise are the Key to Managing eMs Clinical signs:Opinions vary on the usefulness of • difficulty/repeated metforminattempts a ast a medication to aid swallowing in the control of EMS. It is given as • stretching/arching tabletsof the neorally,ck in feed, and the exact mechanism of action is unclear. It is • coughing thought the metformin may reduce • food & saliva dischargingabsorption from of the glucose nose from the gut. In many cases, metformin is only • drooling used when exercise is not an option • disinterest in food due to laminitis. REGULAR DENTAL EXAMINATIONS AND • occasionally a lumpAs m withay be those seen humans or felt suffering TREATMENT CAN REDUCE THE RISK OF CHOKE on the left side of thetype ne 2c diabetes,k. horse / ponies with EMS should not be given sweet If you suspect your hosugaryrse is su feedsffering or from tit-bits as these KEYwill POINTS choke it is important toresult prevent in an your insulin horse surge which is eating as this will make the blockage worse undesirable. • Don’t panic! Chokreegular is rarely weight life-thre aMteningonitoring and is iMportant and more difficult to clear. many cases will resolve spontaneously.

If the obstruction doesn’t clear quickly of its • Seek veterinary advice if the choke lasts more than 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 bre aths/ (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 veterinaryrisk. profession made up of independently owned,to reduce the risk of choke as a result of a painful progressive veterinary practices located throughout themouth. United 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