Medical management of 26 clinical cases of horses with esophageal obstruction treated during a six-year period (2008-2014): review, diagnosis, and protocols used
DOI:
https://doi.org/10.15359/rcv.43-2.1Keywords:
esophageal obstruction, bronchoaspiration, medical management, equinesAbstract
This article addresses esophageal obstruction in horses to raise awareness about the problem, make a specialized literature review on the topic, recommend an early differential diagnosis, and propose therapeutic alternatives for effective management of the situation. Diagnosis relies primarily on a comprehensive medical history and a systematic general clinical examination, supported, in some cases, by laboratory and imaging studies, including radiography, ultrasound scanning, and endoscopy. Medical management should focus on providing adequate metabolic support therapy, correcting the obstruction to prevent permanent esophageal damage, and utilizing systemic antibiotics to address secondary bacterial pneumonia resulting from bronchoaspiration. The article outlines a clinically successful protocol, endorsed by literature and based on over 30 years of the authors’ professional experience.
Downloads
References
Abutarbush, S. M. (2011). Esophageal laceration and obstruction caused by a foreign body in 2 young foals. The Canadian Veterinary Journal = La Revue Veterinaire Canadienne, 52(7), 764-767.
Ainsworth, D. M. & Cheetam, J. (2010). Disorders of the Respiratory System. En S. M. Reed, W. M. Warwick, & D. C. Sellon (Eds.), Equine Internal Medicine (3.a ed.). Saunders-Elsevier.
Akram, J., Amin, F. M., Toft, J. G., & Rømeling, F. (2013). Treatment of foreign body impactions in oesophagus. Ugeskrift for Laeger, 175(10), 640-643.
Alexander, J. E. (1967). Radiologic findings in equine choke. Journal of the American Veterinary Medical Association, 151(1), 47-53.
Allen, T. (2003). Manual of equine dentistry. Mosby.
Baker, G. J., & Easley, J. (2005). Equine dentistry (2.a ed.). Elsevier Saunders.
Berlin, D., Shaabon, K. & Peery, D. (2015). Congenital oesophageal stricture in an Arabian filly treated by balloon dilation. Equine Veterinary Education, 27(5), 230-236. https://doi.org/10.1111/eve.12229
Bezdekova, B. (2012). Esophageal disorders in horses – a review of literature. Pferdeheilkunde Equine Medicine, 28(2), 187-192. https://doi.org/10.21836/PEM20120207
Bezdekova, B. & Janalik, P. (2018). Oesophageal disorders in horses: Retrospective study of 39 cases. Equine Veterinary Education, 30(2), 94-99. https://doi.org/10.1111/eve.12703
Blikslager, A. T. & Jones, S. I. (2010). Enfermedades del esófago. En B. P. Smith (Ed.), Medicina interna de grandes animales (6.a ed., pp. 688-695). Elsevier.
Boerma, S., Back, W., & Sloet Van Oldruitenborgh‐Oosterbaan, M. M. (2012). The Friesian horse breed: A clinical challenge to the equine veterinarian? Equine Veterinary Education, 24(2), 66-71. https://doi.org/10.1111/j.2042-3292.2011.00302.x
Boerma, S. & Sloet van Oldruitenborgh-Oosterbaan, M. M. (2008). Megaoesophagus in the Friesian horse: A hereditary problem? Proceedings of 10th International Congress of World Equine Veterinary Association, 484. http://www.ivis.org/proceedings/weva/2008/shortcom2/19.pdf?LA=1
Breuer, J., Böttcher, D., Reischauer, A., Müller, K., Spallek, A., Recknagel, S., Uhlig, A., & Schusser, G. F. (2011). Retrospective analysis of 74 horses with disorders of the oesophagus: Pferdeheilkunde Equine Medicine, 27(1), 15-25. https://doi.org/10.21836/PEM20110102
Broekman, L. E. M., & Kuiper, D. (2002). Megaesophagus in the horse. A short review of the literature and 18 own cases. Veterinary Quarterly, 24(4), 199-202. https://doi.org/10.1080/01652176.2002.9695136.
Camacho-Luna, P., & Andrews, F.M. (2015). Esophageal Disease P. 274-279 in Robinson Current Therapy in Equine Medicine, 7th ed. Sprayberry & Robinson, Elsevier Inc. https://doi.org/10.1016/C2011-0-05761-7
Campbell-Beggs, C. L., Kiper, M. L., MacAllister, C., Henry, G., & Roszel, J. F. (1993). Use of esophagoscopy in the diagnosis of esophageal squamous cell carcinoma in a horse. Journal of the American Veterinary Medical Association, 202(4), 617-618.
Campbell, N.B. (2003). Esophageal obstruction (ckoke). In: Robinson, N.E., Current therapy in Equine Medicine, 5th Ed. Amsterdam, The Netherlands. Elsevier Sci 90-94
Carlson, G. P. (1996). Fluid and Electrolyte Disturbances. En M. Siegal, J. E. Barlough, & University of California, Davis (Eds.), UC Davis book of horses: A complete medical reference guide for horses and foals (1st ed, p. 241). HarperCollinsPublishers.
Carr, E. A. (2018). Enteral/Parenteral Nutrition in Foals and Adult Horses Practical Guidelines for the Practitioner. Veterinary Clinics of North America: Equine Practice, 34(1), 169-180. https://doi.org/10.1016/j.cveq.2017.11.012
Chiavaccini, L. & Hassel, D. M. (2010). Clinical Features and Prognostic Variables in 109 Horses with Esophageal Obstruction (1992-2009): Esophageal Obstruction in Horses. Journal of Veterinary Internal Medicine, 24(5), 1147-1152. https://doi.org/10.1111/j.1939-1676.2010.0573.x
Chidlow, H. B., Robbins, E. G., & Slovis, N. M. (2017). Balloon dilation to treat oesophageal strictures in five foals. Equine Veterinary Education, 29(11), 609-616. https://doi.org/10.1111/eve.12538
Chow, R. S. (2021). Terms, Definitions, Nomenclature, and Routes of Fluid Administration. Frontiers in Veterinary Science, 7, 591218. https://doi.org/10.3389/fvets.2020.591218
Conwell, R., & McAra, C. (2008). Four cases of oesophageal obstruction in the horse. Companion Animal, 13(9), 9-12. https://doi.org/10.1111/j.2044-3862.2008.tb00533.x
Crabtree, N. E. & Epstein, K. L. (2021). Current Concepts in Fluid Therapy in Horses. Frontiers in Veterinary Science, 8, 648774. https://doi.org/10.3389/fvets.2021.648774
Craig, D. R., Shivy, D. R., Pankowski, R. L., & Erb, H. N. (1990). Esophageal Disorders in 61 Horses: Results of Nonsurgical and Surgical Management. Veterinary Surgery, 18(6), 432-438. https://doi.org/10.1111/j.1532-950X.1990.tb01120.x
Craig, D. & Todhunter, R. (1987). Surgical Repair of an Esophageal Stricture in a Horse. Veterinary Surgery, 16(4), 251-254. https://doi.org/10.1111/j.1532-950X.1987.tb00948.x
Dacre, K. J. P., Pirie, S., & Prince, D. P. (2003). Choke, pleuropneumonia and suspected gentamicin vestibulotoxicity in a horse. Equine Veterinary Education, 15(1), 27-33. https://doi.org/10.1111/j.2042-3292.2003.tb00208.x
Dixon, P. M. & Gerald, M. P. (2012). Oral Cavity and Salivary Glands. P. 339-367 in Equine Surgery, 4th ed. Auer & Stick, ed. Saunders-Elsevier, St. Louis. Missouri.
Dixon, P. M., Du Toit, N. & Staszyk, C. (2013). A Fresh Look at the Anatomy and Physiology of Equine Mastication. Veterinary Clinics of North America: Equine Practice, 29(2), 257-272. https://doi.org/10.1016/j.cveq.2013.04.006
Duncanson, G. R. (2006). Equine oesophageal obstruction: A long term study of 60 cases. Equine Veterinary Education, 18(5), 262-265. https://doi.org/10.1111/j.2042-3292.2006.tb00460.x
Earley, E. T. & Reiswig, J. D. (2020). Equine Dental Floating (Crown Odontoplasty). Veterinary Clinics of North America: Equine Practice, 36(3), 501-526. https://doi.org/10.1016/j.cveq.2020.08.011
Elce, Y. A. (2009). Esophageal obstruction. En N. E. Robinson & K. A. Sprayberry (Eds.), Current therapy in equine medicine (6.a ed.). Elsevier Saunders.
Epstein, K. L. & Hall, M. D. (2022). Effect of Nasogastric Tube Placement, Manipulation, and Fluid Administration on Transcutaneous Ultrasound Visualization and Assessment of Stomach Position in Healthy Unfed and Fed Horses. Animals, 12(23), 3433. https://doi.org/10.3390/ani12233433
Erkert, R. S., MacAllister, C. G., Higbee, R., Moll, H. D., Reiners, S., Crowson, C., Bahr, R., & Bartels, K. E. (2002). Use of a neodymium:yttrium-aluminum-garnet laser to remove exuberant granulation tissue from the esophagus of a horse. Journal of the American Veterinary Medical Association, 221(3), 403-407. https://doi.org/10.2460/javma.2002.221.403
Estrada-McDermott, J., Vargas-Arrieta, J., & Estrada-Umaña, M. (2021). Manual de sujeción, derribo e incorporación en especies mayores. Departamento de Publicaciones, Universidad Nacional. https://repositorio.una.ac.cr/bitstream/handle/11056/23792/2008-20%20Manual-Versi%C3%B3nDigital.pdf?sequence=1&isAllowed=y
Estrada-Umaña, M. (1985). Alambre metálico impactado en ápex del ciego con fístula al exterior [Comunicación personal].
Estrada-Umaña, M. (2014). Melanoma en base del cuello comprimiendo al esófago externamente [Comunicación personal].
Feige, K., Schwarzwald, C., Fürst, A., & Kaser-Hotz, B. (2000). Esophageal obstruction in horses: A retrospective study of 34 cases. The Canadian Veterinary Journal = La Revue Veterinaire Canadienne, 41(3), 207-210.
Freeman, D. E. (2010). Surgery for obstruction of the equine oesophagus and trachea. Equine Veterinary Education, 17(3), 135-141. https://doi.org/10.1111/j.2042-3292.2005.tb00353.x
Fubini, S. L. (2019). Esophagus. En Equine Surgery (pp. 474-496). Elsevier. https://doi.org/10.1016/B978-0-323-48420-6.00030-2
Golenz, M. R., Knight, D. A., & Yvorchuk-St Jean, K. E. (1992). Use of a human enteral feeding preparation for treatment of hyperlipemia and nutritional support during healing of an esophageal laceration in a miniature horse. Journal of the American Veterinary Medical Association, 200(7), 951-953.
Green, E. M. (1992). Esophageal obstruction. En N. E. Robinson & W. B. Saunders (Eds.), Current Therapy in Equine Medicine (3.a ed., pp. 175-184).
Green, E. M. & MacFadden, K. E. (1996). Esophageal disorders of the horse. En B. P. Smith (Ed.), Large animal internal medicine (2.a ed., pp. 698-709). Mosby.
Green, S., Green, E. M. & Aronson, E. (1986). Squamous-Cell Carcinoma—An Unusual Cause of Choke in A Horse. Modern Veterinary Practice, 65, 870-875.
Greet, T. R. C. (1982). Observations on the potential role of oesophageal radiography in the horse. Equine Veterinary Journal, 14(1), 73-79. https://doi.org/10.1111/j.2042-3306.1982.tb02341.x
Hardy, J., Stewart, R. H., Beard, W. L., & Yvorchuk-St-Jean, K. (1992). Complications of nasogastric intubation in horses: Nine cases (1987-1989). Journal of the American Veterinary Medical Association, 201(3), 483-486.
Hudson, N. P. H., McGorum, B. C. & Dixon, P. M. (2010). A review of 4 cases of dysphagia in the horse: Buccal abscess, lingual abscess, retropharyngeal foreign body and oesophageal obstruction. Equine Veterinary Education, 18(4), 199-204. https://doi.org/10.1111/j.2042-3292.2006.tb00446.x
King, J. N., Davies, J. V. & Gerring, E. L. (1990). Contrast radiography of the equine oesophagus: Effect of spasmolytic agents and passage of a nasogastric tube. Equine Veterinary Journal, 22(2), 133-135. https://doi.org/10.1111/j.2042-3306.1990.tb04225.x
Kiper, M. L., Wrigley, R., Traub-Dargatz, J. & Bennett, D. (1992). Metallic foreign bodies in the mouth or pharynx of horses: Seven cases (1983-1989). Journal of the American Veterinary Medical Association, 200(1), 91-93.
Knottenbelt, D., Harrison, L. & Peacock, P. (1992). Conservative treatment of oesophageal stricture in five foals. Veterinary Record, 131(2), 27-30. https://doi.org/10.1136/vr.131.2.27
Koenig, J., & Kimura, S. (2022). Esophageal Obstruction. En Comparative Veterinary Anatomy (pp. 670-678). Elsevier. https://doi.org/10.1016/B978-0-323-91015-6.00147-3
Koenig, J., Silveira, A., Cribb, N. C., Piat, P., Laverty, S., & Sorge, U. S. (2016). Clinical indications, complications, and long-term outcome of esophageal surgeries in 27 horses. The Canadian Veterinary Journal = La Revue Veterinaire Canadienne, 57(12), 1257-1262.
Komine, M., Langohr, I. M. & Kiupel, M. (2014). Megaesophagus in Friesian Horses Associated With Muscular Hypertrophy of the Caudal Esophagus. Veterinary Pathology, 51(5), 979-985. https://doi.org/10.1177/0300985813511126
Lehman, M., Hendrickson, D. & Selberg, K. (2021). Hiatal hernia with focal megaoesophagus in a Friesian stallion. Equine Veterinary Education, 33(9). https://doi.org/10.1111/eve.13300
Livesey, L. C., Yorke, E., Parra, A., Gray, Q., Davies, C., Weldon, D., Schumacher, J., Kimura, S., Howard, C., Sierra‐Rodriguez, T., & Mora‐Pereira, M. (2020). Use of a carbonated beverage to disintegrate a phytobezoar obstructing the intrathoracic portion of the oesophagus of a horse. Equine Veterinary Education, 32(10). https://doi.org/10.1111/eve.13082
Lohmann, K. L., & Cohen, N. D. (2006). Gastrointestinal Medicine. En Equine Geriatric Medicine and Surgery (pp. 115-130). Elsevier. https://doi.org/10.1016/B0-72-160163-4/50012-8
Lohmann, K. L., Lewis, S. R., Wobeser, B., & Allen, A. L. (2010). Penetrating metallic foreign bodies as a cause of peritonitis in 3 horses. The Canadian Veterinary Journal, 51(12), 1400-1404.
Lundström, T,, Lingström. P,, Wattle. O., Carlén, A., Birkhed, D. (2020). Equine saliva components during mastication, and in vivo pH changes in the oral biofilm of sound and carious tooth surfaces after sucrose exposure. Acta Vet Scand 62(1):21. https://doi.org/10.1186/s13028-020-00518-2.
Mace, S., Shelton, G. D. & Eddlestone, S. (2012). Megaesophagus. Compendium (Yardley, PA), 34(2), E1.
Maxwell, J. (2005). The surgical management of oesophageal obstruction in a horse. Australian Veterinary Journal, 83(1-2), 51-53. https://doi.org/10.1111/j.1751-0813.2005.tb12192.x
McAuliffe, S. B. (2014). Knottenbelt and Pascoe’s color atlas of diseases and disorders of the horse (2da ed.). Saunders-Elsevier.
Meyer, G. A., Helms, R. J., Rashmir-Raven, A., & Brashier, M. (1997). Effect of Oxytocin on Contractility of the Equine Esophagus: Treatment for Esophageal Obstruction? Proceedings of the Annual Convention of the AAEP 1997, 43, 336-337. https://www.ivis.org/sites/default/files/library/aaep/1997/Meyer2.pdf
Meyer, G. A., Rashmir‐Raven, A., Helms, R. J., & Brashier, M. (2000). The effect of oxytocin on contractility of the equine oesophagus: A potential treatment for oesophageal obstruction. Equine Veterinary Journal, 32(2), 151-155. https://doi.org/10.2746/042516400777591660
Montero, J., Estrada, J., Estrada, R., Vargas, J., Somarriba, M., Harrington, S., Segura, C., & Estrada, M. (2009). Exodoncia de molares maxilares en equinos mediante repulsión: Descripción de dos técnicas quirúrgicas diferentes. Ciencias Veterinarias, 27(1), 31-42.
Moore, J. N. & Kintner, L. D. (1976). Recurrent esophageal obstruction due to squamous cell carcinoma in a horse. The Cornell Veterinarian, 66(4), 590-597.
Murray, M. J., Ball, M. M. & Parker, G. A. (1988). Megaesophagus and aspiration pneumonia secondary to gastric ulceration in a foal. Journal of the American Veterinary Medical Association, 192(3), 381-383.
Papaefthymiou, A., Koffas, A., Laskaratos, F.-M., & Epstein, O. (2022). Upper gastrointestinal video capsule endoscopy: The state of the art. Clinics and Research in Hepatology and Gastroenterology, 46(3), 101798. https://doi.org/10.1016/j.clinre.2021.101798
Pirie, R. S. & Jago, R. C. (2015). Nutritional support for the dysphagic adult horse. Equine Veterinary Education, 27(8), 430-441. https://doi.org/10.1111/eve.12371
Ploeg, M., Gröne, A., Saey, V., De Bruijn, C. M., Back, W., Van Weeren, P. R., Scheideman, W., Picavet, T., Ducro, B. J., Wijnberg, I., & Delesalle, C. (2015). Esophageal Dysfunction in Friesian Horses: Morphological Features. Veterinary Pathology, 52(6), 1142-1147. https://doi.org/10.1177/0300985814556780
Prange, T. (2013). Clinical Commentary: Small colon obstructions in foals. Equine Veterinary Education, 293-296.
Prutton, J. S. W., Marks, S. L. & Aleman, M. (2015). Endoscopic Balloon Dilation of Esophageal Strictures in 9 Horses. Journal of Veterinary Internal Medicine, 29(4), 1105-1111. https://doi.org/10.1111/jvim.13572
Reed, S. K. (2015). Milk regurgitation caused by oesophageal stricture in foals. Equine Veterinary Education, 27(5), 237-239. https://doi.org/10.1111/eve.12305
Reichelt, U., Hamann, J. & Lischer, C. (2012). Balloon dilation of oesophageal strictures in two horses. Equine Veterinary Education, 24(8), 379-384. https://doi.org/10.1111/j.2042-3292.2011.00297.x
Roberts, M. C. & Kelly, W. R. (1979). Squamous cell carcinoma of the lower cervical oesophagus in a pony. Equine Veterinary Journal, 11(3), 199-201. https://doi.org/10.1111/j.2042-3306.1979.tb01343.x
Sánchez, L. C. (2018). Disorders of the Gastrointestinal System. In S. M. Reed, W. M. Warwick, & D. C. Sellon (Eds.), Equine Internal Medicine (pp. 709-842). Elsevier. https://doi.org/10.1016/B978-0-323-44329-6.00012-7
Santos, A., Martin, M., Vieitez, V., Jiménez, J., & Ezquerra, L. J. (2010). Revisión de las complicaciones en las obstrucciones esofágicas. Revista Electrónica de Veterinaria, 11(9). https://www.redalyc.org/pdf/636/63615732002.pdf
Schmitt, E., Weil, M., Tellhelm, B., & Litzke, L.-F. (1999). Foreign body obstruction of the small colon in foals: Pferdeheilkunde Equine Medicine, 15(5), 419-422. https://doi.org/10.21836/PEM19990503
Scott, E. A., Snoy, P., Prasse, K. W., Hoffman, P. E., & Thrall, D. E. (1977). Intramural esophageal cyst in a horse. Journal of the American Veterinary Medical Association, 171(7), 652-654.
Sisson, S. (1975). Equine digestive system. En R. Getty (Ed.), Sisson and Grossman’s the anatomy of domestic animals. W. B. Saunders.
Speirs, V. C., Wrigley, R. H., & Mueller, G. E. (1997). Clinical examination of horses (7.a ed.). W. B. Saunders.
Stucchi, L., Zucca, E., Stancari, G., Conturba, B., Roncon, S., Ferro, E., Gualtieri, M., & Ferrucci, F. (2017). Conservative treatment of acquired oesophageal strictures by endoscopic‐guided balloon dilation in two horses. Equine Veterinary Education, 29(5), 259-265. https://doi.org/10.1111/eve.12433
Swain, J. M., McGorum, B. C., Scudamore, C. L., & Pirie, R. S. (2010). Persistent oesophageal obstruction (choke) associated with a diverticulum of the terminal oesophagus in a pony. Equine Veterinary Education, 16(4), 195-198. https://doi.org/10.1111/j.2042-3292.2004.tb00297.x
Terron-Canedo, N., Compostella, F., Hill, A., Roberts, V. L. H., & Tremaine, H. T. (2011). Case Report: Successful endoscopic removal of a foreign body in a young horse with oesophageal obstruction. Companion Animal, 16(9), 4-6. https://doi.org/10.1111/j.2044-3862.2011.00122.x
Traver, D. S., Egger, E. & Moore, J. N. (1978). Retrieval of an esophageal foreign body in a horse. Veterinary Medicine, Small Animal Clinician: VM, SAC, 73(6), 783-785.
Tremaine, W., Dixon, P., McGorum, B., & Watt, N. (1995). Pleuropulmonary abscessation in a horse caused by a gastric foreign body. Veterinary Record, 136(25), 637-638. https://doi.org/10.1136/vr.136.25.637
Van der Kolk, J. H., Ploeg, M., Back, W., De Bruijn, C. M., & Wijnberg, I. D. (2011). Needle electromyography of the oesophagus in Friesian horses with and without oesophageal dysfunction. Proceedings of American College of Veterinary Internal Medicine, Annual Forum, Denver, USA. http://www.acvim.org/websites/forum2011/index.php?p=48
Vance, S.J., McDonald, R.E., Cooper, A., Smith, B.O., Kennedy. M.W. (2013). The structure of latherin, a surfactant allergen protein from horse sweat and saliva. J R Soc Interface. 10(85):20130453. https://doi.org/10.1098/rsif.2013.0453.
Watson, T. & Sullivan, M. (1991). Effects of detomidine on equine oesophageal function as studied by contrast radiography. Veterinary Record, 129(4), 67-69. https://doi.org/10.1136/vr.129.4.67
Woodford, N. S., Randle, T. J. L. & McCluskie, L. K. (2010). Diagnostic investigation and surgical management of an oesophageal mural inclusion cyst in a pony yearling. Equine Veterinary Education, 22(4), 165-169. https://doi.org/10.1111/j.2042-3292.2010.00038.x
Wooldridge, A. A., Eades, S. C., Hosgood, G. L., & Moore, R. M. (2002a). Effects of treatment with oxytocin, xylazine butorphanol, guaifenesin, acepromazine, and detomidine on esophageal manometric pressure in conscious horses. American Journal of Veterinary Research, 63(12), 1738-1744. https://doi.org/10.2460/ajvr.2002.63.1738
Wooldridge, A. A., Eades, S. C., Hosgood, G. L., & Moore, R. M. (2002b). In vitro effects of oxytocin, acepromazine, detomidine, xylazine, butorphanol, terbutaline, isoproterenol, and dantrolene on smooth and skeletal muscles of the equine esophagus. American Journal of Veterinary Research, 63(12), 1732-1737. https://doi.org/10.2460/ajvr.2002.63.1732
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ciencias Veterinarias
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 Unported License.
Licensing of articles
All articles will be published under a license:
Licencia Creative Commons Atribución-NoComercial-SinDerivadas 3.0 Costa Rica.
Access to this journal is free of charge, only the article and the journal must be cited in full.
Intellectual property rights belong to the author. Once the article has been accepted for publication, the author assigns the reproduction rights to the Journal.
Ciencias Veterinarias Journal authorizes the printing of articles and photocopies for personal use. Also, the use for educational purposes is encouraged. Especially: institutions may create links to specific articles found in the journal's server in order to make up course packages, seminars or as instructional material.
The author may place a copy of the final version on his or her server, although it is recommended that a link be maintained to the journal's server where the original article is located.
Intellectual property violations are the responsibility of the author. The company or institution that provides access to the contents, either because it acts only as a transmitter of information (for example, Internet access providers) or because it offers public server services, is not responsible.
