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{{review}}
      
Also known as: '''''Choke
 
Also known as: '''''Choke
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==Description==
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==Introduction==
    
Impaction (obstruction) of the oesophagus or 'choke' is the most common oesophageal disease of cattle and horses. Obstruction usually occurs at the level of the thoracic inlet, the base of the heart or the hiatus oesophagus of the diaphragm (i.e. the narrowest points). In horses, causes of choke include consumption of unsoaked sugarbeet, rapid ingestion of roughage (hay), indadequate mastication of food, or rarely the ingestion of a foreign body (e.g. corn cob). Horses that are fed incorrectly or have poor dentition are more prone to developing the condition.  
 
Impaction (obstruction) of the oesophagus or 'choke' is the most common oesophageal disease of cattle and horses. Obstruction usually occurs at the level of the thoracic inlet, the base of the heart or the hiatus oesophagus of the diaphragm (i.e. the narrowest points). In horses, causes of choke include consumption of unsoaked sugarbeet, rapid ingestion of roughage (hay), indadequate mastication of food, or rarely the ingestion of a foreign body (e.g. corn cob). Horses that are fed incorrectly or have poor dentition are more prone to developing the condition.  
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'''Cattle:'''
 
'''Cattle:'''
 
In cattle, rumenal bloat caused by the obstruction is an emergency and requires immediate treatment. This is achieved by trocharisation through the left paralumbar fossa. Once the bloat has been relieved, the obstruction may be manually broken down via percutaneous massage, or may resolve spontaneously due to the large volume of saliva present. As in the horse, a sedative such as xylazine may be administered combined to provide both sedation and muscle relaxation. Broad spectrum antibiotics should be administered if there is any suspicion of aspiration pneumonia.
 
In cattle, rumenal bloat caused by the obstruction is an emergency and requires immediate treatment. This is achieved by trocharisation through the left paralumbar fossa. Once the bloat has been relieved, the obstruction may be manually broken down via percutaneous massage, or may resolve spontaneously due to the large volume of saliva present. As in the horse, a sedative such as xylazine may be administered combined to provide both sedation and muscle relaxation. Broad spectrum antibiotics should be administered if there is any suspicion of aspiration pneumonia.
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In cattle, stomach tube can be used to push the obstructive material down to the rumen. For this procedure, keep the animal head at a 45* angle and place the lubricated stomach tube in the oral cavity and slowly move further down the left side of the neck. Care should be taken not to place the tube inside the trachea. (If the tube enters the trachea accidentally, the operator can notice the wind blowing sound, condensation of the tube if it is transparent and the cow will also show dyspnea. The tube should be withdrawn immediately and correct placement into the oesophagus attempted.) When the tube in the oeasophagus touches the foreign body, resistance can be felt. An attendant standing on the left side of the cow can feel the tube end and the foreign body. Once reached at the particular level, gently push the tube further down to move the foreign body. If the foreign body moves down to the rumen, the operator can see the bloat reducing within few minutes and the animal feels more comfortable. (The tube should be lubricated with any available non toxic lubricants before insertion.)
    
==Prognosis==
 
==Prognosis==
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In the horse, the prognosis for a complete recovery after an episode of simple choke is good. In the cow, the prognosis is good providing minimal manipulation and tissue damage has occurred. A poorer prognosis is associated with prolonged obstruction or perforation of the oesophagus.  
 
In the horse, the prognosis for a complete recovery after an episode of simple choke is good. In the cow, the prognosis is good providing minimal manipulation and tissue damage has occurred. A poorer prognosis is associated with prolonged obstruction or perforation of the oesophagus.  
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==Literature Search==
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{{Learning
[[File:CABI logo.jpg|left|90px]]
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|Vetstream = [https://www.vetstream.com/equis/Content/Disease/dis00728.asp Esophageal impaction]
 
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|literature search = [http://www.cabdirect.org/search.html?q=%28%28title%3A%28Oesophagus%29+OR+title%3A%28esophagus%29%29+AND+title%3A%28impaction%29%29+OR+title%3A%28choke%29 Oesophageal obstruction publications]
 
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}}
Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
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<br><br><br>
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[http://www.cabdirect.org/search.html?q=%28%28title%3A%28Oesophagus%29+OR+title%3A%28esophagus%29%29+AND+title%3A%28impaction%29%29+OR+title%3A%28choke%29 Oesophageal obstruction publications]
      
==References==
 
==References==
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* Hillyer, M. (1995) '''Management of oesophageal obstruction ('choke') in horses''' ''In Practice November 1995, 17:450-457''
 
* Hillyer, M. (1995) '''Management of oesophageal obstruction ('choke') in horses''' ''In Practice November 1995, 17:450-457''
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* Hance, S. R., Noble, J., Holcomb, S, Rush-Moore, B. and Beard, W (1997) '''Treating Choke with Oxytocin''' ''Proceedings of the Annual Convention of the AAEP 1997, 43: 338-339)
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* Hance, S. R., Noble, J., Holcomb, S, Rush-Moore, B. and Beard, W (1997) '''Treating Choke with Oxytocin''' ''Proceedings of the Annual Convention of the AAEP 1997, 43: 338-339
    
* Haskell, S. R. R. (2008) '''Blackwell's Five Minute Veterinary Consult: Ruminant''' ''Wiley-Blackwell''
 
* Haskell, S. R. R. (2008) '''Blackwell's Five Minute Veterinary Consult: Ruminant''' ''Wiley-Blackwell''
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[[Category:Oesophagus_-_Pathology]][[Category:Cattle]][[Category:Expert_Review]]
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{{review}}
[[Category:To_Do_-_SophieIgnarski]]
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[[Category:Oesophageal_Disorders_-_Horse]]
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==Webinars==
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<rss max="10" highlight="none">https://www.thewebinarvet.com/gastroenterology-and-nutrition/webinars/feed</rss>
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[[Category:Oesophagus_-_Pathology]][[Category:Oesophageal Diseases - Cattle]][[Category:Expert_Review - Horse]][[Category:Expert Review - Farm Animal]]
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[[Category:Oesophageal Diseases - Horse]]
 
[[Category:Impaction - Horse]]
 
[[Category:Impaction - Horse]]

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