Changes

===Treatment===

===Treatment===

In the horse, treatment is usually conservative as most obstructions resolve spontaneously or with medical treatment. Treatment comprises passage of a nasogastric tube followed by intraluminal oesophageal lavage. Before attempting this procedure it is important to ensure that the horse is well sedated (with its head below the thoracic inlet) so that the risk of aspiration is minimised. The administration of oxytocin may be beneficial, particularly in animals with cranial onstructions. If conservative treatment fails to resolve the problem, surgery to remove the obstruction may be required. Careful consideration should be given before embarking such treatment due to the high complication rate associated with oesophageal surgery.  

In the horse, treatment is usually conservative as most obstructions resolve spontaneously or with medical treatment. Treatment comprises passage of a nasogastric tube followed by intraluminal oesophageal lavage. Before attempting this procedure it is important to ensure that the horse is well sedated (with its head below the thoracic inlet) so that the risk of aspiration is minimised. The administration of oxytocin may be beneficial, particularly in animals with cranial onstructions. Following removal of the obstruction, analgesia may be provided using a non-steroidal anti-inflammatory drug such as flunixin. Possible recurrence of an obstruction may be avoided by withholding dry food for 72 hours. Initially, fluids only should be offered, folllowed by gradual introduction of soft foods such as bran mash. Small amounts of hay or haylage may be added gradually. Following treatment of the impaction, it may be beneficial to perform an endoscopic exam of the oesophagus. This aids in identifying any areas of inflammation or ulceration that may require further treatment.

 

If conservative treatment fails to resolve the problem, surgery to remove the obstruction may be required. Careful consideration should be given before embarking such treatment due to the high complication rate associated with oesophageal surgery.  

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.

===Prognosis===

===Prognosis===

In the horse, the prognosis for a complete recovery after an episode of choke is good. Possible recurrence of an obstruction may be avoided by withholding dry food for 72 hours. Initially, fluids only should be offered, folllowed by gradual introduction of soft foods such as bran mash. Small amounts of hay or haylage may be added gradually. Following treatment of the impaction, it may be beneficial to perform an endoscopic exam of the oesophagus. This aids in identifying any areas of inflammation or ulceration that may require further treatment.

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 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.  

===References===

===References===

[[Category:Oesophagus_-_Pathology]][[Category:Cattle]][[Category:Horse]] [[Category:To_Do_-_Review]]

[[Category:Oesophagus_-_Pathology]][[Category:Cattle]][[Category:Horse]] [[Category:To_Do_-_Review]]

]][[Category:To_Do_-_SophieIgnarski]]

[[Category:To_Do_-_SophieIgnarski]]