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soleil2nd
Jun. 7, 2010, 10:39 AM
Sorry if this is long - but it is strange and I thought the more info the better.

Before Christmas my 13 year old QH/Belgian cross mare seemed to have an episode of choke. It cleared without much intervention. She was however off her feed for about a week and not terribly interested for about 2 months. Which is very odd for her - she is usually a very easy keeper and relishes every mouthful. She lost a fair amount of weight, even though we increased her grain. During this time we also found gobs of spit and chewed up hay on the floor in front of her stall. (it looked like it had been coughed up). And we did witness her coughing this up.

In mid April she started to "choke" more often and was bringing up more hay. She lost a huge amount of weight in about a week. I had the local vet have a look and her and draw some blood. Nothing was found.

She continued to get worse and lose more weight. The choking seemed to happen every time she ate. So we took to the local teaching vet college. They scoped her stomach. Even though it had been more than 12 hours since she last ate, her stomach was half full of hay. During the scope, some stomach contents surged up her esophagus. The vet said that she had never seen this in 30 years of practice. They did an ultrasound of her stomach and found it to be enlarged (visable in the 14th intercostal space) They admitted her and tubed her with fluids. It took 4 days for the mass of hay to clear from her stomach. Her bloodwork was all normal. She was then discharged.

We fed her very soupy concentrates in small meals for a few weeks. We have gradually added soaked alfalfa cubes and well soaked hay to her diet. She has put on weight and looks great. However, she is coughing while she is eating and we are finding regurgitated food on the floor again.

I'm at a loss as to what to do next. She is such an easy keeper, that she can't stay at the current amount of concentrates without foundering or becoming obese. (she was getting 25 lbs aday and is now at 15 lbs a day). Has anyone had a similar experience?

HD2008
Jun. 7, 2010, 12:07 PM
Sounds like she may have a smooth muscle problem. I am assuming she does not have any severe dental problems. In small animals, there are a few possible causes for what is known as megaesophagus. One is a neuromuscular disorder known as myasthenia gravis and is considered to be an autoimmune disease. Did the vets say if her espophagus seemed to have normal muscle tone? Many horses that choke repeatedly have either strictures from previous chokes that narrow an area of the esophagus, or they have pockets where the espohagus was stretched out (known as diverticula) where food can get stuck. Some must be maintained on concentrates and/or fresh grass to prevent further episodes. If your horse is an easy keeper, there are many diets available now that will be easier to help keep his/her weight in check. For example, senior diets are designed to able to be fed as the sole source of nutrition and can be soaked easily to make them less likely to become stuck. Small frequent meals (make sure the horse eats slowly and doesn't bolt feed -can place large rocks in feed dish to make them work to get the food). There are also low starch diets now. Feeding on the ground can also help to reduce the coughing as things that should not go down the trachea will not with gravity to help. Hope there are some ideas in that for you. Good luck!

soleil2nd
Jun. 7, 2010, 12:15 PM
Thanks for the input. I will check on the diseases you suggested. Her teeth have always been done regularily and were done when she was at the vet college. Her feed tub and hay are on the floor.

We don't think she is actually choking. More that it is a syptom of the stomach contents coming back up. On the scope we could actually see the food coming back up her throat. The best guess is that she is not digesting the hay properly and it is impacting in her stomach, which is causing the reflux. They just don't know why the hay isn't digesting.

There were no abnormalities in her stomach or her esophagus.

Bluey
Jun. 7, 2010, 12:26 PM
Have they tested her for HYPP?
Some horses with that seem to have similar symptoms.

Pancakes
Jun. 7, 2010, 01:24 PM
I agree that she should go back to the vet school/university and have them examine her again. She sounds like she has a motility issue, which could be caused by any number of things. More diagnostics, maybe even stomach biopsies, may be needed to figure things out.
Sorry you have to go through this; I'm sure it's frustrating and distressing for you to see her recover and then relapse.
Good luck with her and let us know how things turn out.

soleil2nd
Jun. 22, 2010, 10:16 AM
Unfortunately, they don't think there is anything further medically that they can do for her. Since the motility issue is in her stomach, they don't have any treatment options.

We are still playing with her food. She is turned out for 5 or 6 hours a day and gets some soaked alfalfa cubes (along with some concentrates and beet pulp). She is still refluxing/regurgitating some of this.

Tough to know what to do next.

deltawave
Jun. 22, 2010, 12:10 PM
Since the motility issue is in her stomach, they don't have any treatment options.

Reglan. Propulsid. Erythromycin. All stimulate gastric motility.

soleil2nd
Jun. 22, 2010, 01:30 PM
I am going to try the Erythromycin (in conjunction with bute for any inflamation). From the reading I have done this seems the most promising. The vet feels the most likely none will be effective because it is her stomach and not further along the digestive tract.

foggybok
Jun. 22, 2010, 02:08 PM
I am going to try the Erythromycin (in conjunction with bute for any inflamation). From the reading I have done this seems the most promising. The vet feels the most likely none will be effective because it is her stomach and not further along the digestive tract.

I know you don't have a lot of options, but please note that erythromycin has been known to cause severe, fatal diarhhea in adult horses.

I hope she comes around for you!

soleil2nd
Jun. 23, 2010, 07:22 AM
Yikes! I did not know. I will be very careful. Thanks for the info.