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  Discussion on Choke & Aspiration Pneumonia
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New Member:
Tweeter

Posted on Friday, Nov 4, 2005 - 6:32 pm:

I'm a new member and am looking for advise for my 28 yr old stallion. He choked about 10 days ago and the vet says he has aspirated pneumonia. This is the 4th time in 3 yrs that he has choked but this is also the worst. He is on 3 antibotics and pain killers. We also have him on wet feed and excellent alfalfa hay. My problem is he hates the wet feed. Does anyone know if it is ok just to feed old horses crimped steamed oats and alfalfa hay? He has been on Senior Pellets but the vet say unless he will eat them wet not to feed them. I want to switch him to oats but the vet says they don't have what he needs as a older horse. What did they feed old horses before pellets? He has lost weight and is still very sick but I'm confident we will pull him through. Any thoughts on the oats? Thanks Kathy
Member:
Lilly

Posted on Friday, Nov 4, 2005 - 8:38 pm:

Hi,
I have a subscription to Horse Journal and several months ago they ran an article comparing race oats to complete feeds. They absolutely loved the oats for nutrition. I can't remember the supplements they suggested to add (there were only a few) or any information specific to a horse's age. I will try to find the article and see what the details were. What about oats mixed with soaked beet pulp? Most horses go crazy for warm, soaked beet pulp. Some people swear that it is great for putting weight on a horse. I read that it helps keep a horse warm in the winter because of the way it is digested.
Member:
Quatro

Posted on Friday, Nov 4, 2005 - 11:37 pm:

Hi Kathy, My 2 older horses have both choked. I now feed them 1/3 beet pulp, 1/3 crimped rolled oats and 1/3 senior feed with 1/2 lb or Nutrena Empower to help with weight. I soak it 1/2 hour with warm water before feeding and they slobber it right up. No problems with choke if they eat it wet. Hope this helps, Good Luck with your guy. I know a bunch of life long horse people, who have never had a horse choke, and me, a newbie has had 2 choke in the last 3 years. Good Luck
suz
Moderator:
DrO

Posted on Saturday, Nov 5, 2005 - 8:25 am:

The problem with straight oats for older horses is that it is deficient in protein, calcium, and vitamins. However all of these problems are addressed with green alfalfa. Together they should make a good diet for your older horse.
DrO
Member:
Corinne

Posted on Saturday, Nov 5, 2005 - 9:32 am:

So sorry to hear about both your experiences with choke. Sugar Beet Pulp is apparently so tasty that my horse will knock anyone down he sees carrying it.
I too have only been a horse owner a few years so I could be wrong, but I was told by my last barn and about every person I know here, including my current instructor, that sugar beet pulp has to be soaked for a full 24 hours, to prevent choke as well and to prevent it from expanding in the digestional tract....
My current barn just soaks the next days beet pulp feed the same time chores are done so it's ready for the next evening's feed.
It could be overkill soaking it that long but at least I don't worry about it rehydrating and obstructing something.
Anyone know if I am off base on the soaking times?

Good luck!

v/r
Corinne
Member:
Corinne

Posted on Saturday, Nov 5, 2005 - 9:35 am:

P.S. Welcome to HA Kathy....I love the information as well as the friendly and very caring horse owners and moderators on this site....you will find it's the best money you can spend in a month. HA membership....cheap....Valuable, reliable, information for caring for the horses you love...Priceless.
Member:
Hwood

Posted on Saturday, Nov 5, 2005 - 10:08 am:

Kathy, what do you mean by "wet feed?" Is that the same as soaked pellets or soaked senior feed?

I have a 30 plus year old Appy (yep, another one, folks . . . just something about those wonderful old Appy geldings that I can't resist) and he is pretty picky about his feed. I tried an unsweetened complete pellet, soaked, and he ate it for awhile, but really didn't enjoy it, and since he has low body weight, I needed to find something that was more palatable for him. I discovered a locally milled, senior feed that has "softer pellets for the older horse." I can smell some sweetness to the pellets, and they are much thinner pellets, so they are easier for him to chew. He ADORES them. Sometimes we have to dig around, locally, to find what's available, and there may be lots of options out there for you.
P.S. Corinne, I don't know how else to touch base with you, so am following up your post to this topic. Just want you to know that e-mails to you from me keep bouncing back as "delayed" and then, "undeliverable."
New Member:
Tweeter

Posted on Saturday, Nov 5, 2005 - 11:13 am:

Hi everybody:
Thanks for the advise. My old guy is better today, he still has the snot nose and is breathing hard but has a little spark back in his eyes. His vet checked him yesterday afternoon and said she could still hear noise in his lungs so we are not out of the woods yet. Still on SMZ's and Gentamicin and Banamine for at least the next 5 days. We also added Gastroguard just to coat his stomach because of all the meds and a oral probotic.
Hopefully with all this he will pull through and then we can focus on long term management. He does not like and refuses to eat wet or soaked feed. I guess being 28 yrs old he has his likes and dislikes. Can't say I blame him! Anyone have any ideas of how to get him to drink more water. He is not a big water drinker about 1/4 bucket per night. The vet said maybe that is part of his problem. Can I shake salt on his feed because he will not touch a salt block.
Kathy
Moderator:
DrO

Posted on Saturday, Nov 5, 2005 - 11:46 am:

Thanks for the kudos Corrine. I would not use regular salt but you can get loose mineral salts which could be added to the feed at the rate of 2 ozs a day.
DrO
Member:
Corinne

Posted on Saturday, Nov 5, 2005 - 5:49 pm:

Holly you can try to reach me at LtSassy2@min.midco.net.... Shouldn't bounce back off of that one. On my way to the the barn...just got a call Demetrius' knee is injured...Wish me luck. Don't know what I will find!

v/r
Corinne
New Member:
Tweeter

Posted on Monday, Nov 7, 2005 - 2:27 pm:

Dr. O:
Hi just wanted to ask your opinion. The vet and I both feel that my stallion is clear of choke. She passed the tube twice and he is eating and drinking now. He never had a temp however she did treat him for and told me she thought for sure that he had aspirated. Now 2 1/2 weeks later he is still on antibotics but we are noticing when he eating grass his nasal discharge is green and yesterday when I gave him his SMZ's it came back out his nose on the opposite side that I put it in his mouth. I have not seen anything that looks like food and he eats and drinks with no problem. The vet even seems puzzled as to why anything would be coming out of his nose..unless he is choked again. If he choked again I thought I would see the same thick heavy foamy stuff like before, this is just green snot and like I said yesterday the white SMZ paste. He is eating and drinking but is still very weak when he walks around, he is on 12, SMZ's twice daily, Genomecin 30 CC once a day and 5 cc Banamine once a day. He is eating a wet oat and bran mash twice daily and all the alfalfa and timothy hay he wants. He appears to have no problem eating.
Just wondering your thoughts.
Thanks
Kathy
Moderator:
DrO

Posted on Tuesday, Nov 8, 2005 - 6:50 am:

I am most concerned that you think he continues to look like he does not feel well (weak). What exactly do you see and what does the vet think is the reason? The green discharge and antibiotic reflux probably indicate problems with swallowing other than another choke. There can be many reasons for this including a temporary one from the trauma of the last choke. To investigate it further you would need to scope the pharyngeal area.
DrO
New Member:
Tweeter

Posted on Tuesday, Nov 8, 2005 - 12:45 pm:

Dr. O:
I have been around and owned horses most of my life. (I'm 47) I have owned this stallion for 15 years, hand bred him and watch babies grow and turn into great horses. He has always been a quiet stallion however since this choke he just is not himself. When he walks his feet drag like they weigh a ton. He used to have a fit and run up and down the fence when he could not see the other horses but now he could care less. I guess the best word I can use is lethargic. It has been 3 weeks today since he choked. The vet and I have had (2) from the same practice see him, really don't have much to say. They say it is that he is old and the choke wore him down. They also say that aspiration pneumonia is really bad and hard to get rid of. I'm still not 100% sure that he did have the pneumonia, he never had a temp in fact his temp is sub-normal hanging around 98. When he was sick it was 97.5 to 97.8. He still does the repeat swallowing, lip smacking stuff. The good news is that I have him eating his breakfast and dinner and he eats like he is hungry. Do you think that 3 weeks is long enough since the choke to scope him? And how hard is it to see something?
Thanks
Kathy
Moderator:
DrO

Posted on Wednesday, Nov 9, 2005 - 8:20 am:

Something is still bothering this horse Kathy that they have not discovered: pain (apparently not colic like pain however considering the appetite), infection, or possibly something else. I don't think this is related to the nasal reflux either unless the pharynx is painful. Hmmm I see he was on 3 antibiotics did he receive any as IM injections? How many? If this is such a pain it should be bute responsive. Have you tried 1 gram bute twice daily to see if it makes him feel better? It appears physical exams have been done how about a lab workup?
DrO
Member:
Cpacer

Posted on Wednesday, Nov 9, 2005 - 9:24 am:

Hi Kathy, I feel for you...I'm about to celebrate my 1-year anniversary of horse ownership and have dealt with 3 chokes, with the last one being pretty bad (barn thinks he had an obstruction overnight before he was discovered). We followed tubing with IV antibiotics to starve off pneumonia and Bute for his throat pain.

Since mushy pellets weren't that appealing (had tried rocks added to the dish and spreading the pellets out to no avail) I ended up switching him to Sweet Feed and haven't had a choke since (knock on wood). Not sure if that's the food of choice but it's working for us.

I know it just sucks seeing your baby all lethargic like that! I hope he perks up soon.

ps. I think I read somewhere on this site that adding apple juice to the water may help.
New Member:
Tweeter

Posted on Wednesday, Nov 9, 2005 - 9:32 am:

Good morning Dr. O:
Yes he has had 3 blood profiles with all 3 being normal except one level (can't remember) something that showed inflammation. I was not sure if I told you or not: 2 days after the choke the vet came to re-tube him to make sure all the choke was gone before he started eating again. She sedated him and passed the tube, about the time she said she was sure she was in the stomach he gritted his teeth, I mean really gritted them we could hear it, sounded terrible then he held his breath for several seconds and fell over in the stall. I have never seen this before, never seen a horse grit his teeth. The vet immediately withdrew the tube and he layed on the stall floor breathing really hard. It was truly plain to see that something was hurting him bad. We agreed not to try to pass the tube again because maybe his esophagus was still very sore. He layed on the stall floor most of the early morning resting. Later that day he ate a little hay and rested.

As of yesterday I would say that he was looking and feeling better however this morning he did not want breakfast just wanted to go out in his pasture so I put him out. He is walking around eating grass but still walking slow and tired looking. I'm sure he is not ckoked again because I saw him drink a pretty good drink of water.

Speaking of drinking water he also has now started to act like drinking must be a careful act. He mouths the water almost like a dog several times before he actually swallows.

To answer your question on the bute. No I have not given him any bute. And yes he received IM and IV injections of antibiotics. Naxzal (spelling)?, 10cc twice daily 12 days, Genamicin 30cc once daily (still on it) and Banamine 10cc twice daily. He had a cather in and I gave him his meds through that. We took that out last friday. He also had fluids every other day for 4 days. He was on Banamine for over 10 days and I was worried all this stuff may start to upset his tummy. He was also on Gastroguard for 8 days and I am giving him gel probotics once a day. Maybe I sure try the bute to see if it helps. He is still on Genamicin once daily 30 cc and SMZ's 12 pills twice daily. Any ideas what to do next?
Thanks
Kathy
Moderator:
DrO

Posted on Wednesday, Nov 9, 2005 - 6:58 pm:

Try the bute.
DrO
Member:
Vickiann

Posted on Wednesday, Nov 9, 2005 - 8:38 pm:

A horse of mine had a choke episode when he was eating and a crabby mare charged into his stall and went after him. After not eating or drinking for days, along with clearing the choke by passing a gastric tube, he was given a steroid shot to reduce pain and inflammation. For him that was like a miracle, but maybe it was just coincidence. He began eating and drinking normally.
Moderator:
DrO

Posted on Thursday, Nov 10, 2005 - 7:08 am:

The steroid injection has the advantage of not leaving a bad taste in the horses mouth but may not be as helpful for the already sore areas of the neck.
DrO
Member:
Tweeter

Posted on Thursday, Nov 10, 2005 - 5:18 pm:

Good evening:
Dr. O:
I gave him 2 grams of bute this morning in his wet feed. It took him until noon to finish eating breakfast but he ate it all. I will give him another gram in his am feed. Don't know if it was the bute this morning or not but he dug into his evening feed. I have been taking his senior feed and crimped oats with a little bran making a warm mash for him. He eats it very slow but at least he appears to be able to swallow it ok. Yesterday I added 2 ozs of loose mineral salt trying to make him drink more.
I did notice tonight he had a clear to slightly green discharge from his nose again. Just a slight discharge not like what comes with choke, more like a runny nose.
I'm wondering if all the antibiotics are effecting his appetite I know when I take them my stomach feels terrible. Its been over 3 weeks so if he does not have a temp by now and his lungs sound "not bad" according to the vet, maybe we can stop the antibiotics and just give him bute for a few days? The vet is due for a checkup in the AM so I will see what she thinks.
Kathy
Moderator:
DrO

Posted on Saturday, Nov 12, 2005 - 10:00 am:

I would use respiratory rate, lung sound characteristic on auscultation, and body temp to decide and if they are all normal I would certainly discuss with the vet to discontinue the antibiotic.
DrO
Member:
Tweeter

Posted on Saturday, Nov 12, 2005 - 11:05 am:

Good Morning Dr. O:
Vet was out yesterday to check him again and said heart rate, 28, body temp 98.7, lungs "not bad" she said his lungs are hard to hear because he has really loud gut sounds. We decided to stop the antibiotic and continue with 1 1/2 grams of bute once a day.
He is eating wet mash grain and hay and seems a bit perkier.
I have a question for you that my vet could not answer. I think the discharge from his nose and the choke are two separate issues. He still has a discharge from his nose. Clear to green color especially when he comes in from the pasture. Do you think this could be allergies? I asked my vet and she said she did not know. I also asked about antihistamine for him and she said they don't make very good ones for horses. I know when I don't take my allergy meds my ears, nose and lungs get full of fluids. Maybe he is eating a spring and fall weed in the pasture that he is allergic to which causes his throat to swell?? Just trying to figure this out so I can make sure it never happens again.
Any thoughts?
Thanks
Kathy
Moderator:
DrO

Posted on Sunday, Nov 13, 2005 - 11:13 am:

When you say green discharge, I have always pictured "grass green". Is this true or could it be a "mucous green"? What does your vet say. I don't think this is an allergic issue causing his throat to swell as you would see other symptoms too. I think more likely you continue to see some sinus irritation and drainage from the past choke. These sinuses do not drain all that well.
DrO
Member:
Tweeter

Posted on Monday, Nov 14, 2005 - 7:04 pm:

Hi Dr. O;
Sorry I did not get back to you yesterday.

Yes, the green discharge is "grass green" or just a little darker.

If it is sinus irritation due to the choke, how long will this last? It will be a month tomorrow since he choked. I only have him on 1 1/2 grms of bute at this time. It does seem to help him with his eating.

I guess we should scope him to see what we can find but I'm worried because of how he acted the last time. He acted like it really bothered him. Do you think 1 month since the choke is long enough time for him to heal to be scoped?
Thanks
Kathy
P.S. My vet does not have a clue. She suggested scoping him as well.
Moderator:
DrO

Posted on Tuesday, Nov 15, 2005 - 8:20 am:

A month is already longer than usual but if it is grass colored I cannot think what else it would be. Time or possibly a scoping will tell.
DrO
Member:
Tweeter

Posted on Tuesday, Nov 15, 2005 - 1:58 pm:

Hi Dr. O:
I guess I will go ahead and schedule the scope to see if it tells us anything. I still feel we are dealing with something separate from the choke. It seems to be some sort of sinusitis or COPD something respiratory. He is now coughing when he rolls...coughs hard at least 5 or 6 times just from rolling. Good thing is temp is normal and he is eating and drinking. I will keep you posted.
Thanks much
Kathy Clymer
Member:
Tweeter

Posted on Wednesday, Nov 16, 2005 - 9:30 am:

Good morning:
Well maybe we are starting to make some progress. The drainage is slowing down and he seems to be feeling much better. He actually galloped to the gate this morning. I called him in because the weather is getting bad and he ran all the way from the top of his pasture which is about a 5 acre pasture. He did not cough when he got to the gate however he was a little winded but not bad. I kept looking for "snot" or drainage and did not see any. I'm still going to schedule the scope for early next week, I will keep you posted.
Thanks again
Kathy CLymer
Member:
Tweeter

Posted on Monday, Dec 12, 2005 - 6:40 pm:

Hi Everyone:
Well I have an update on my old guy. I had an equine specialist out today to scope because he still has the drainage from his nose. The scope showed that he has damage to his esophagus most likely from the choke but not exactly sure. The esophagus does not open & close properly. The drainage is because he is aspirating some food and water as he eats and drinks. Since he is 28 surgery is out of the question so we are going to try a course of steroids to see if it helps. The vet said it may just be something that he will have to live with and we will have to keep watch out for choke because he will always be prone to choking with the damage. Right now he is eating sweet feed mixed with oats and alfalfa hay and is doing well other than his nose is always draining. He seems to deal with it just fine. I will let you know how the steroids work.
Thanks
Kathy Clymer
Moderator:
DrO

Posted on Tuesday, Dec 13, 2005 - 7:00 am:

Wow Kathy,
a esophagus with impaired function creating a nasopharyngeal reflux. I would love to know what the ph of the fluid from the nose is. If it is acidic it indicates it is coming all the way from the tummy. If if is neutral to slightly alkaline it may indicate a diverticulum in the esophagus which collects material then refluxes it.
DrO
Member:
Tweeter

Posted on Tuesday, Dec 13, 2005 - 9:38 am:

Dr. O:
How would I test the ph? The vet said he has partial paralysis on the left side (grade IV) whatever that means. I started him on the Prednisolone last night. He will get 700mg once daily for 7 days, then 400mg once daily for 7 days and the 400mg every other day for 7 days. He also said if improvement was to occur we should see it on day 4. It sounds like to me that nothing else can be done if this does not work other than surgery which at his age is out of the question. He was going to call New Bolten (Univ of Pa) to see if they had any other ideas of treatment because he feels that he will most likely develop pneumonia again at some time. One note since we have had snow on the ground for the last week the drainage has been clear. Before that he was still grazing and the drainage was green.
Thanks
Kathy
Moderator:
DrO

Posted on Tuesday, Dec 13, 2005 - 10:51 am:

Hmmm, perhaps a swimming pool test strip or your vet could use a urinary test strip. I would probably use my aquarium ph test kit. You can dilute with deionized water, say 50/50 to get adequate volumes or a clean enough solution to test but it should not have a effect on whether you get a very acid result or not. Most tap water will greatly effect the result.
DrO
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