Esophageal Obstruction
Basic Information 
Epidemiology
Risk Factors
• Horses and ponies that have ravenous appetites or “bolt” their feed may be at increased risk.
• Older horses and ponies with poor dentition and young horses with erupting teeth may be at an increased risk because of poor mastication of food.
• A previous episode of esophageal obstruction may predispose to further episodes; some horses are affected by repeated episodes of esophageal obstruction as a result of stricture or diverticulum formation.
Clinical Presentation
Physical Exam Findings
• Affected horses often sweat excessively and appear distressed, but the body temperature is usually normal.
• The heart rate may be mildly elevated.
• Mucous membranes may be mildly congested.
• There may be a palpable swelling in neck in the jugular groove or over the trachea (if the obstruction is in the cervical region). If the obstruction is in the cervical part of the esophagus, most affected horses will retch immediately after attempting to swallow. (There is often a 10- to 12-second delay between the swallow and the onset of retching if the obstruction is in the distal esophagus.)
Etiology and Pathophysiology
• The obstructing mass is usually food, especially dry pelleted food or dry sugar beet pulp. The dry, fibrous material swells with the absorption of saliva, and an expanding bolus occludes the esophageal lumen. Subsequent boluses compound the obstruction.
• Primary feed impactions may also be composed of roughage, especially leafy alfalfa hay, coarse grass hay, bedding, and even grass.
• Occasionally, foals and young horses may eat foreign bodies that lodge in the esophagus and initiate an obstruction.
• Eating too soon after sedation or general anesthesia (when coordinated muscular activity of the esophagus has not yet returned) may predispose horses to obstruction.
• The most common sites of esophageal obstruction are the proximal esophagus and just cranial to the thoracic inlet.
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