Sheet Fact Sheet

hoke
Tie Forward Surgery
a relatively common condition seen in horses
es and is typically
Dorsal caused by obstruction
displacement of the
of the soft palate
gus (food pipe) with food; occasionally a foreigncondition
(DDSP) is a performance-limiting
be involved of
e.g.
thewood
upper orrespiratory
plastic. Fortunately
tract which occurs
ses of chokeduring
resolve quickly
fast andwhen
exercise spontaneously
the soft palate
cases in which
moves the above
obstruction lasts for(part
the epiglottis longer of the
minutes are larynx),
likely to creating
require veterinary
a functional assistance.
obstruction
ortant to note that this is not the same as the
within the airway. This restricts airflow
atening condition
to theinlungs
humans, where the
and causes term loss
a sudden
refers to blockage of the windpipe
of performance rather
and often than theor
a choking
agus. This difference means that unlike humans,
gurgling noise.
with choke can still breathe.

Diagnosis of DDSP
• Static endoscopy at rest can rule out some other
causes of airway disease.
• Dynamic endoscopy (with the horse galloping),
either on a treadmill or gallops is the only
definitive way to diagnose this condition.
Following a diagnosis of DDSP, frequently a number
of conservative management strategies are tried
in an attempt to manage the condition. These may
include:
• tongue straps
• crossed nosebands
• glycerine applied to the back of the tongue. An over grounD enDoScoPe FiTTeD To The
briDle AllowS exAminATion oF The ThroAT
REGULAR DENTAL
Cases that EXAMINATIONS
are non-responsive to AND
conservative AreA while The PATienT moveS AT SPeeD
TREATMENT CAN REDUCE THE RISK OF CHOKE
management are candidates for tie forward
surgery.
KEY POINTS

• Surgical treatment
Don’t panic! Choke is rarely life-threatening and
No surgical
many cases technique
will resolve has been found that can
spontaneously.
replace the strength of the muscles. The operation
• Seek veterinary
is conducted advice if the choke
through a sterilelasts more incision
surgical than on
30 minutes and while waiting for the vet remove
the underside of the throat. The aim of the allsurgery
food to is
prevent your horse eating and worsening
to advance the larynx (voice box) forward, so
the obstruction
it sits over the soft palate, forcing it to stay in the
• correct
Following position.
an episode of The voice
choke it isbox is held
worth in position by
monitoring
permanent
your horse’s sutures.
respiratory rate (normal <16 breaths/
min) andIn rectal
additiontemperature for surgery,
to the sterile several days.
cautery of the soft
• Arrangepalate is performed
regular via the for
dental check-ups mouth,
yourcausing
horse the soft
palate to scar and tighten.
to reduce the risk of choke as a result of a painful
mouth. Recent studies have found tie-forward surgery to
have 80% success. Surgery involveS The PlAcemenT oF PermAnenT
SuTureS To holD The lArynx ForwArD

XLEquine - Better Together

 XLEquine Tie Forward Surgery
Fact Sheet Surgery And
Surgical conditions SC

Post-operative
management
•
Choke
Anti-inflammatory medications are administered
Choke is a relatively common condition Wound
Post-operative
complications
seeninfection
in horses - presents as heat, swelling
post-operatively to reduce swelling around the
incision. and ponies and is typically causedand bydischarge
obstructionat theof the site, treated with flushing and
wound
oesophagus (food pipe) with food;antibiotics.
occasionally a foreign
• Antibiotics are usually administered prior to and
body can be involved e.g. wood or plastic. Fortunately
following surgery to protect against bacterial infection
many cases of choke resolve quickly
of the operation site.
Infection of the implant sutures
and spontaneously
- wound infections can spread to involve the sutures used
and only cases in which the obstruction lasts for longer
• The skin is held together immediately post- to fix the larynx and can be difficult to treat, sometimes
than
operatively using skin 30 minutes
staples. are likely
These will usually be to require veterinary
necessitating assistance.
removal of the surgical implant sutures.
It is important to note
removed approximately 14 days after the surgery is that this is not the same as the
performed. life-threatening condition in humans, Surgical where the failure
term - if the tension in the sutures
• Following surgery, all“choke”
food and refers to blockage
water should be fed of the windpipe rathernot
holding the larynx is than theit may not prevent the
correct
DDSP . Early turn out may contribute to this.
oesophagus. This difference means that unlike humans,
from a height for at least three weeks, and the horse
should not be turnedhorses withAllowing
out to grass. chokethecan still breathe.
On occasion, the horse may be noted to make a louder
horse to lower its head results in stretching of the respiratory noise at exercise than that noticed prior to
permanent suture material and may contribute to surgery, this should resolve with increased fitness levels.
failure of the surgical procedure.
• Trotting exercise can begin following staple removal,
however canter work should not recommence for
approximately four weeks after the surgery

ical signs:
culty/repeated attempts at
lowing
ching/arching of the neck
ghing
& saliva discharging from the nose
oling
nterest in food
REGULAR DENTAL EXAMINATIONS AND
asionally a lump may be seen or felt TREATMENT CAN REDUCE THE RISK OF CHOKE
he left side of the neck.
uspect your horse is suffering from KEY POINTS
is important to prevent your horse
s this will make the blockage worse • Don’t panic! Choke is rarely life-threatening and
iF The TenSion in The SuTureS
e difficult to clear. many cases
The horSe cAn normAlly reTurn To will resolve spontaneously.
holDing The lArynx iS noT correcT
struction doesn’t clear quickly TrAiningof its AFTer 4 weekS • Seek veterinary advice if the chokeiTlasts willmorenoTthanPrevenT DDSP
ord then veterinary assistance must 30 minutes and while waiting for the vet remove all
ht. There are a number of steps food to prevent your horse eating and worsening
can take to help to confirm and treat the obstruction
lem.
• Following an episodeFor further information contact your local XLEquine practice:
of choke it is worth monitoring
and ponies with dental problems your horse’s respiratory rate (normal <16 breaths/
vent them grinding their food min) and rectal temperature for several days.
), individuals that bolt their food too
and those fed XLEquine
dry pelleted or cubed • Arrange regular dental check-ups for your horse
is a novel and exciting initiative conceived from within
e all at increased risk. profession made up of independently owned,
the veterinary
to reduce the risk of choke as a result of a painful
progressive veterinary practices located throughout themouth.
United
Kingdom, members of XLEquine are committed to working
together for the benefit of all their clients.
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