Nutritional Considerations for Equine Choke

Unlike when humans choke due to trachea obstruction, choke in horses occurs when the esophagus is blocked. Complications relating to choke can be severe, so contacting your vet is recommended when you spot the signs of choke: nasal discharge of feed material or saliva; anxiety & distress, depression; arching and stretching the neck; coughing, difficulty swallowing; excessive saliva (Hawkins, 2024). Choke incidents are often related to any physical and behaviour factors which alter normal chewing and feed intake, such as:

• Dehydration

• Eating when heavily sedated

• Esophageal disease including neuromuscular, anatomical and other obstructive (abscess/cyst) issues

• Prior esophagus trauma from previous choke

• Inadequate mastication from poor dentition

• Pain associated with chewing

• Horses who bolt their feed due to enthusiasm or feed-related anxiety (ie herd feeding situations)

I know you're thinking it: "does beet pulp cause choke in horses?".

There's a common belief that beet pulp has a higher risk for choke than other feeds due to concerns of beet pulp swelling in size in the horse's esophagus, but this is unfounded. Both dry and soaked beet pulp have been safely fed to horses at levels as high of 45-55% total diet (Harris and Rodiek, 1993; Warren et al., 1999), and high-quality, peer-reviewed data suggests that beet pulp can be a useful ingredient in many balanced diets.

So, if it's not beet pulp to blame, what is?

This may be shocking - it's not one type of feed.

Across the literature, reported feedstuffs ingested prior to a choke episode range and vary greatly, including basically every feedstuff horses come into contact with: grass, hay, carrots, apples, dry pelleted and cubed feeds, as well as non-food items such as bedding (Hawkins, 2024; Chiavaccini and Hassel, 2010). If your horse can ingest it, they can choke on it.

Many anecdotal reports amongst horse owners on social media communities report choking when feeding a complete feed (a feed designed to replace fiber in the diet, commonly used for senior horses who are losing the ability to consume hay) or high fiber feedstuffs such as beet pulp (which can help supplement fiber in horses who cannot handle hay or when hay is in short supply).

In this group of horses, these horses either cannot eat hay OR are being fed LESS hay while hay is replaced with the complete feed/fiber alternative. As a result, fiber is meal-fed, and the horse is introduced to more meals per day. Eager for chew-time on their new feeding program, on top of possible reduced chewing efficiency due to senior dentition and less saliva production when consuming pelleted feed, we begin to check a lot of the risk factors of choke as discussed above.

When considering anecdotal evidence (ie 'real world stories'), we must consider the whole picture and maintain the mindset that correlation does not equal causation, same as we would in well-designed equine research studies. Working with your horse's support team can help you identify what risk factors your horse is exposed to, and how we can reduce this risk for your individual horse.

In a 2000 retrospective study (Feige et al, 2000), the material blocking the esophagus was identified in 21 cases. The most frequent obstruction was pelleted or cubed feeds (9/21 cases), but no significant menton of beet pulp was included. Other obstructions included grass or hay (5/21), carrots (4/21) and apples (3/21). Any pelleted or cubed feed may offer an increased risk of choke, but from existing peer-reviewed evidence, beet pulp is not at any higher risk.

TDLR: You shouldn't be worried about just beet pulp - worry about everything instead (as is always the case with horses, it seems).

So, should I avoid pelleted & cubed feeds for my horse prone to choke?

It's important to consider the physical attributes & feeding management of pelleted & cubed feeds.

• Size: Due to the small particle size of pelleted and cubed feeds, horses are able to consume them quicker than they would hay or grass. Compared to chewing hay, pelleted feeds stimulate less saliva production, which increase the risk of a dry bolus moving through the esophagus (Meyer, Coenen and Guer, 1985). Faster ingestion = less moistened feed = higher risk.

• Meals: Pelleted or cubed feedstuffs are also commonly meal-fed, an unnatural feeding routine for an animal adapted to foraging little and often. Meals can create stress = rushed feeding.

• Palatability: Depending on the composition, these feeds are often highly palatable - everyone knows a horse who has lots of hay but is still super hype for their dinner!

• Dental wear: Horses who are fed mostly pelleted diets have more uneven toothwear due to the reduced chewing effort required. Altered toothwear = Increased risk.

Management-related risk factors such as time without feed and dehydration may result result in fast consumption of feed forming a dry bolus in the esophagus (Pinto, 2017), especially if the horse is fatigued after exercise or weakened from chronic health issues (Menzies-Gow, 2016). When feeding the choke-prone or choke-risk horse, feeding management to reduce the rapid ingestion of dry feeds and promote hydration is key. At Honos, soaking feeds, maximizing chew time throughout the day and adding salt directly to the meal is frequently recommended, but especially for these cases.

Long story short: Avoiding pelleted or cubed feeds may not be necessary, as long as we feed them strategically (soggy n' salted ;)).

How can we reduce the risk of choke?

Based on available peer-reviewed data, no matter what you feed, there is always risk of choke. Due to the wide variation in factors associated with an obstruction of the esophagus, the following risk factors should be of focus, as well as paying attention to WHY these factors are present in each horse's case:

Improper mastication/chewing. Why? Anything that limits normal chewing can be to blame - poor dental health, pain in the mouth, or head/neck/jaw pain. Duncanson (2006) reported that 87% of examined retrospective choke cases had sharp dental overgrowths, speaking to the presence of dental abnormalities in horses who have choked.

Consuming feed too quickly. Why? Time without feed and hay feeding management are two big factors, as well as environment - this includes general ability to feel safe, as well as herd dynamics. Stress or perceived food scarcity may increase feed intake rates.

Dehydration. Why? Water is the most important nutrient, and inadequate intake will limit digestive function. Water availability, meeting electrolyte needs and proper recovery strategies after exercise or exertion all play a key part in your horse's hydration status.

Decrease in saliva production. Why? Saliva moistens and softens food for easy transport to the stomach. Chewing stimulates saliva production, so anything that reduces chew time (ie time without feed; smaller feed particles; reluctance to chew) may also increase the risk of choke.

In Summary

Choke isn’t about one specific feed, it’s a multi-factorial issue that can happen with almost anything a horse eats. Factors like chewing ability, hydration, feed texture, and mealtime management all play a role. The good news? With the right feeding approach and nutrition plan, you can reduce your horse’s risk.

Make sure your horse is equipped to chew: Keep up with routine dental care - at least annual dental checks, with every 6 months often recommended for senior horses (Ralston, 2000), are crucial. These checks can help you identify if your horse is experiencing dental failure which may require a change in diet, as well as correcting abnormalities where possible.

Slow feed consumption: Soaking feedstuffs can increase the time spent eating, which may help to both slow down consumption (Grimm et al., 2025), guarantee some water intake and may lubricate the esophagus. Feed consumption for both forages and pelleted feeds can also be slowed via grazing muzzles (Venable et al, 2016) and slow-feeders. Consider the effect of environment on your horse's feed intake rate, and make changes accordingly to help your horse feel safe and secure during feeding.

Promote hydration: Ensure fresh, clean water is available at all times, make your horse get some of their water from their meals by soaking their feed (Ferreira et al., 2025), and feed adequate amounts of salt and if needed, electrolytes, based on bodyweight and workload. Adding salt directly into the feed can guarantee intake better than free-choice salt access would alone.

Promote saliva production: Maximize chew time to keep saliva production constant - this will help promote all areas of digestive and mental health too! Using slow-feeders and appropriately matched hay can help you maximize your horse's chew time. Forages stimulate almost 2x the amount of saliva as pelleted feeds, in addition to requiring more chew time to grind the fibrous material.

If you’re managing a choke-prone horse or want support fine-tuning your feeding program, I’d love to help! Feel free to reach out to book an equine nutrition consult.

LET'S WORK TOGETHER!

References

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