Читать книгу Special Report on Diseases of the Horse - Charles B. Michener - Страница 47

The mechanical trouble of choking is quite common. It may occur when the animal is suddenly startled while eating apples or roots, and we should be careful never to approach suddenly or put a dog after horses or cows that are feeding upon such substances. If left alone these animals very rarely attempt to swallow the object until it is sufficiently masticated.

Choking also arises from feeding oats in a deep, narrow manger to such horses as eat very greedily or bolt their feed. Wheat chaff is also a frequent cause of choke. This accident may result from the attempts to force eggs down without breaking or from giving balls that are too large or not of the proper shape.

Whatever object causes the choking, it may lodge in the upper part of the esophagus, at its middle portion, or close to the stomach, giving rise to the designations of pharyngeal, cervical, and thoracic choke. In some cases where the original obstruction is low we find all that part of the gullet above it to be distended with feed.

Symptoms.—The symptoms vary somewhat according to the position of the body causing choke. In pharyngeal choke the object is lodged in the upper portion of the esophagus. The horse will present symptoms of great distress, hurried breathing, frequent cough, excessive flow of saliva, sweating, trembling, or stamping with the fore feet. The abdomen rapidly distends with gas. The diagnosis is completed by manipulating the upper part of the throat from without and by the introduction of the hand into the back part of the mouth, finding the body lodged here. In cervical choke (where the obstruction is situated at any point between the throatlatch and the shoulder) the protrusion caused by the object can be seen and the object can be felt. The symptoms here are not so severe; the horse will be seen occasionally to draw himself up, arch his neck, and make retching movements as though he wished to vomit. The abdomen may be tympanitic. Should there be any question as to the trouble, a conclusion may be reached by pouring water into the throat from a bottle. If the obstruction is complete, by standing on the left side of the horse and watching the course of the esophagus, you can see the gullet, just above the windpipe, become distended with each bottle of water. This is not always a sure test, as the obstruction may be an angular body, in which case liquids would pass it. Solids taken would show in these cases; solids should not, however, be given, as they serve to increase the trouble by rendering the removal of the body more difficult.

In thoracic choke the symptoms are less severe. Feed or water may be ejected through the nose or mouth after the animal has taken a few swallows. There will be some symptoms of distress, fullness of the abdomen, cough, and occasionally retching movements. Sometimes a choking horse is heard to emit groans. The facial expression always denotes great anxiety and the eyes are bloodshot. The diagnosis is complete if, upon passing the probang (a flexible tube made for this purpose), an obstruction is encountered.

Treatment.—If the choke is at the beginning of the gullet (pharyngeal) an effort must be made to remove the obstacle through the mouth. A mouthgag, or speculum, is to be introduced into the mouth to protect the hand and arm of the operator. Then, while an assistant, with his hands grasped tightly behind the object, presses it upward and forward with all his force, the operator must pass his hand into the mouth until he can seize the obstruction and draw it outward. This mode of procedure must not be abandoned with the first failure, as by continued efforts we may get the obstacle farther toward the mouth. If we fail with the hand, forceps may be introduced through the mouth and the object seized when it is just beyond the reach of the fingers. Should our efforts entirely fail, we must then endeavor to force the obstruction downward by means of the probang. This instrument, which is of such signal service in removing choke in cattle, is decidedly more dangerous to use for the horse, and I can not pass this point without a word of caution to those who have been known to introduce into the horse's throat such objects as whipstalks, shovel handles, etc. These are always dangerous, and more than one horse has been killed by such barbarous treatment.

In cervical as well as in thoracic choke we must first of all endeavor to soften or lubricate the obstruction by pouring oil or mucilaginous drinks down the gullet. After this has been done endeavor to move the object by gentle manipulations with the hands. If choked with oats or chaff (and these are the objects that most frequently produce choke in the horse), begin by gently squeezing the lower portion of the impacted mass and endeavor to work it loose a little at a time. This is greatly favored at times if we apply hot fomentations immediately about the obstruction. Persist in these efforts for at least an hour before deciding to resort to other and more dangerous modes of treatment. If unsuccessful, however, the probang may be used. In the absence of the regular instrument, a piece of inch hose 6 feet long or a piece of new three-quarter-inch manila rope well wrapped at the end with cotton twine and thoroughly greased with tallow should be used. The mouth is to be kept open by a gag of wood or iron and the head slightly raised and extended. The probang is then to be carefully guided by the hand into the upper part of the gullet and gently forced downward until the obstruction is reached. Pressure must then be gradual and firm. At first too much force should not be used, or the esophagus will be ruptured. Firm, gentle pressure should be kept up until the object is felt to move, after which it should be followed rapidly to the stomach. If this mode of treatment is unsuccessful, a veterinarian or a physician should be called, who can remove the object by cutting down upon it. This should scarcely be attempted by a novice, as a knowledge of the anatomy of the parts is essential to avoid cutting the large artery, vein, and nerve that are closely related to the esophagus in its cervical portion.

Thoracic choke can be treated only by means of the introduction of oils and mucilaginous drinks and the careful use of the probang.