You should seek the advice of your veterinarian if your pet is ill as only he or she can correctly advise on the diagnosis and recommend the treatment that is most appropriate for your pet.

Animals occasionally get something stuck at the back of their throat or in their gullet (oesophagus) and they can choke. If the airway is blocked and they cannot breath for any length of time they can die - though this is uncommon.

In the USA airway obstruction due to food accounts for an estimated 3900 human deaths every year - making it one of the top 10 causes of death.  It is not so common in veterinary medicine, but is does occur from time to time, and when it does emergency treatment is needed.

When there is an obstruction at the back of the throat - blocking the throat and the entrance to the windpipe (the trachea) signs of choking occur  including :

• A loud rasping or whistling noise when the animal attempts to breath in. It sounds like the airway is blocked
• A loud noise or an attempt to cough when the animal tries to breath out
• Sudden onset coughing during eating may be seen
• The animal may gag or retch - attempt to eject the object by contracting muscles in its throat - this is similar to attempts to vomit, the mouth is held wide open but it does not involve abdominal/stomach contractions
• The animal may stand with it's head pushed forward and its neck fully extended
• The breathing rate (chest movements) will increase becoming very rapid and shallow
• If inadequate air can be breathed in or out the animal will start to panic and may throw itself around in desperation
• The visible mucous membranes eg lips and gums  lose their normal pink-red color and turn pale then blue and get darker as oxygen levels in the blood decrease
• The animal collapses
• Death occurs in less than 5 minutes

Choke is also used to describe obstruction of the gullet (oesophagus) preventing swallowing and food reaching the stomach. This is typically seen in farm animals when a large object eg a potato may become stuck during swallowing, but it is also common in dogs that swallow large sharp pieces of bone which get lodged in the oesophagus - usually low down where the oesophagus enters the chest or where it passes near to the heart . In these cases signs include :

• Reluctance to eat
• Regurgitation of food after it has been swallowed.
• If the food is soft the regurgitated food will be sausage-shaped.
• Some animals drool excessive saliva
• Weight loss if obstruction has been present any length of time

Treatment of choke involves removal of the obstruction, and this is best done in a veterinary practice where a range of implements and the option for general anesthesia and emergency surgery are available :

• In humans an emergency  technique called the Heimlich manoeuvre has been described in which a person stands behind the patient, grasps around their abdomen and quickly and forcibly squeezes upwards on the patients upper abdomen - this increases pressure on the diaphragm causing the object to be ejected by rapid air movement out of the lungs. However, although a similar technique could be attempted in large and giant breed dogs and larger animals, this technique is potentially dangerous in children and small animals.
• If it can be visualised and lies at the back of the throat a foreign object causing choking can be removed by being grasped with long forceps (or something similar) passed via the mouth. This is best done by a skilled person such as a veterinarian or veterinary nurse, but in an emergency it could be attempted by an owner. NEVER put fingers inside the mouth of a conscious animal that is choking - there is a high risk that you will be bitten! 
• If a proper mouth gag is available this can be used by experienced personnel to hold the mouth open to gain access to the foreign object
• If removal of an object in a conscious animal is not possible a general anesthetic will be needed
• Under anesthesia many objects can be removed using a special scope (an endoscope) with a grasping device
• Depending on the type of object and the site of the obstruction surgery may be needed to remove the object

If a choking animal slips into unconsciousness it may be possible to remove the foreign object, then emergency resuscitation should be attempted :

• Remove the foreign body - see above
• After removal of the object the tongue should be pulled forwards to open the upper airway 
• The chest should be compressed by pushing down in forceful jerky movements every second for a minute,  to provide external cardiac massage and to stimulate breathing.
• If oxygen is available it should be administered by mask
• In a veterinary practice an endotracheal  tube can be placed into the trachea and various drugs can be used to help resuscitate the patient

Emergency tracheotomy. If the obstruction can not be removed an emergency tracheotomy can be performed. This should only be attempted by a skilled person :

• A cut is made using a sharp instrument (eg scalpel or  razor blade) in the midline of the front of the throat over the windpipe below the "adams apple" and below the obstruction.  
• A puncture is made in the midline of the windpipe between two of the firm cartilage rings
• A tube is passed through the hole into and down the windpipe.
• If the animal is breathing ok - if not, artificial respiration can be given by blowing down the tube every 5 seconds to inflate the lungs 

The procedures described here should only be used in an emergency and in all cases veterinary attention should be sought as soon as possible.

Updated October 2013