40 SPECIAL EQUINE THERAPY 



modic chokes almost as quickly as the effects of the injec- 

 tion become evident. If no relief is evident at the end 

 of three or four hours the injection may be repeated. All 

 feed must be withheld. Water is allowed. Sloppy food 

 should be given the patient for a few feeds after an 

 attack of choke. Cases that prove unusually obstinate 

 should be given several days' time before it is decided to 

 resort to surgical interference. In the meantime, an in- 

 jection, hypodermaticaUy, of a grain of apomorphin may 

 be successful in relieving the choke. 



Important points in the treatment of a case of spas- 

 modic choke are : 



1. Complete, absolute abstinence from food. 



2. Access to water must be allowed. 



3. Patience. Give the case time. There is no cause for 

 worry if all feed is withheld. 



4. Forbid all forms of mechanical interference. 

 Cases that do not yield to the above treatment within 



forty-eight hours are almost positive to be dilatation 

 chokes. Judicious use of the probang, or direct surgical 

 aid is then indicated. Cases in which the obstruction is 

 in the thoracic portion of the esophagus, and that do not 

 yield to medication must be patiently subjected to re- 

 peated entrances of the probang. The introduction of an 

 ordinary stomach tube and the irrigation of the mass 

 with water through this tube will, in many instances, 

 yield good results if patiently and delicately carried out. 

 The use of force is not permitted, especially in cases due 

 to dilatation of the esophagus. The esophageal wall is 

 very thin in some of these cases and is therefore easily 

 torn by even ordinary pressure. In the cervical por- 

 tion Merillat's operation is the operation of choice. 



Horses that are known to be the subjects of an esopha- 

 geal dilatation should be fed on semi-liquid feed at all 

 times. Even this, however, does not prevent occasional 



