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Feline Choking Event
Choking is a common reason that pets are brought to the veterinarian. Usually, the owner confuses coughing or vomiting with choking and the pet is not truly choking. Understanding the cause and signs of choking can help determine proper care and treatment for your pet.
Choking can occur due to an obstruction of the airway from a foreign object in the throat, severe swelling of the throat or constriction of the neck. True choking is an emergency and immediate veterinary assistance is crucial.
Oral Foreign Object
Having “something stuck in the throat” is a common problem in pets. Due to their curious nature and indiscriminate eating habits, dogs and cats can get all kinds of items stuck in their mouth. Large pieces of food, bone, balls, toys, wood, cloth, metal and even fish hooks have been removed from the mouths of dogs and cats.
Just having an object stuck in the mouth does not always result in the emergency condition associated with choking. In order for the foreign object to cause choking, the object must obstruct the opening to the airway. For example, bone ingestion does not always result in choking. Bones can get stuck between teeth, around the lower jaw or even stuck on the roof of the mouth, but it only causes significant distress for the pet and not choking.
A complication associated with choking is pulmonary edema. This is the accumulation of fluid within the lungs associated with neck injury. The exact reason this occurs is not completely understood. When the neck is constricted or the airway is blocked, it is though that nerve stimulation in the neck results in fluid accumulation in the lungs. This can lead to significant breathing problems.
Other Causes of Choking
Severe throat swelling can occur and is usually associated with an allergic reaction or response to trauma. The tissues within the throat can swell so much that the opening to the airway is occluded.
Constricting neck injury is usually associated with collars and ropes. Dogs and cats that get collars tangled can choke due to the constriction of the neck from the tightness of the collar. In severe cases, dogs and cats can hang from collars, leashes and ropes. For example, a dog may be tied to a leash with just enough slack to jump the fence but not enough slack to allow the dog to touch the ground on the other side. A more common example is the exuberant puppy that constantly pulls on the choke chain while on a walk. This can result in choking.
What to Watch For
- Difficulty swallowing
- Difficulty breathing
- Pawing at face
- Anxiety and distress
Diagnosis is based on history and physical examination. For oral foreign bodies, a thorough oral exam reveals the cause of the obstruction. In severely distressed animals, sedation may be required to examine the inside of the mouth.
Chest x-rays may be necessary if breathing difficulty is noted. X-rays are taken to look for signs of pulmonary edema (fluid accumulation in the lungs).
A thorough physical exam is necessary to determine if there are any other injuries.
For oral foreign bodies, the foreign object needs to be removed immediately. After removal, the mouth needs to be examined again, to look for wounds that could have been caused by the object. Other treatments may include:
- Oral antibiotics if oral wounds are noted
- Removal of the collar and any constricting item
- Hospitalization, based on chest x-rays and physical examination
- Oxygen supplementation for cats and dogs with breathing difficulty
- Diuretics such as furosemide for animals with pulmonary edema to try to reduce the fluid in the lungs
- Tracheostomy in severe cases that do not quickly respond to treatment. This is a temporary measure that allows the pet to breath until the cause of the choking can be resolved. A temporary tracheostomy is performed by making a small incision in the neck. The trachea (windpipe) is then cut to allow a breathing tube to be placed directly into the trachea.In select cases, some patients may require assisted breathing with a ventilator.
If you notice your pet is choking, remove any item that may be constricting the neck. Examine inside the mouth and remove any foreign object you see. Do not blindly place your hand down your pet’s throat and pull any object you feel. Dogs and cats have small bones that support the base of their tongues. Owners probing the throat for a foreign object have mistaken these for chicken bones. Do not attempt to remove an object unless you can see and identify it.
If you cannot easily remove the object, lift and suspend a small animal with the head pointed down. For larger animals, lift the rear legs so the head is tilted down. This can help dislodge an item stuck in the throat.
Another method is to administer a sharp hit with the palm of your hand between the shoulder blades. This can sometimes dislodge an object.
If this does not work, a modified Heimlich maneuver can be attempted. Grasp the animal around the waist so that the rear is nearest to you, similar to a bear hug. Place a fist just behind the ribs. Compress the abdomen several times (usually 3-5 times) with quick pushes. Check the mouth to see if the foreign object has been removed.
Even if you are successful in removing a foreign object, veterinary examination is recommended. Internal injury could have occurred that you may not realize.
Make sure your pet has a collar that fits properly. Tight collars can create serious injury.
Do not let your pet have sufficient slack in a tie out to allow jumping over fences.
Keep all small items, toys and balls away from your pet. Super balls and racquetballs are a common cause of upper airway obstruction in large breed dogs. Make sure the ball you use to play fetch is large enough to prevent getting stuck in the throat.
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