“My dog is choking!” I get these frantic phone calls way too often. Sometimes at two o’clock in the morning. Or the time I was sitting in my backyard in a bathing suit reading on a sunny Sunday afternoon. A man came racing around the side of my house carrying a big labrador in his arms, shouting urgently “My dog is choking!” I got another such case early one morning last month. An urgent message from the answering service. A client reported that her golden retriever, Slippers, was choking on the squeaker from a dog toy. You dog owners know what she was talking about — those stuffed animal dog toys with an air-filled plastic sphere inside that makes squeaky noises when the dog squeezes it. I know my dog, Quinna, will not stop chewing toys like this until she eviscerates it and kills that squeaker. Slippers must have done the same thing to her toy.
There were two possibilities I needed to consider. Maybe Slippers had tried to swallow the squeaker and was gagging because it was stuck in her esophagus — the tube that connects mouth to stomach. Or was the squeaker lodged in a way that was obstructing her trachea — the “windpipe” that carries air to the lungs? Here’s where we have to talk about semantics. The standard definition of choking is when a person or animal is having “severe difficulty in breathing because of a constricted or obstructed throat or a lack of air.” Actual cases of choking in the true sense of the word are rare in dogs.
If Slippers had merely swallowed the squeaker and it had gone all the way into her stomach, she would probably not be showing any signs her owner could misinterpret as choking. Any time a dog eats a large inedible object, there is the risk of intestinal blockage. The good news is that although this must be addressed promptly, it is almost never an acute life-threatening emergency. Some material can be encouraged to pass with the administration of lubricant laxatives and keeping the animal well hydrated with subcutaneous or intravenous fluids. Objects that are truly too big to pass can be removed surgically, but there is almost always time to plan where and when to do such procedures. Over the years I have removed large rocks, rib bones, socks, fish hooks, tampons, strips of car seat upholstery, a super ball, and a variety of other objects from animals’ stomachs or intestines.
Once in a great while, however, a foreign object gets swallowed but doesn’t get all the way down to the stomach, lodging instead in the esophagus. In horses this is actually such a frequent occurrence it is known by horsey folks simply as “choke.” The horse certainly can look as if he is choking. He may seem anxious, extend his neck, repeatedly cough, snort, and gag. But these horses are able to breathe just fine. The food lodges in the esophagus, not the windpipe. Choke usually occurs when horses eat too quickly, don’t chew enough, or swallow large chunks of things like apples or corn cobs. Left untreated, it can lead to dehydration, pneumonia, and permanent damage to the esophagus. I haven’t done any equine work in many years, but I believe it is still treated with sedatives or muscle relaxants and, if needed, with a nasogastric tube to lubricate and flush the material down. If the squeaker was stuck in Slippers esophagus, like a horse “choking” on an apple, she would best head straight off-Island to a specialist who could try retrieving it using a fiber-optic endoscope. But what if the squeaker was truly occluding her airway?
Although very rare, it sometimes happens that an over-eager dog playing catch gets a ball or other such object pushed too far back in the throat, blocking the windpipe. These animals are truly choking and can die very quickly from lack of air. It is possible to try a modified Heimlich maneuver, but this is not very effective in dogs. If the dog is conscious, one can try to remove the object with forceps. If unconscious, a finger sweep can be attempted with caution. (Never stick your hand in a conscious dog’s mouth as you risk serious injury this way.) I recently learned of a new, safer, and more effective emergency treatment for extracting an object like a ball from the throat of an unconscious choking dog — the eXternal eXtraction Technique (XXT). It’s not something you should ever try at home but if you want to learn about it there is an interesting training video, at youtube.com/watch?v=ABDnuvbREX4 as well as videos of actual dogs being saved by veterinary professional staff at youtube.com/watch?v=j-OPuDVl-jM.
I have never needed to use such a maneuver, but I was on high alert and ready to try if necessary. Knowing that time was of the essence, I called the client back immediately, adrenalin pumping. False alarm. Turns out Slippers had chewed up the toy the day before. The owner was just worried because she couldn’t find the squeaker, and because Ruby had been coughing and gagging quite a bit yesterday. That morning she was already improving but her mom wanted us to check her out, just to be sure.
“My dog is choking!” More than half the time, the dog in question either has infectious tracheobronchitis, commonly known as kennel cough, or a condition called “reverse sneeze.” These animals are not choking. They are coughing and sneezing. False alarm. On physical exam, Slippers was breathing fine. She ate treats eagerly with no evidence of esophageal obstruction. We advised her owner to continue to observe Slippers and call back if anything changed. Oh, and the dog who was carried into my backyard that sunny Sunday summer day? He just had a stick stuck across the roof of his mouth and was freaking out. I pulled the stick out using a pair of hemostats. He wasn’t choking either.
