I have an early retiree due to some back/neck/nerve pain (15, he’s been retired since 9 ish) that is a repeat choker as of about 18 months ago. He’s definitely got some sort of stricture right at his throatlatch so he never aspirates, just goes into bad coughing. It does resolve easily with ace/banamine, but I had a few vet visits before I figured that out (it also conveniently started when I was on DL with shoulder sx. I can give a 1 handed IM shot, but not an IV lol).
I’ve always soaked food primarily because it can never be a bad thing to get more water in them, and both of them get ration balancer with some added beet pulp or alfalfa cubes to make it seem like they get more than a handful of feed, I also use ground trays. So I was already doing a choke protocol when it started. No bueno. Even more fun when he was started repeat choking when he had access to hay and nothing else (hay hut/round bale). I was starting to think he wasn’t going to have a long term prognosis. I kept him off hay for a day and fenced him off the hay hut and put his hay on a ground nibble net. I found a net system for hay huts and introduced him back to the round bale with no more chokes, even when I removed the net so they could finish off the last 2 days of the bale.
A full year later someone left an obscure pasture side gate open and at some point in the wee hours of the morning they got out and ate 40 !!! lbs of deer feed at the feeding station, so there was a lot of vet attention, including trying to empty the stomach and oiling. I remembered the stricture and told the vet to use a smaller diameter ng tube (she could still feel it). There were no bad consequences to that buffet except to my wallet… BUT a few days later guess who choked? That’s when the light bulb went off on my head, he hadn’t done those repeat chokes on hay, but because the ng tube really irritated/inflamed the esophagus.
Well, alrighty then… Special horse continues being special. In addition to being an early retiree whose nickname is The Thug for the delightful way he treats his pasture mate, he cribs and is a choker. He also tried to bleed to death when he was gelded and any minor wound is problematic up to and including rejecting stitches. He’s pretty much told me in every way that they will be no extraordinary lifesaving measures if he colics since he’s not sx candidate and now he can’t get an ng tube w/o complications.