Prevention and Treatment of Horse Sand Colic
Colic is the most common medical ailment in the horse. by Jay Altman, DVM
Sand Colic Prevention
Over the past 25 years there have been great strides in both the prevention and treatment of equine colic.
Improvements in deworming products and schedules, equine dentistry, and management practices have
helped to reduce the number of colic cases. Advances in veterinary knowledge and the development of new
drugs and surgical techniques have helped to improve the survival rate for horses suffering with colic. Still
today, each year 10-11% of the horse population suffers from colic. One of the causes of colic, sand ingestion, can be a substantial risk to certain horses.
Horses ingest sand either through grazing or eating hay or grain from the ground. The problem is most
prevalent in the semi-arid west and southwestern states and the coastal states, although it can be a problem
in any state. Soil or “dirt” consists of a certain amount of sand, which is a naturally occurring finely divided
rock. In fact, many soils not only contain sand, but also contain silt which is an even finer particle of rock and
some contain gravel which are the rock particles that are larger than sand. The silt, sand and gravel ingested
must travel through the digestive system of the horse to be removed within the feces. One of the problems
associated with this situation is that the sand and gravel and to a lesser degree the silt can produce irritation within the digestive system.
Additionally, in certain situations the sand can accumulate within the digestive system and the irritation can
intensify due to this accumulation. As sand accumulates in the intestinal tract, a combination of the irritant
effects and the weight of the sand can lead to impaired motility, reduced absorption of nutrients including
water and thus, digestive upset. If the accumulation of sand continues, the resultant digestive upset will
eventually lead to poor condition, diarrhea and eventually colic. Making the situation even more troubling is
the fact that clearance of the sand from the large colon, where most sand accumulates, requires adequate
gastrointestinal motility. So once the sand begins to collect in the colon, any resulting reduction in motility will further add to the horse’s accumulation of sand and gravel.
As mentioned above the signs of sand accumulation can include poor condition, difficulty in maintaining
weight, diarrhea and colic. Since none of these conditions are unique to a sand accumulation problem, the
owner seeing any or all of these signs cannot assume that the cause is sand. Sand accumulation can at times
be diagnosed and there are four methods for this diagnosis, two of which are not conclusive and two of
which are. The easiest of the methods, since the horse owner can perform it, is the fecal floatation test. With
this method feces are collected from the horse and a standardized amount is added to a container with water
. The water and feces are mixed so that any sand within the feces is suspended within the mixture and then
allowed to settle to the bottom of the container. Once the sand has settled in the bottom of the container, the
sand can be quantified. Although many veterinarians suggest this method and it has historically been
considered to be one of the best in field tests, it has limitations. The test by design will inform you the horse is
passing sand through his digestive system. The test will not tell you if the horse is accumulating sand within
the digestive system. If some amount of sand is detected in the feces, it could be that the rate of ingestion and
the rate of sand passage is equal and the horse is not accumulating any appreciable amount within the colon.
On the other hand, if the rate of ingestion over a period of time outweighs the rate of sand passage, the horse begins to accumulate sand within the colon.
Once this accumulation begins there is a likelihood that the sand will impair motility within the colon and
additional accumulation will ensue. If no sand is detected using this test method one must then wonder if the
horse is accumulating sand, because none of it is being passed in the feces. If very large quantities of sand
are detected within the feces one can assume that the horse does have a sand problem. So although this test is used, the results are often hard to interpret and should always be scrutinized.
The second method, which is most commonly performed by a veterinarian, is to listen for sand in the colon.
Utilizing his stethoscope your veterinarian can listen to the contractions of the colon within the abdomen and
under certain conditions can actually hear the sound of sand moving within the colon. When the veterinarian
discovers this sound and diagnoses a sand condition the results are reliable. Where this method encounters a
shortcoming is when the sound is not detected, yet there is actually sand within the bottom of the colon. This
can occur if the sand load is not moving either because the sand has impaired motility of the colon itself, or
the normal motility within the colon does not have the force to move the sand and thus create the sound.
The two methods that are completely reliable for sand detection are not readily accessible and are both quite
expensive. The first method is to radiograph the abdomen and diagnose the sand load based upon the
radiograph results. Equine abdominal radiographs must be performed in a hospital or clinic, with a
radiograph generator that is powerful enough to penetrate the equine abdomen. Although this method is non
-invasive it is inconvenient and incurs considerable expense. Furthermore, although considered to be reliable,
some doctors have questions as to the sensitivity (ability to detect the sand) of this test, when the sand is
spread over 70-100 feet of intestines. The last method although possibly the most reliable, is not only
impractical for many reasons, but it is also invasive and expensive. Exploratory abdominal surgery although
totally reliable in detecting sand, is only chosen with a horse ill enough to undergo colic surgery to relieve the condition.
It is recommend that if your horse is exposed to eating sand or dirt, the first step is to control the
consumption through management changes. These changes include feeding, both grain and hay, only out of
feeders, feeding off the ground and using mats in the feeding area. These steps will all help to control the
sand intake. When feeding outside in a dry lot or a sparsely vegetated pen or pasture, covering a large area
with mats, will help control both the eating area and the surrounding area where the horse is likely to browse
for every last morsel of hay. These control measures will help in many cases, yet there are situations in which
it is either hard or impossible to control the consumption of sand including herd pasture management, dry
-land pasture grazing, and various other housing arrangements. For horses that do consume some quantity of
sand, if complete control of sand intake is not possible, sand removal treatment with psyllium is a viable
option. Historically there have been four problems with most psyllium treatments, not enough psyllium within
the product administered, not enough product administered at each dosing, not a long enough or regular
enough treatment period, and the lack of clearance due to altered colonic motility. There is a new, pelleted
psyllium product that has just become available, called Assure Plus, and this product works to overcome
the common shortcomings of prior psyllium protocols. The investment in management changes and Assure Plus treatment can result in a healthier and less colic prone horse.
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