Sand Colic in Horses: Diagnosis, Treatment, and Prevention

Sand accumulation in the horse’s gut can lead to obstructions, irritation, and signs of colic, weight loss, and diarrhea. Read more in the Spring 2023 issue of The Horse.

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radiograph of significant sand accumulation in the large colon
This radiograph shows significant sand accumulation (outlined with arrows) in a horse's large colon. | Courtesy Dr. Isabelle Kilcoyne
Sand accumulation in the gastrointestinal (GI) tract of horses occurs commonly in regions with sandy soils, including Arizona, California, Florida, New Mexico, and Texas. Affected horses consume the sand inadvertently while grazing or eating off the ground. Horses housed on drylots with sand or dirt as the footing are more predisposed to picking up and ingesting sand as they eat, particularly if they are fed off the ground. Other predisposing factors can include poor-quality feed, overgrazed or overstocked pastures, and hierarchy if horses are housed together. Because sand weighs more and is finer than feed, it tends to settle and accumulate in a layer on the bottom of the large colon. A significant amount of sand can build up in the gut over time, leading to obstructions and irritation of the GI tract lining and resulting signs of colic (abdominal pain), weight loss, and diarrhea.

Diagnosing Sand Colic

If a horse exhibits signs of colic, and the owner or veterinarian believes sand might be a contributing factor, certain diagnostics can help confirm their suspicions. In addition to the routine colic diagnostic work-up, careful auscultation (listening with a stethoscope) of the ventral (lower) abdomen might reveal oceanlike sounds indicating the presence of sand. Veterinarians can also measure fecal sedimentation by placing fecal balls in a rectal sleeve and adding water to see if sand accumulates in the fingers of the glove. However, these methods are not always accurate, and horses with significant sand accumulations might not have sand in their feces at the time of examination. An ultrasound exam can help identify the presence of sand, but it can be subjective and does not help the vet quantify how much sand is present.

Gastrointestinal tract radiographs allow veterinarians to definitively identify sand in the gut and quantify how much has accumulated. The downside is this diagnostic modality might only be available in a hospital setting and not in the field, particularly for larger horses. Abdominal radiography is the best diagnostic method for evaluating the amount of sand accumulation, and it can also serve as a tool for monitoring sand disappearance with treatment. Further, evaluating radiographs for excessive gas accumulation might increase the index of suspicion of a displacement or complete obstruction in painful horses and expedite going to surgery if colic signs persist despite medical treatment

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Written by:

Isabelle Kilcoyne, DVM, Dipl. ACVS, is an associate professor of surgical and radiological sciences at the University of California, Davis, School of Veterinary Medicine.

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