Study: Horses With Sand Colic Have 'Excellent' Prognosis
There usually isn’t much good news when it comes to colic. But, one researcher has reported that when it comes to sand colic, the news about prognoses is positive. Isabelle Kilcoyne, MVB, Dipl. ACVS, of the University of California, Davis, School of Veterinary Medicine, said this condition generally has an excellent prognosis regardless of whether horses receive medical or surgical treatment, during a presentation at the 2017 American Association of Equine Practitioners Convention, held Nov. 17-21, in San Antonio, Texas.

Sand accumulation in the large colon occurs relatively frequently in regions with naturally sandy soils, including California, Texas, and Florida. Affected horses, who consume sand inadvertently while grazing or eating off the ground, can develop gastrointestinal tract obstructions, intestinal tract lining irritation, altered gut motility, weight loss, diarrhea, and overt colic.

If a practitioner suspects sand colic, Kilcoyne recommended that, in addition to a standard colic workup, he or she take radiographs to help confirm sand in the gut and quantify how much has accumulated. This is because listening to the abdomen’s oceanlike sounds using a stethoscope (a traditional method of diagnosing sand accumulation) and measuring fecal sedimentation are only effective in approximately 20% of cases, she cautioned.

With a positive diagnosis, the veterinarian can discuss treatment options—either medical or surgical—with the owner. Kilcoyne said one of the key factors veterinarians should consider when selecting their approach is how much gas has built up in the abdomen, based on radiographs and transrectal palpation.

“Evidence of intestinal distention (swelling) due to that gas accumulation, based on radiographs or rectal palpation, suggests that surgery should be performed,” she said.

Otherwise, medical therapy involves providing intravenous fluids and passing a nasogastric tube to administer enteral fluids, psyllium, and either magnesium sulfate or mineral oil.

“Both medical and surgical management resulted in over 94% of treated horses surviving to discharge from our hospital, based on a review of the medical records of 153 horses with sand colic,” Kilcoyne said. “One factor to consider, however, is that half of all horses treated medically suffered recurrent colic, whereas only 17% of surgically treated horses suffered sand colic again.”

In sum, the amount of accumulated sand in the gastrointestinal tract does not dictate management strategy. Instead, gas accumulation appears to be a more important factor.