The Colorado Rocky Mountains… beautiful, majestic, with amazing recreational opportunities beckons visitors to come and live here. The mountains, as beautiful as they are, present a significant problem to horse owners …SAND. Rarely do we see our horses lapping up sand like its some rare commodity. But inevitably horses end up with burdens of sand in their intestinal tracts from grazing sandy pastures or eating off the ground. In areas with sandy soil, horses might pull up grass and ingest sand clinging to roots. Horses fed on the ground might eat sand as they clean up the last wisps of hay or kernels of grain. Even if fed in buckets or feed racks, horses might eat spilled feed from the ground. Intestines can be obstructed with sand, causing colic.
There are different symptoms presented by horses with an accumulation of sand in their intestines. A common presenting complaint is depression and inappetance. This is a common presentation of intermittent colic, losing weight or unable to gain weight (regardless of what the owner feeds them), and decreased appetite. Another common symptom is watery diarrhea. As the sand accumulates in the large intestine, it acts like sand paper and erodes the intestinal mucosa (lining of the gut). One of the large intestine’s functions is to absorb water. Due to sand accumulation and irritation to the mucosal lining, water is not absorbed well, resulting in watery manure. This same theory explains why horses with a lot of sand lose weight or are unable to gain weight. The horse’s intestinal lining is damaged and does not digest nutrients well. Because of the damage sand causes, this can cause discomfort and pain leading to depression, going off feed, or colic. A horse can show one or any combination of these symptoms with sand in its digestive tract.
There are various methods which an owner or veterinarian can diagnose a horse with sand problems. The easiest method is to take a small amount of manure (5-6 fecal balls) from the top of a fresh manure pile and dilute the manure with water. This can be mixed in a bucket, rectal sleeve or clear bag. First, one should break apart the manure manually and then sift off the top layers, which will result in the sand settling to the bottom due to gravity. More than 1/2 tsp of sand per 5-6 fecal balls is significant. However, horses can pass varying amounts of sand at different times – so this method should be repeated. This technique can give owners and veterinarians a ballpark idea of the degree of sand inside the horse. Another method to diagnose sand accumulation is for the veterinarian to listen to the horse’s abdomen with a stethoscope. The veterinarian will auscultate at the lowest aspect of the abdomen (gravity) for sand. You can hear the sand moving; it sounds like the sea moving off a sandy beach. Again, depending on how active the horse’s intestinal motility is , sometimes a veterinarian may not hear much sand movement even if the horse has a lot (for example, if the horse’s motility is hypomotile/slow during a colic episode). The last way to diagnose a sand problem is take abdominal radiographs (x-rays). Because the abdomen is so large, a very powerful x-ray machine must be used- usually only at referral hospitals.
So, how is sand accumulation treated? The best way to treat sand problems is to PREVENT them which means keeping the horse from ingesting it. In the Rocky Mountains, it is difficult to prevent horses from eating any sand at all. But, one can certainly reduce the bulk of ingestion. The primary time horses ingest sand is at “feeding time”. To reduce the amount ingested, some methods which work are:
Rubber mats under feeders or out in paddock/stall where horse is fed
Use large feeders on ground which can’t be overturned (old bathtubs/large plastic feeders)
Feed on top of shavings or straw
Offering grass hay during the day to give the horse something to do (rather than scrounge every morsel off the ground)
If you have one of the rare horses that just likes to eat dirt… a grazing muzzle may be needed (these muzzles have openings around the nose so horse can breathe & drink easily through them).Obviously, these need to be removed at feeding time.
Once a horse already has sand accumulation, PSYLLIUM is the only way to remove the sand (short of surgery). Psyllium tends to swell, pick up sand, and carry it along, moving it out of the tract with manure. There are numerous psyllium products available for horses. Psyllium comes in two forms, a powder or flavored pellets. The pelleted form is more palatable (tasty) to most horses and easier to feed. The powder form tends to blow away more easily, is less palatable, and can’t be mixed with water (or will turn into an undesirable gel mass). The recommended “colic” dose of psyllium for a symptomatic horse is a double dose per day for 2 weeks on, and then 2 weeks off until the sand accumulation is resolved. This could take 1-3 months. New studies have shown that mixing psyllium with a probiotic (ie. Probios) improves sand clearance. A new psyllium product, Assure Plus, now has probiotics mixed in with the psyllium. Or, you can buy a probiotic and mix them together yourself. After the initial high dose therapy, a maintenance dose of psyllium of 1 scoop per day for 1 week a month is recommended to prevent sand build-up. Sometimes when a horse with a lot of sand accumulation starts on psyllium, the horse may act colicky due to irritation and resulting inflammation of the sand passing through the gut. Your veterinarian may prescribe bute or banamine when a horse is treated for sand colic. Bute (phenylbutazone) and Banamine (flunixin meglumine) are anti-inflammatories which can reduce this discomfort. Some horses may also get gaseous when starting on psyllium. If this occurs, exercise, small amounts of bute or banamine given orally, and/or 30-60cc Maalox can ease this transient effect. Remember, psyllium is a helpful supplement to clear sand but will only work in combination with prevention. If your horse is still eating large amounts of sand, all the psyllium in the world won’t eliminate all the sand.
If your horse is treated for sand colic by a veterinarian, they will probably initially pass a nasogastric tube and give your horse psyllium, water and mineral oil. Studies have shown that the combination of psyllium and oil improve sand clearance. Sometimes during sand colic episodes, the horse’s intestines will slow down and become gas distended. If this happens, a combination of intravenous and/or oral fluids may be needed to treat the horse to improve the intestinal motility and expel the painful gas. If the horse has an enormous amount of sand and is not responsive to medical treatment by your veterinarian, surgical intervention may be needed. The horse is sent to a referral surgical facility and the sand is removed from the large intestine by a surgeon. Usually the prognosis is good, but there is a risk of the large intestine rupturing during surgery due to the heavy weight of the sand.- a horse can have as much as 100 lbs of sand in them!
The important thing to remember about treating a sand problem is PREVENTION! Treatment will not be effective if the horse continues to ingest large amounts of sand.