Sand Enterotherapy

Sand Enteropathy is the accumulation of sand or gravel in the large colon, that subsequently causes inflammation of the colon wall. There is no doubt that most horses ingest some sand or gravel in their daily ‘graze’ around their stall or turn-out. I some areas of the country, like here in Arizona, there is little grass, and a higher likely-hood of sand ingestion. When the rate of sand intake exceeds the rate of sand elimination, it tends to build up in the large colon and cause irritation to the colon wall.

Horses with a significant amount of sand accumulation may be thin, ‘hard keepers’ that eat a lot, but do not gain weight. They may also have loose manure and pass sand in their manure. When the sand reaches a critical mass, colic signs can set in. If left untreated, the damage to the intestine can be so severe, that the intestine can tear and lead to death.

This patient is a 9 year old, quarter-horse mare, that developed colic signs.

– Sand Enterotherapy

This is the initial x-ray showing a mixture of sand and gravel accumulation in the large colon (red arrows).

– Sand Enterotherapy

Gravel passed in her manure during treatment.

This patient was treated with double doses of psylluim and probiotics to encourage passage of sand/gravel. Her access to sand was controlled as much as possible.

– Sand Enterotherapy

After 5 weeks of treatment, follow-up x-rays show a significant decrease in the amount of sand/gravel accumulation in the large colon (red arrows). Her owner reported that she had not been showing any colic signs.

Horses with sand in their intestines are usually thin despite a good appetite, have a poor haircoat, and pass loose manure.

An examination by a veterinarian can help to identify the presence of sand within the intestine. X-rays are the best way to see the amount of sand present and to monitor its passage during treatment.

If discovered early, medical treatment is usually successful in removing the sand. However, if it has reached a critical mass and is causing an obstruction or is not passing with medical therapy, surgical removal is required.

Floating your horse’s manure periodically can help identify sand passing in the manure

  1. Place 2 fecal balls in a plastic baggie
  2. Fill baggie 1/2 full of water
  3. Agitate to loosen manure ball to release any sand
  4. Hang baggie with one corner down, for 5 minutes, then examine the lower corner for any sand grains. Even a few grains can be significant
  5. If you find sand in your horse’s manure call your veterinarian for advice.

Here are a few ways to help prevent sand enteropathy:

  • Use stall mats under feeding areas and sweep them clean frequently
  • Limit turn-out in sandy areas if possible
  • Use a grazing muzzle to decrease sand intake.
  • Feed a psyllium product daily for 7 days, each month.

The bottom line is treat your horse if there is sand in his intestine, before it causes weight loss or colic.

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