If your horse spends much of his day on fine, sandy soil, you might want to feed him psyllium monthly to help avoid sand colic.

Horses kept on fine, sandy soils are at risk of developing colic related to eating sand. Fortunately, some feeding and management techniques can minimize the risk of sand-related colic.

Sand colic basically means intestinal pain related to the presence of sand in the horse’s digestive tract. In its mildest form, the pain is low grade and related to irritation of the gut lining by the sand. This type of pain responds well to analgesics like flunixin (Banamine), though, of course, they don’t solve the problem of sand being there in the first place.

As the collections of sand get heavier, they can weigh down the intestine and pull on the surrounding tissues (the mesentery). This condition also responds fairly well to analgesics, but the bouts of pain may be more frequent at this point.

Pain at these stages is relatively mild and could even be missed entirely if the horse is not being closely watched. Nonspecific signs would include the horse being more sluggish under saddle or not moving around as much as normal in the field. The horse may seem preoccupied or irritable and be a little anxious or sensitive to touch. His appetite may or may not be off. With large accumulations, you may notice the horse standing stretched out or lying down more often.

As sand continues to accumulate, more serious problems can result. Impactions can occur or the horse may develop a volvulus, which is a twist in the colon. The volvulus may occur when the horse is rolling or exercising. To imagine this, picture a wet towel or rag that you twist to wring out the water. When a volvulus occurs, the food material cannot pass through easily, if at all, and blood supply may be compromised at the twist. With impactions or especially a volvulus, the horse may require surgery.

Calling the Vet
Any time your horse is exhibiting symptoms of discomfort that you think are related to an abdominal problem, you need to call the vet. “Better safe than sorry” always applies. Don’t give the horse drugs and wait to see what happens. There’s no such thing as a routine colic, and in the early stages, you won’t know which colic situations will turn out to be life-threatening and which ones will pass.

While the degree of pain is often used as an indicator of how severe the problem is, some horses are fairly stoic and will not show signs of severe pain until the problem has reached a point that the chances of successful treatment are very low. With sand-related problems, you are much better off calling the vet early, when symptoms are mild and you have a better chance of solving it without resorting to surgery.

If surgery will be needed, delay may mean the horse’s general medical condition (dehydration, etc.) is not all it should be to withstand anesthesia and surgery, and that the involved section of bowel may suffer irreversible damage.

Diagnosing Sand Colic
Diagnosing sand accumulations can be difficult. If the horse is colicky and has been eating from the ground or grazing in sandy areas, sand colic should certainly be suspected. But there are many other causes of colic.

Sand Sense
Keep your grass long enough that the horse won’t pull it out by the roots and eat the sand. Consider feeding psyllium one week a month to prevent sand colic. Be aware of any subtle changes in your horse’s attitude and condition Any colic can be serious, so don’t hesitate to call the vet. Early treatment can be a lifesaver and also may avoid surgery.

Rectal exams usually don’t help because the sand-filled segments of bowel are very heavy and lie low down, out of reach of the veterinarian’s hand. With obstructions of volvulus, the parts of the intestinal tract “upstream” from the blockage will usually be distended, but this doesn’t help in determining what is actually causing the blockage.

Performing a peritoneal tap is a standard diagnostic procedure with colics. The vet places a needle into the lowest portions of the belly and collects a sample of the fluid from the abdominal cavity. This is the fluid that bathes the intestines (not material from inside them), and changes in the number of cells or protein level provide clues as to the health of the bowel.

With sand collections, the procedure is riskier than usual because the needle could puncture a heavy loop of bowel sitting along the lower abdominal wall. If this happens, the specimen will contain sand and the diagnosis will be made, but the puncture will allow bacteria from the intestines to escape into the abdominal cavity, where they can cause peritonitis (inflammation/infection of the abdominal cavity).

The commonly used fecal tests for sand  will confirm if the horse is actually eating sand, but these tests are far from foolproof.

The best method of diagnosis is radiographs (X-rays) of the abdomen. On an adult horse, abdominal X-rays won’t show much detail, but they can pick up accumulations of sand and may show large pockets of gas upstream from the sand.

Psyllium and How to Use It

Psyllium is the common name for several plants in the genus Plantago. Psyllium seeds, particularly their husks (outer covering), are high in water-soluble fiber and mucilage. When mixed with water, this forms a gelatinous mass that stimulates bowel motility and can suspend loose sand, trapping it so that it is moved out of the bowel. To be effective, the psyllium has to be in contact with water and form this slimy, gel-like consistency. For best results, add water to the psyllium before adding it to the feed. Though it looks disgusting to us, most horses will eat it readily. Tightly packed psyllium pellets do not always break up well, so they may not be as effective as loose powder. Two good equine products are Uckele’s Psyllium Husk Fiber, www.uckele.com, $94.95/25 lbs., or HorseTech’s Sand Trap DFM, www.horsetech.com, $101.95/30 lbs. If your horse is recovering from a sand problem, use psyllium as directed by your vet. For routine preventive use in sandy areas, the most common recommendation is to feed 2 to 4 oz. of psyllium by weight (a 2 oz. volume measure scoop of psyllium weighs about 1 oz.) daily for a week, followed by three weeks off, then repeat the seven-day daily treatment. The reason for not using it every day is that the organisms in the horse’s large intestine can become efficient at digesting the psyllium. In fact, psyllium is a good prebiotic — i.e., “food” for the beneficial organisms. The problem with that as it relates to sand, though, is that the psyllium will be eaten by the organisms and therefore not available to help mechanically move the sand. Flax seed is another supplement that forms a slimy, gelatinous mass when soaked. Many people have asked if feeding flax, which has other health benefits too, would work instead of psyllium. The answer is yes, to a point. Psyllium contains at least six times more mucilage than flax seed, meaning you would have to feed a lot more flax to get the same effect.

Manure Tests for Sand

You can use several testing procedures to check for sand in your horse’s manure. They all basically involve taking one or several fecal balls, putting them into a large jar, adding water, stirring well to break up the balls and allowing the well-mixed solution to settle. Sand is heaviest and will show up as a layer on the bottom. Just about any horse will have some sand in his manure. As a rough guideline, the more you see, the more the horse is eating. However, the amount of sand does not indicate how much may have built up in his intestinal tract. Horses can have large, hard collections of sand with very little sand in their manure at the time of the test.

Treating Sand Colic
Horses whose sand collections have progressed to the point of a severe impaction or volvulus may require surgery. Your vet will use the same tests to determine whether surgery is needed as are used for any type of colic. These include:

Severe pain difficult to control with medicationsFluid backup on the stomach (fluid is obtained under pressure when a stomach tube is passed)

Very high heart rate

Abnormal color to the mucous membranes of the mouth (red or grey/blue)

Worsening dehydrationWorsening of findings on rectal exam

Changes in peritoneal fluid obtained by peritoneal tap

If the horse is being treated in a hospital setting, blood tests will also be used to monitor him and determine when it may be time to go to surgery.

For milder cases of sand colic, or those that are detected early and treatment begun before the horse is in bad shape, the decision is often made to try to get the sand to move out. This is done by intravenous fluids and oral administration of fluids and psyllium. Mineral oil is often used too, but that doesn’t help with loosening and moving the sand like psyllium does (see sidebar on page 19).

If your horse is fortunate enough to avoid surgery and respond well to fluids, psyllium and mineral oil, it’s very important to remember that this does not necessarily mean that all the sand has been removed. Removing enough to allow the intestinal contents to pass through will relieve the more severe symptoms, but considerable sand may remain.

This is why your vet will also recommend a maintenance program, which includes psyllium on a schedule to be determined by your vet, and starting a preventive program. Your vet may also recommend periodic X-rays of the lower abdomen to determine if any remaining sand collections are moving on, or are increasing in size again.

Preventing Sand Colic
You can’t completely prevent your horse from ever eating any sand, but there are several things you can do to minimize it.

Always ensure a steady supply of fresh water. While water alone can’t prevent sand accumulation, not having enough water in the gut causes intestinal contents to pack more tightly.

Do not allow grazing in pastures with sandy soils when the grass is short — either overgrazed or new growth. The closer to the ground the horse is eating, the more sand he’s likely to take in. This is because the lower portions of the plant will always have more surface dirt, and because the horse is more likely to pull the grass out by the dirt-covered roots, which some horses will also eat.

Never feed hay or grain on the ground. Buckets, tubs and hay racks/bunkers should be used. For best effect, do not place these on sandy soils either. A feeding area should be used where the ground is either tightly packed clay, concrete or covered with rubber mats. The protected area should be large enough that hay or grain spills onto the ground do not end up on sandy soil.

Don’t place salt blocks directly on top of sandy soils. Use a holder and place these in a protected area away from the soil. Otherwise, when blocks get rained on, the salt will melt into the ground, creating an attractive spot for dirt eating.

Consider feeding psyllium one week out of the month.