Investigation of the treatment of sand accumulations in the equine large colon with psyllium and magnesium sulphate

K.E Niinistö,M.O Ruohoniemi,F Freccero,M.R Raekallio

doi:10.1016/j.tvjl.2018.06.005

Abstract

Enteropathy associated with sand accumulation in the large colon of horses has been reported worldwide. Intestinal sand accumulations are commonly treated medically, but randomised controlled clinical trials on horses are scarce. This prospective study evaluated the efficacy of an enterally administered combination of psyllium and magnesium sulphate (MgSO4) for the removal of large colonic sand accumulations in horses without clinical signs of acute colic. The two groups comprised 20 untreated control horses and 20 horses treated with 1g/kg bodyweight (bwt) of psyllium and 1g/kg bwt of MgSO4 administered by nasogastric intubation once daily for 4 days.Both groups had no access to soil during the study period. The amounts of accumulated sand were evaluated radiographically before and after treatment. Significantly more treated horses cleared their sand accumulations than horses in the control group. This clearance was determined by observing the estimated quantity by area of sand remaining in the large colon (P<0.001) and by comparing the numbers of successfully treated horses (P=0.004) between the two groups after 4days of treatment. However, there were unexplained individual variations in the clearance of sand accumulation.

Highlights

Enteropathy associated with sand accumulation in the large colon of horses has been reported worldwide
The two groups comprised 20 untreated control horses and 20 horses treated with 1 g/kg bodyweight of psyllium and 1 g/kg bwt of MgSO4 administered by nasogastric intubation once daily for 4 days
Most horses in both groups required sedation for radiography, but this did not appear to affect the clearance of sand

Summary

Introduction

Enteropathy associated with sand accumulation in the large colon of horses has been reported worldwide. Even though medical (Ruohoniemi et al, 2001; Hart et al, 2013; Niinistö et al, 2014; Kaikkonen et al, 2016) and surgical removal of sand (Specht and Colahan, 1988; Ragle et al, 1989, 1992; Granot et al, 2008; Kilcoyne et al, 2017) has been described both in clinical cases (Ruohoniemi et al, 2001; Hart et al, 2013; Kaikkonen et al, 2016) and experimentally (Hammock et al, 1998; Hotwagner and Iben, 2008; Landes et al, 2008), randomised controlled clinical trials are lacking. A recent retrospective study reported on the efficacy of repeated nasogastric tubing with psyllium and/or MgSO4, compared with orally administering psyllium (Kaikkonen et al, 2016) and another study suggested beneficial effects of combining psyllium with MgSO4 for the removal of intestinal sand accumulations, but this study lacked an untreated control group (Niinistö et al, 2014)

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