How long to clear sand from gut?

[BlueDrifter]

My new 4yo horse has a “lot of sand” per vet listening for it.

Her recommendation was double-dose psyllium for two weeks and recheck.

Still sand…

Now on normal dose Assure Plus for six weeks.

He is eating off mats and shavings. Orchard+three-way He has some fecal water 4 of 7 days.

After reading about how psyllium works from the AssurePlus site, it seems very little sand is removed w psyllium, and psyllium acts as probiotic and laxative, but hay is what moves things along.

Is there any guidance as to how long it takes to clear sand?

The alternative is 3 hospital days of NG tube and psyllium+laxative. That doesn’t sound like fun.

[Scribbler]

Does he have any symptoms?

[2tempe]

You are correct that psyllium itself doesn’t move the sand, the hay does. I dont have the answer to your question as to how long. But you say he is new to you; did he come from an area where there is lots of sand? Is that different from where you are? Life style change alone may take away some of the worry and reduce the risk. That said, free choice hay, slow feeder.
I’m no expert on listening to sand in the gut. Our vet listens but also likes the visual test method - how much sand is coming out in the poop. You can do this yourself periodically for tracking purposes.
I’ve been in Florida (land of sand!) for 13 years, have horses at 2 boarding barns and do not know of any cases of identified as sand colic. This is NOT TO SAY it doesn’t happen; but it is only one of many reasons a horse will colic.
BTW if you are really worried, an abdominal xray can be done, but for now, with no symptoms of discomfort, I’d just do management as you already have begun.

[Roadmix3]

My older gelding had sand colic, so basically he was starting to show symptoms from his sand load. They didn’t hear anything odd when listening to his gut sounds, but found it on abdominal x-rays. He had a lot of sand. Sand is heavy and does collect, and sink to the bottom portion of the intestines, making it hard to be moved out when there is a large accumulation. I also read that lots of hay/fiber helps it to move out, but I wonder sometimes if that’s only helpful when there isn’t much built up already? I don’t know for sure of course, just a thought.

He stayed at the equine hospital for three days with IV fluids, then they tubed him each day with a mixture of mineral oil, water and psyllium. We then went home with instructions to be on a psyllium product, like sand clear (but they make others too). They wanted him on the product for about a month, then transition to the standard seven days out of each month protocol. Upon x-ray recheck, the sand was all gone, except for some slight sediment left in the lower portion of intestines. You can try an abdominal x-ray to see what the accumulation looks like, and that will probably give some direction on how to go about treating him from there. Just some ideas.

[BlueDrifter]

He has no symptoms, other than a bit of fecal water, which I initially attributed to a new diet. He was on bermuda/poor alfalfa per seller. Now he is on orchard/3-way. He appears to be a little pudgy to me, but others have said that it is just muscle and we can feel (not see) his ribs. He was an active ranch horse, so he is well-muscled.

I have had him two months. The first month he was in a very sandy temp corral. I fed in haybags, but there is spillage. Vet thinks accumulation isn’t just from temp corral, but from prior location.

I have read that the fecal ball test doesn’t really tell you much – as the presence of sand could be an efficient “moving out of system” vs evidence of an accumulation - but I am going to do it anyway. I would definitely do xrays if vets can still hear it at end of December. I was just wondering if 8 weeks is enough time for sand to pass.

I was also reading prior threads that said Amazon psyllium powder worked better for them than the horse psyllium pellets. I know AssurePlus markets that their psyllium is “better” than others, but really?

[2tempe]

UltraCruz makes a psyllium powder, on Amazon, that I use. Its a big bag so dont get shocked by the price, it lasts a long time when you are on the 1 week/month. It will be more cost effective than the pellets. Agree that the fecal test is only part of the story, but done maybe weekly it can tell you what is coming through and if there are noticeable changes.

[BlueDrifter]

Thanks! I will look into UC psyllium after my AssurePlus is used up. I am going to try the fecal test today.

[Warmblood1]

More common in Europe, but I believe the most effective way of removing sand is via nasogastric tubing using psyllium and magnesium sulphate.

Comparison of the effects of enteral psyllium, magnesium sulphate and their...

The best way to treat sand colic

[BlueDrifter]

Yes, that is what my vet said would be the next steps. Didn’t sound like much fun. Then others said it took a LONG time to clear sand using psyllium/hay and removing access to sandy feeding – I was just wondering if that “long time” was weeks or months.

I am doing the AssurePlus until end of December, and then likely do an xray if they still hear something. But no symptoms, and he is getting plenty of exercise, and no longer near sand, so I dunno, fingers crossed?

[Garythesquirrel]

This is an interesting study on treating sand colic in horses:

https://www.sciencedirect.com/science/article/pii/S1090023318302648?via%3Dihub

## Conclusions

This study demonstrated that medical treatment of horses with sand accumulation in the large colon by daily nasogastric tubing of a combination of psyllium (1 g/kg bwt) and MgSO4 (1 g/kg bwt) for 4 days resolved the sand accumulation more efficiently than only preventing access to soil. However, in some horses, sand accumulations did not fully resolve, even after continuation of medication for 7 days, although the area of the sand accumulation decreased by at least 50%.

[Warmblood1]

If I’m remembering correctly, the oral route maybe clears ~22 percent of horses. Success rate is quite low even over a more extended treatment (versus 3-4 days with the nasogastric tube).

[BlueDrifter]

Oh my, you guys are not encouraging, lol (!!)

I do have one sand clearing first hand experience. My horse was colicking every 3 days. We xrayed, he had sand and a nail. San Luis Rey said that wasn’t the cause of his colic.

I begged San Luis Rey to keep him for a week. They did, on pasture. He didn’t colic. We decided the colic was pain from pulled shoes (first horse, I thought barefoot was better). We re-shod him and I asked for an exit xray: sand and nail were gone.

Granted, that must have been a small amount, but horses CAN clear some on their own.

BTW, I did the fecal test. Or tried too. All I got was a sediment layer of hay – I poured off the liquid, added more – still just hay at the bottom, no sand that I could see. There must be a way to get the hay to pour off?

I realize that no sand could just mean that he can’t pass any of it. I sense an xray in my future.