Sand Colic in Horses

Sand Colic

Every horse owner is horribly familiar with the word, colic.  It is something dreaded by owners and riders because, despite the best management practices, colic can strike even in the most well-managed yards.

Why are horses prone to colic?

A small stomach and an enormously long hind gut with plenty of twists and turns along the way is a fertile landscape for a blockage of food material.  But the horse is also prey to other factors which can cause colic. 

The intestine is populated with gut flora which digests the food and is specific to the dietary elements that need to be broken down.  Change that environment suddenly and the digesting microbes have not had time to adapt and this can cause upset. Worm infestation, poor dental health or simple stress can also induce different types of colic.  All any self-respecting horse owner can do is follow the best practice which will minimise the possibility of the horse suffering a colic episode. It won’t, however, eliminate it completely.

Different types of colic

Colic is a generic description of gut pain.  The vet’s principal task is to establish what type of colic the horse is suffering from so an appropriate treatment plan can be determined. 

There are different things which can cause the intestinal wall to spasm which is partly a cause of the intense pain the horse experiences.  One of these is a physical blockage a popular reason for which is partly chewed or undigested food matter. Another contributor to a material obstruction is grains of sand producing sand colic.

What is a sand colic?

Sand colic is a specific type of colic caused by the ingestion of fine grains of sand from the soil.  The horse accumulates these over time in locations where there is sandy soil and grazing is commonly sparse.  If the horse is eating close to soil ground on poor pasture, it is easy to see how he will slowly uptake some of the contents of the soil.

Sand colic accounts for approximately 5% of total colic cases.  As symptoms of colic can be quite generalised within a set range, the vet would need to determine that it is actually sand colic and does not have another causation.  However, commonly these horses also present with diarrhoea which is not usually a symptom of other types of colic so this can be a significant indicator.

 Sandy soil

Horses that graze in areas with sandy soil are clearly more vulnerable to sand colic.  Grass quality is generally poorer in locations with this soil type and this contributes to the risk factor as good grass coverage clearly protects the horse from exposure to the soil beneath.  Risk can be increased with horses on permanent sandy pasture by feeding grain on the floor and also hay when the grazing is depleted. Both hay and fodder need to be fed at chest height if possible to minimise exposure.

Signs and symptoms of sand colic

Many signs of colic are general and whilst clearly indicating that colic is present, may not signpost which type of colic the horse is suffering from.  This has to be determined by a vet and time is of the essence. Some classic colic indicators include:-

·         Pawing at the ground and snatching up with the hind legs or kicking out

·         A bloated appearance to the abdomen of the horse which can indicate a large volume of gas

·         Sweating

·         Elevated heart rate and respiration

·         Repeated rolling

·         Box walking

·         Disinterest in food and water

·         A strange or unusual stance which the horse adopts to ease pain and discomfort

·         Absence of gut noises or alternatively, a very noisy and overactive gut

·         Swinging around and staring at the abdomen or trying to bite the area where the pain is located

·         Diarrhoea which is one sign specifically linked to sand colic.  This is caused by the abrasive nature of the sand grains against the intestinal wall and the loss of nutrient absorption resulting in watery droppings.  However, not every horse with sand colic will exhibit diarrhoea

·         There is a particular type of gut noise associated with sand colic, it sounds rather like the tide rolling in and rolling out, it is totally distinct to this specific type of colic

Sand colic can build up gradually.  Initially, the number of sand grains the horse ingests will not make a difference or at least one that is discernible to the owner.  If the horse is not removed from the pasture or other measures taken then the sand will increase and begin to trouble the horse. This type of colic has only one possible advantage in that there can be warning signs over the preceding weeks or months.  Horses may have mild colicky type episodes which pass quickly without intervention. They may sometimes appear out of sorts or uncomfortable. Their droppings may begin to change in texture and appearance.

Relying on these signs is not an excuse to do nothing as horses exposed continuously to sandy pastures can easily go on to develop full-blown colic.  Some horses don’t show any signs of trouble until serious colic is evident so you cannot rely on external warning signs potentially indicating the level of sand build up in the intestine. 

Managing horses on sandy soil

Keeping horses on sandy soil may be unavoidable if that is your location but there are steps you can take to minimise your horses’ ingestion of sand grains.  Sand colic does not have to be an inevitability of keeping horses on this type of land:-

·         Promote good grass coverage by rotating grazing and never allowing paddocks to be overgrazed or bare

·         If horses have to remain on spare pasture because there is no other available or they are on restriction for another reason such as laminitis, supplement inadequate grazing with a fibre source such as hay or haylage.  Feeding adequate good quality forage will compensate for poor grazing and help promote healthy digestive function in its own right

·         Feed hard feed and hay at chest height not on the ground

·         Do not turn your horse out onto spartan grazing after the first rains of the season

·         Monitor your horse’s droppings for any unexpected or unexplained changes

·         Test the faeces by taking a few balls of dung and dropping them into clear water, about a quarter of a bucket full.  Stir the manure until it is completely broken down and then let the contents of the bucket rest for about fifteen minutes.  Pour the contents of the bucket through a fine-meshed sieve or rectal sleeve which will remove the water and any large elements leaving you with fine grains of sand if they are present.  This is a good way to regularly check the droppings of horses grazed on this type of soil. Tiny amounts of sand may be present but anything more than the equivalent of a teaspoon would be a cause for concern. 

The droppings test is neither fully reliable nor conclusive and the absence of any sand in that particular sample does not mean your horse is free from sand in his intestine.  It is a good test as a routine and regular check for horse grazed on sandy pastures but is no substitute for calling the vet out if you suspect your horse has colic. Some horses will always show an element of sand in their droppings to no ill effect.  Different horses can tolerate varying levels of sand in their gut with some showing less tolerance than others. Good husbandry is a very effective tool at keeping sand in the horse’s gut negligible or virtually non-existent.

Veterinary intervention

Diagnosis of sand colic is made on the presenting symptoms, owner’s history and circumstantial evidence.  Digital radiography is now so advanced that vets can radiograph your horse’s abdomen to confirm the presence of sand, quantify the amount and assess the response to treatment. There are two types of treatment option which the vet may recommend. The main route which owners are familiar with is psyllium husks which are fed to help move the sand along the digestive tract.  Your veterinarian may also “drench” your horse with psyllium to help shift the sand. This involves passing a nasogastric tube to administer the psyllium directly into the stomach.

Horses that have a large obstruction which may not clear with psyllium may require surgery to remove the build-up of sand.

What are Psyllium Husks?

Psyllium husks are derived from the seed of the Plantago Ovata plant.  This plant has other names such as blond plantain, desert Indian wheat and blond psyllium. It is a medicinal plant found in western and southern Asia but it does also grow wild in parts of the United States.  It is used in human laxative products such as Metamucil.

Psyllium husks are highly soluble fibre and can absorb a lot of water in the horse’s intestine.  Sandflush is a natural psyllium husk pellet.

Benefits of feeding Sandflush include :

  • Sandflush is made from 95% human-grade psyllium ensuring only the highest quality psyllium husk is fed to your horse.
  • Sandflush is made in a Feedsafe accredited facility which undergoes stringest refugulatory measures.
  • Sandflush is extremely palatable to even the fussiest of horses.
  • Sandflush can has been Feedtested at only 13.6% sugar, meaning it is low-sugar and may be fed to horses and ponies prone to obesity or those suffering from Equine Metabolic Syndrome

Sandflush works as the pellets absorb water in the gastrointestinal tract to create a soft, sticky gel. As the husks pass through the intestines, they can collect the sand which adheres to the sticky substance and is then passed out via the manure. In the case of an actual bout of sand colic, once pain relief has been given, the vet may directly administer psyllium husks via a tube and this may be repeated several times a day for several days. It could be necessary to keep the horse hydrated via IV fluids. A large sand blockage that won’t shift may be potentially life-threatening and requires surgery.

Prevention is better than cure

If you have no option but to graze your horses on pasture with a sandy soil then you can feed your horse psyllium husks for one week in every month to ensure any sand ingestion is kept to an absolute minimum.  Psyllium works best if it is fed intermittently rather than continuously. Long term use can diminish the effectiveness. 

In a group of horses on the same pasture, some will always exhibit more sand in their faecal matter than others.  Some horses are less fussy about what they eat – youngsters and foals who are more curious – and certain horses seem to favour licking the soil whereas others in the group will not.  Treat each horse as an individual.

Never assume colic is caused by sand ingestion even if that appears highly likely and feed psyllium husks without taking veterinary advice.  If the colic is in fact caused by something else, you could make the situation far worse.

Outcomes

On the scale of seriousness, sand colic is usually deemed to be towards the mild or moderate end of the scale and responds well to fairly conservative treatment.  Left untreated however, and sand colic can prove fatal.

Colic in horses

Colic – what it is and how to treat it

Colic, the very word strikes fear into the hearts of horse owners everywhere but what is colic and how can it be both managed and prevented?

The definition of colic

Colic is a generic description of abdominal pain and is not confined purely to horses.  Other mammals and humans can also suffer from colic. However, in equines, it does have a specific connotation and is never something to be ignored.  Across the equine population, anywhere from between 4%-10% of horses can suffer at least one colic episode. There are different types of colic:-

·         Spasmodic Colic – literally muscle spasms or cramps in the intestine

·         Impaction Colic – a blockage usually caused by food material which has been only partially chewed through inadequate mastication or digestion and causes a physical obstruction at some point along the intestinal tract.  The horse will not usually pass any droppings

·         Gas Colic – a build-up of gas in the gut which can be caused by eating inappropriate food, for example, gorging on lush grass.  The gut will be very noisy and there will be a lot of flatulence

·         Sand Colic – this colic is caused by the ingestion of sand from the soil which builds up over a period of time, often due to inadequate grazing.  The sand accumulates eventually resulting in a troublesome blockage

·         Parasitic Colic – caused by a heavy worm burden particularly tapeworms and small redworms

·         Strangulation Colic- occurs when the blood supply to a portion of the intestine is restricted or cut off totally hence the name.  Strangulation colic is fairly rare but very serious

·         Twisted Gut – it used to be thought that this occurred due to the horse rolling repeatedly, twisting a portion of the intestine in on itself – a torsion – or where a section of intestine inverts into itself – intussuception

Why is colic so frightening for horse owners?

Colic is so worrying for horse owners because it can strike unexpectedly even with the best management routines and it can be fatal.

Colic must always be treated as a veterinary emergency.  Not every horse will succumb to colic but it is impossible to tell without veterinary intervention which type of colic your horse has.  Time is of the essence.

The symptoms of colic

Horses can exhibit a range of symptoms just prior to and during a colic episode.  Some horses may show some signs but not others. These can include:-

·         Unexpected restlessness which does not have any other obvious cause

·         A withdrawn, depressed demeanour

·         Box walking

·         Pawing the ground

·         Lying down and getting up repeatedly

·         Agitation including tail swishing, kicking up or out with the hind leg, swinging the head and neck around to stare at the flanks

·         Rolling

·         Lying on their back

·         Elevated respiration

·         Sweating

Colic attacks when they are in full swing can be violent and traumatic but often these bouts are preceded by a subtle change in the horse when they may appear dull and listless and just not quite right.  Any alteration in characteristic behaviour should always be closely monitored as this may just give you the requisite warning to make an early and prompt intervention. This could make the difference between a successful outcome and an unhappy ending.

Decisions on colic surgery are not to be taken lightly but must be taken quickly.  Studies have shown that early treatment from vets gives the horse the best chance of recovery.  If you are contemplating travelling a horse for surgery then you will need to do this before the colic becomes so severe that the horse is in too much pain and distress to be travelled safely.

Immediate First Aid

Contact your vet without delay.  Even if the colic looks really mild, it is helpful for the practice to know that you may have a potential issue and they can ensure someone remains nearby in your area, on hand when they are needed.

If the horse will remain in the stable then observe him.  Remove hay and any feed – if the horse has an impaction then this will only make it worse as food matter has nowhere to go.  Check for droppings and keep a note of the horse’s behaviour and whether he passes any more dung. Walking in hand can help certain types of colic – remember you don’t know which type your horse may have just by looking.  Mobility can help with gut motility and can ease discomfort in horses which are continually going down to roll.

What information does the vet need?

It is very easy to panic when presented with a colicking horse but it is important to remember that the vet needs clear information.  The type of things the vet will need to know include:-

·         How long the horse has been colicking for – you may have only just discovered the horse but the bedding may be disturbed and you should be able to tell the last time you saw the horse and it was well

·         What behaviour is the horse exhibiting?  Is he just uncomfortable and getting up and down occasionally or is he really in a lot of pain?

·         If you are able to provide heart rate and respiration this is useful

·         Can you hear any gut noises if you place your head against the side of the horse?  Check both sides

·         Is the number of droppings in the stable normal both in terms of number and appearance?

·         Is there anything that you may be aware of which has caused the episode – for instance, the horse broke into the feed room and has consumed pellets which are designed to be fed soaked or was discovered in a far-flung field on rich grazing so he has gorged himself.  This can give the vet a head start on what type of colic he may be dealing with

Veterinary treatment

Vets will treat colic as an emergency and prioritise your call.  Whilst you wait for the vet, you might wish to organise a few things.  Do you have transport available if required or do you need someone on standby?  Do you need a friend to travel with you if need be? If you have other horses that require attention in your absence, is there anyone who can do this for you if you have to travel the horse to a hospital quickly.

Upon arrival, the vet will examine your horse in one of a number of ways.  As well as listening to your account of events to understand the timeline, the vet will check the following:-

·         The colour of the mucous membranes in the mouth, nostrils and eyes

·         Check the hydration status of the horse

·         Heart rate

·         Respiration

·         Gut sounds

Depending on presentation and evaluation of symptoms, the vet may perform a rectal examination, nasogastric intubation, abdominal ultrasound or belly tap.  Treatment options will depend on the severity of the colic and the type of colic. Treatment options will include:-

1.    Pain Relief  – administered intravenously, for instance, Phenylbutazone or bute

2.    Antispasmodics – these are really effective with spasmodic or gas colic and calm down the muscle spasm that causes the intense pain

3.    Fluids or electrolyte therapy – usually administered via a drip, this can be done at home if necessary

4.    Laxative – most commonly, liquid paraffin which is used in the case of blockages of impactions and administered via a stomach tube

5.    Surgery – often the only option for some horses in the case of strangulation or twisted gut or blockages which cannot be moved via other means

Colic Surgery

Not for the fainthearted and really should only be contemplated in the case of early colic in an otherwise fit and healthy horse.  Colic surgery is far more commonplace than it used to be but that is because surgery has advanced so much in terms of technique, anaesthetics and post-operative recovery.  Colic surgery does however still present unique challenges and survival rates are now past 50% but this increasingly upward trend may be more a reflection of which horses are being presented for surgery in the first place.

Colic surgery is expensive.  Know if you are covered for surgery under your insurance policy and what is the limit on the claim.  It is not the time to be discussing this when your horse is down on the floor and rolling. Costs for colic surgery in Australia are heading north of $8,000 as a minimum so expect your vet to ask the question if you are contemplating opting for surgical intervention.

Colic prevention

Despite the best management routines, colic is sometimes unavoidable.  However, it is always worth eliminating or certainly reducing some obvious causes so that the risk can be minimised as much as possible.  Here are some points to consider:-

·         Manage your horse’s worm burden through appropriate treatments and faecal egg counts.  Worm infestation is known to increase the risk of colic

·         Introduce dietary changes very gradually so the gut flora can acclimatise.  This includes a move onto new pasture particularly in springtime, any hard feed alterations and even different hay.  The change should take place over a period of around ten days

·         Ensure dentition is in good order.  Poor mastication can mean that food is not adequately chewed before it is passed down the oesophagus increasing the chances of a blockage or impaction

·         Some horses struggle to process coarser fiber or straw even when their teeth are in good order.  Always make sure that your fiber source is suitable for your horse

·         Follow the principles of good feeding, feed little and often and never more than 5kg of concentrates in any one feed

·         Mimic the horse’s natural lifestyle as much as possible.  A higher percentage of colic cases occur in stable kept rather than grass kept horses.  One of the reasons for this difference is thought to be the constant movement of the horse when he is grazing in the field.  Good gut motility is linked to the horse’s mobility

·         Reduced exercise unsurprisingly also has an impact on the incidence of colic so horses suddenly confined on box rest due to injury or illnesses will need a review of their diet if they have been receiving a lot of hard feed

·         Horses which crib bite demonstrate increased susceptibility to colic

·         Stress through competition or traveling can cause colic.  Whilst it can be impossible to remove stress totally from the horse’s life, it is possible to manage it and minimise it with forethought and careful planning

A simple understanding of the complexities of the horses gut and the anatomy of his intestine will demonstrate quite clearly why they are prone to colic as a species. 

Good management practices will always promote the best health for the horse and reduce the likelihood of colic occurring.  Colic is no more or less common than it used to be but its fearsome reputation can cause undue worry amongst owners. Colic does not have to mean the end as some cases can respond quickly and successfully to veterinary assistance.  Always give your horse the best possible chance of a good outcome by seeking professional help quickly.