Comparison of the effects of enteral psyllium, magnesium sulphate and their combination for removal of sand from the large colon of horses.
Authors: Niinistö Kati, Hewetson Michael, Kaikkonen Ritva, Sykes Ben W, Raekallio Marja
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Sand accumulation in the equine large colon represents a significant clinical challenge, yet evidence-based guidance on medical management options remains sparse. This prospective study evaluated the efficacy of three treatment protocols in 34 horses with substantial radiographically-confirmed sand deposits (>5 cm × 15 cm): psyllium mucilloid alone (1 g/kg), magnesium sulphate alone (1 g/kg), or a combination of both agents, each administered once daily via nasogastric tube for four days. The combined approach proved markedly superior, with nine of twelve treated horses (75%) achieving sand clearance by day 4 (defined as <25 cm² residual sand on lateral radiographs), compared to just three of twelve (25%) receiving psyllium monotherapy and two of ten (20%) on magnesium sulphate alone—both differences statistically significant. Practitioners managing sand colic cases should consider the synergistic benefit of combining these two agents rather than relying on either in isolation, particularly given the straightforward once-daily nasogastric administration protocol, though the study's relatively short follow-up window means longer-term efficacy and recurrence rates warrant further investigation.
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Practical Takeaways
- •For horses with large sand accumulations in the colon, combining psyllium and magnesium sulphate via nasogastric tube once daily for 4 days offers the best medical treatment success rate (75%), compared to either agent alone
- •Single-agent treatments have poor efficacy (20-25% success), so practitioners should not rely on psyllium or MgSO4 monotherapy for significant sand impactions
- •This combination approach provides a non-surgical option to attempt before considering more invasive interventions for naturally acquired colonic sand accumulation
Key Findings
- •Combined psyllium and magnesium sulphate treatment resolved sand accumulation in 9/12 horses (75%) within 4 days
- •Psyllium alone resolved sand in only 3/12 horses (25%)
- •Magnesium sulphate alone resolved sand in only 2/10 horses (20%)
- •Combination therapy was significantly more effective than either constituent alone (P<0.05)