Comparison of psyllium feeding at home and nasogastric intubation of psyllium and magnesium sulfate in the hospital as a treatment for naturally occurring colonic sand (geosediment) accumulations in horses: a retrospective study

Abstract

BackgroundIngestion of geosediment (further referred as sand) may cause weight loss, diarrhea and acute or recurrent colic in horses. Our aim was to compare the efficacy of three treatment protocols in clearing colonic sand accumulations in clinical patients. This retrospective clinical study consisted of 1097 horses and ponies, which were radiographed for the presence of colonic sand. Horses included to the study (n = 246) were displaying areas of sand in the radiographs of ≥75 cm2 and were treated medically monitoring the response with radiographs. The horses were assigned into three groups based on the given treatment: Group 1 was fed psyllium [1 g/kg body weight (BW)] daily at home for a minimum of 10 days (n = 57); Group 2 was treated once with psyllium or magnesium sulfate by nasogastric tubing followed by daily feeding of psyllium (1 g/kg BW) at home for a minimum of 10 days (n = 19), and Group 3 was treated by daily nasogastric tubing for 3–7 days with psyllium and/or magnesium sulfate (1 g of each/kg BW) (n = 170).ResultsThe initial area of sand did not differ significantly between the treatments. Group 3 had significantly less residual sand than Groups 1 and 2, and the proportion of resolved horses was higher in Group 3 than in Groups 1 and 2.ConclusionsDaily nasogastric tubing with psyllium and/or magnesium sulfate for 3–7 days removes large accumulations of sand from the colon in horses more effectively than feeding psyllium for at least 10 days.

Psyllium supplementation is associated with changes in the fecal microbiota of horses

“…Contrary to our hypothesis, fecal silica analyses (ADIA) from this study did not demonstrate any increase in silica excretion with manufacturer-recommended prophylactic doses of psyllium husk crumbles. Other studies providing therapeutic doses of psyllium as well as combinations of additional therapeutics (prebiotics and probiotics) demonstrated increased clearance of silica with supplementation [2,13,15,27]. We did see greater levels of fecal silica excreted from the yearlings.…”

Free Faecal Water: Analysis of Horse Faecal Microbiota and the Impact of Faecal Microbial Transplantation on Symptom Severity

“…PPIs have been recommended when performing FMT as the acidic gastric environment can limit the viability of the transplanted microbiota [27,48]. Psyllium is a dietary fibre that has a gutstimulatory effect, and can be used in the treatment of diarrhoea, constipation and sand accumulation [49][50][51]. Whilst it could be speculated that omeprazole and/or psyllium directly contributed to the decreased FFW symptom severity observed in this study, this would seem unlikely as no significant decrease in FFW symptom severity was seen until 14 days after their last administration.…”

Diagnosis and management of sand enteropathy in the horse

“…Radiography is considered the reference standard for diagnosis of sand enteropathy, as sand and other types of geosediment give a distinct shadow of mineral opacity in the abdominal radiograph (Fig 1a and b). Absolute size, or size relative to the horse's size, has been used to categorise sand accumulations in order to compare these with clinical signs or the accuracy of other diagnostic methods (Kaikkonen et al, 2000(Kaikkonen et al, , 2016Ruohoniemi et al, 2001;Korolainen & Ruohoniemi, 2002;Kendall et al, 2008;Keppie et al, 2008;Hart et al, 2013;Kilcoyne et al, 2017, Niinist€ o et al, 2019. Grading systems based on height and length (Kendall et al, 2008;Korolainen & Ruohoniemi, 2002) or area (Kaikkonen et al, 2016;Kilcoyne et al, 2017;Niinist€ o et al, 2014Niinist€ o et al, , 2018 of the accumulation visible in the radiograph have been used to describe the two-dimensional size of the accumulation.…”

“…Absolute size, or size relative to the horse's size, has been used to categorise sand accumulations in order to compare these with clinical signs or the accuracy of other diagnostic methods (Kaikkonen et al, 2000(Kaikkonen et al, , 2016Ruohoniemi et al, 2001;Korolainen & Ruohoniemi, 2002;Kendall et al, 2008;Keppie et al, 2008;Hart et al, 2013;Kilcoyne et al, 2017, Niinist€ o et al, 2019. Grading systems based on height and length (Kendall et al, 2008;Korolainen & Ruohoniemi, 2002) or area (Kaikkonen et al, 2016;Kilcoyne et al, 2017;Niinist€ o et al, 2014Niinist€ o et al, , 2018 of the accumulation visible in the radiograph have been used to describe the two-dimensional size of the accumulation. The exact amount of radiographically measured sand required to cause disease is not known but >75 cm 2 has been suggested as clinically relevant breakpoint (Korolainen & Ruohoniemi, 2002;Niinist€ o et al, 2019).…”