Changes

Bulk laxatives such as Psyllium are widely used to assist in the movement of sand. A mixture of Psyllium mucilloid and water is administered directly into the stomach via a nasogastric tube. This treatment is continued for up to a week until all sand is fully removed from the colon. Intravenous fluid therapy may be beneficial in increasing the fluid content of the impacted ingesta.

Bulk laxatives such as Psyllium are widely used to assist in the movement of sand. A mixture of Psyllium mucilloid and water is administered directly into the stomach via a nasogastric tube. This treatment is continued for up to a week until all sand is fully removed from the colon. Intravenous fluid therapy may be beneficial in increasing the fluid content of the impacted ingesta.

If the impaction is large or non-responsive to medical treatment or analgesia, surgery may be indicated. A ventral midline exploratory coeliotomy is peformed and the sand is removed via a pelvic flexure enterotomy. Post-operative complications such as ileus, peritonitis and endotoxaemia are relatively common due to the abrasive nature of sand.

If the impaction is large or non-responsive to medical treatment or analgesia, surgery may be indicated. A ventral midline exploratory coeliotomy is peformed and the sand is removed via a pelvic flexure enterotomy. Post-operative complications such as ileus, peritonitis and endotoxaemia are relatively common due to damage to the colonic wall.

Prevention of recurrence is important; horses should be fed from buckets to prevent further ingestion of sand. Water should be freely available and plentiful. Horses should not be allowed access to over-grazed pasture. High fibre diets such as hay are recommended.  

Prevention of recurrence is important; horses should be fed from buckets to prevent further ingestion of sand. Water should be freely available and plentiful. Horses should not be allowed access to over-grazed pasture. High fibre diets such as hay are recommended. Psyllium may be administered every four to twelve months to horses that are chronically affected.

===Prognosis===

===Prognosis===