Efficiency of a Combination of Polyethylene Glycol and Psyllium on the Evacuation of Sand Compared to Established Treatment Regimes in Sand Enteropathy of the Horse

The accumulation of sand in the abdomen is a rising risk for colic in horses. Sand mainly accumulates in the ascending colon in the cranioventral abdomen. Evacuation of sand is facilitated by the application of psyllium supported with a laxative via nasogastric intubation. Laxatives currently used are either sodium sulfate/magnesium sulfate or mineral oil. The aim of this study was to compare the efficiency of polyethylene glycol, a laxative already used in human medicine for chronic constipation, with that of the above-described, established therapy options. Therefore, 44 horses diagnosed with sand enteropathy were randomly assigned and received psyllium in combination with either sodium sulfate, mineral oil or polyethylene glycol for four days. Pre- and post-therapy radiographs were assessed using a modified scoring system of Keppie et al. and Kendall et al. Adverse side effects during treatment were recorded and compared between treatment options. Median score reduction of sodium sulfate was −2 points, of polyethylene glycol −3.5 points and of mineral oil −2.5 points. Sand severity score was significantly reduced following all treatment options (p < 0.001), but did not differ between groups (p = 0.428). As all therapy regimens were successful in eliminating sand, polypropylene glycol might be the best option, as no adverse effects have been described in the literature or were seen in this study.