Clinical findings and management of 153 horses with large colon sand accumulations.

The research studied the effects of the volume of sand accumulation in the colon of a horse when deciding between medical versus surgical management. It was found that the sheer amount of sand is not the determining factor, but rather the additional presence of gas accumulation and abnormal rectal examination results.

Methodology

• The study involved a retrospective examination of 153 horses presented for colic between 2004 and 2014.
• Medical records and abdominal radiographs were reviewed and the severity of sand accumulation was quantified by tracing and measuring a region of interest using a commercial software program.
• Various factors were recorded, including breed, weight, amount of sand, presence of diarrhea at presentation, treatment, and the development of complications.

Results

• The mean cross-sectional area of sand accumulation was found to be 692.9 cm, with a median of 658.7 cm.
• An increased accumulation of gas on radiographs and abnormal transrectal examination findings were associated with an increased likelihood of surgery.
• The most common complication was the development of diarrhea (20.3%), with only 2.6% of horses being positive for Salmonella spp.
• Horses had a favorable prognosis, with 94.8% of those treated medically and 94.7% of those treated surgically surviving to discharge.

Conclusions

• The study concluded that an increased accumulation of gas on radiographs and the results of a transrectal palpation of impaction or intestinal gas distension increase the likelihood of opting for surgery.
• Between medical and surgical treatments, both were found to carry a good prognosis.
• The overall amount of sand was not found to be a determining factor when considering surgical intervention, thereby suggesting greater emphasis should be placed on checking for increased gas accumulation on rectal or radiographic examination.