title: Medical management of sand enteropathy in 62 horses.
abstract: BACKGROUND
  Medical management of sand enteropathy is common in equine practice, but the clinical features and outcomes associated with medically managed sand enteropathy are not well described.
  
  
  OBJECTIVE
  To review clinical features, therapeutic approaches and outcomes associated with primary medical management of sand enteropathy in the mature horse.
  
  
  METHODS
  Medical record databases at 3 equine referral hospitals from January 2000 to April 2010 were reviewed for cases of sand enteropathy diagnosed via abdominal radiographs in mature horses that were initially managed medically. Data were collected and descriptive analyses compiled. Uni- and multivariate logistic regression was used to evaluate factors potentially associated with treatment failure.
  
  
  RESULTS
  The medical records of 62 horses were analysed; 90% of horses survived to discharge and 50% of horses that had repeat abdominal radiographs taken demonstrated improvement in the degree of sand accumulation after treatment. Nine horses underwent exploratory laparotomy during hospitalisation, and colonic sand impaction was found in all 9, with a concurrent gastrointestinal lesion identified in 7. Four horses were subjected to euthanasia during or after surgery because of disease severity or complications. Need for exploratory laparotomy was the factor most strongly associated with nonsurvival.
  
  
  CONCLUSIONS
  These data suggest that medical management can result in clinical and radiographic resolution of uncomplicated sand enteropathy in mature horses, and is associated with a good prognosis. Horses with sand enteropathy that exhibit persistent colic signs despite medical management are likely to have a concurrent gastrointestinal lesion, so prompt exploratory laparotomy should be considered in such cases.
  
  
  CONCLUSIONS
  Uncomplicated sand enteropathy can be managed medically in mature horses, and serial abdominal radiography can be used to monitor sand clearance. Surgery to evaluate for and correct concurrent gastrointestinal lesions should be recommended without delay in horses showing persistent colic signs.
authors.affiliation: Department of Large Animal Medicine, University of Georgia College of Veterinary Medicine, USA. khart4@uga.edu
authors.forename: K A
authors.initials: KA
authors.lastname: Hart
authors.forename: W
authors.initials: W
authors.lastname: Linnenkohl
authors.forename: J R
authors.initials: JR
authors.lastname: Mayer
authors.forename: A M
authors.initials: AM
authors.lastname: House
authors.forename: J R
authors.initials: JR
authors.lastname: Gold
authors.forename: S
authors.initials: S
authors.lastname: Giguère
mesh_terms: D000700:Analgesics; D000818:Animals; D005260:Female; D005440:Fluid Therapy / Q000662:veterinary*; D006734:Horse Diseases / Q000473:pathology / Q000628:therapy*; D006736:Horses; D007410:Intestinal Diseases / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D054368:Laxatives / Q000627:therapeutic use*; D008297:Male; D012189:Retrospective Studies; D012822:Silicon Dioxide
chemical_list: D000700:Analgesics; D054368:Laxatives; D012822:Silicon Dioxide