Depth and distribution of colonic sand accumulation in a desert population of horses and its association with diagnosis of sand colic.

Sand depth on radiographs is a key predictor of sand colic; each millimeter increases diagnostic odds by 2%.

This prospective study investigated radiographic sand accumulation in a desert-based equine population, examining patient and management characteristics associated with sand colic diagnosis and surgical intervention. Horses were allocated into three groups: controls, sand colic cases, and non-sand-associated colic cases. Radiographic sand depth was the primary measurement tool, with median sand depth significantly greater in sand colic horses compared to both other groups (112.16 mm vs. 10.5 mm and 12.0 mm, respectively). Each millimeter increase in sand depth conferred a 2% increase in the odds of a sand colic diagnosis. Factors independently associated with sand colic diagnosis included lower body weight, presence of cranial sand distribution on radiographs, and increasing sand depth. Younger horses (median 2 years) were more likely to be diagnosed with sand colic, while surgical intervention was paradoxically more common in older horses (median 2.6 years vs. 1.3 years). Importantly, greater sand accumulation depth was not independently associated with increased risk of requiring surgical management. These findings provide clinicians with quantitative radiographic thresholds to better contextualize incidental sand findings versus clinically significant accumulations in horses presenting for colic evaluation, supporting more informed triage and treatment decisions in equine emergency settings.

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