Elephant specific information, if available, is in blue.

Chemistry – Psyllium is obtained from the ripe seeds of varieties of Plantago species. The seed coating is high in content of hemicellulose mucillages which absorb and swell in the presence of water.

Storage/Stability/Compatibility – Store psyllium products in tightly closed containers; protect from excess moisture or humidity.

Pharmacology – By swelling after absorbing water, psyllium increases bulk in the intes­tine and is believed to induce peristalsis and decrease intestinal transit time. In the treatment of sand colic in horses, psyllium is thought to help collect sand and to help lubricate its passage through the GI tract.

Uses/Indications – Bulk forming laxatives are used in patients where constipation is a re­sult a too little fiber in their diets or when straining to defecate may be deleterious. Psyllium is considered to be the laxative of choice in the treatment and prevention of sand colic in horses.

Psyllium has also been used to increase stool consistency in patients with chronic, watery diarrhea. The total amount of water in the stool remains unchanged.

Pharmacokinetics – Psyllium is not absorbed when administered orally. Laxative action may take up to 72 hours to occur.

Contraindications/Precautions – Bulk-forming laxatives should not be used in cases where prompt intestinal evacuation is required, or when fecal impaction (no feces being passed) or intestinal obstruction is present.

Adverse Effects/Warnings – With the exception of increased flatulence, psyllium very rarely produces any adverse reactions if adequate water is given or is available to the patient. If insufficient liquid is given, there is an increased possibility of esophogeal or bowel obstruction occurring.

Overdosage – If administered with sufficient liquid, psyllium overdose should cause only an increased amount of soft or loose stools.

Drug Interactions – Because the potential exists for bulk-forming laxatives to bind digoxin, salicylates and nitrofurantoin, it is recommended that bulk-forming laxatives be administered at least 3 hours apart from these drugs.

Doses –

Horses:

For treatment of sand colic:

a)   0.5 kg in 6-8 L (1 pound in 1.5-2 gallons) of water via stomach tube. Mix with water just before administration; simultaneously mixing water with psyllium as mixture is being pumped is ideal. May repeat as necessary as long as horse con­tinues to pass feces and fluid does not accumulate in stomach. After initial treatment, may add up to 125 gm with each feeding; best if mixed with grain or sweet feed. Water must be available. (Calahan 1987)

b)   0.25 kg mixed in 8 L of warm water bid. After obstruction is resolved may add to grain ration; may require 2-3 weeks of therapy to eliminate the majority of sand. (Clark and Becht 1987)

Monitoring Parameters –

1)    Stool consistency, frequency

Client Information – Contact veterinarian if patient begins vomiting. Be sure animal has free access to water.

Dosage Forms/Preparations/FDA Approval Status/Withholding Times –

Veterinary-Approved Products:

Equi-Psyllium®  (Equine Healthcare) is a product labeled for use in horses. It is available in 5 lb. jars.

Human-Approved Products: There are many human-approved products containing psyllium, most products contain approximately 3.4 grams of psyllium per rounded tea­spoonful. Commonly known products include: Metamucil®  (Procter & Gamble), Hydrocil® Instant (Reid-Rowell), Correctol® Powder (Plough), Konsyl® (Lafayette), Serutan (Beecham), Effer-syllium®  (Stuart), Perdiem® Plain  (Rorer), and Siblin®  (Warner-Lambert). These products are all OTC.