Abstract
Background:
Sandy enteropathy is more common in horses living in sandy environments, such as those in Saudi Arabia. Sand accumulation in the intestines can be eliminated and prevented by administering psyllium husk.

Aim:
This study focuses on the combination of psyllium and aloe vera extract, known for its protective and anti-inflammatory properties.

Methods:
Fourteen Arabian horses with naturally acquired sand accumulation were randomly assigned to two groups: the Psyllium Group (PG, n = 7) and the Psyllium & Aloe Vera Group (PAG, n = 7), both of which were treated daily for 7 days. Efficacy was evaluated via daily fecal sand analysis (sedimentation test) and hematological assessment on days 0 and 14.

Results:
PG showed a reduction in inflammation indicators, evidenced by a significant decrease in the white blood cell (WBC) count from 9.1±0.36 to 6.2±0.047×10 9. by day 14. In contrast, PAG exhibited a more complex immunomodulatory response, characterized by a more significant final decrease in WBC count (7.8 to 5.3±0.33×10 9 /l). Interestingly, the percentage of neutrophils in PG was high during the treatment period, where the percentage was 71.5± 1.6 and 69 ± 0.41 during the first and second weeks, respectively. In contrast, a decrease in neutrophils was observed in PAG during the treatment period, where the percentage was recorded as 45.7 ± 0.73 and 50.1 ± 0.43 during the first and second weeks, respectively. The amount of sand in the excreted PG fluctuated, reaching its highest point on Day 5 at 8.86% and ending at 4.71% on Day 7. PAG began with a similar sand concentration of 5.43%. The sand excretion peaked at 7.14% on Day 1 and then followed a general downward trend for the rest of the week. The lowest concentration for this group was 2.28% on day 6.

Conclusion:
The combination of psyllium and aloe vera appears to result in lower overall mean sand excretion and a more modulated immune response.

Key words: Aloe vera; Colic; Horse; Psyllium; Sand.