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Equine Final Year > Common diseases and surgery of the stallion/gelding > Flashcards

Common diseases and surgery of the stallion/gelding Flashcards

1
Q

When are why are the most common reasons for castration?

A

•Most male horses are castrated for behavioural reasons

–Reduce aggression towards other horses and people, mounting mares, ability to handle and training

  • Early castration preferred (6-12 months)
  • Time of year important (restricted exercise post op, and no flies)
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2
Q

How is a standing castration performed?

A
  • Most are open technique
  • Restraint

–Sedation

–Twitch

–Tail rope

  • Parental antibiosis first
  • TAT
  • Clean scrotum
  • Stand on left and hold neck of scrotum
  • Inject 10ml 2% lignocaine (2inch 19G needle)
  • Redirect into 2 or 3 sites
  • Leave 15 mins
  • Re-clean scrotum
  • Hold neck scrotum with left hand
  • Bold incision into most dependant part through skin, dartos, vaginal sac
  • Squeeze with left hand and testis emerges
  • Apply traction with left hand
  • Emasculate across cord and part of vaginal sac
  • Leave for 1 minute (don’t let them hang)
  • Repeat other side
  • Pull scrotal skin over the sac
  • There is often haemorrhage from skin
  • If constant stream after 15 mins pack wound
  • If continues may need to re-explore
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3
Q

What is a closed castration?

A
  • Incise into scrotum
  • Blunt dissect tunic (dry swabs works well)
  • Transfixing ligature across vaginal sac
  • Emasculators placed distal to ligature
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4
Q

What is a modified technique castration?

A
  • Open the vaginal sac
  • Ligate the vascular portion and emasculate
  • Ligate the non-vascular portion and emasculate
  • Twist vaginal sac into pedicle apply transfixing ligature and emasculate
  • Advantages

–Vaculature ligated directly

–Vasculature does not protrude through sac

•Disadvantages

–Takes longer

–Needs good sterility

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5
Q

How can you perform a cyrptorchid castration?

A
  • Make sure you carefully palpate castration cases pre-op, and plan surgery
  • Palpate under sedation and do not go ahead if you cannot feel both testes
  • Do not remove the descended testes and leave the other one!
  • Techniques as previously described:

–Enlarge and explore the inguinal ring

–Para-inguinal laparotomy

–Laparoscopically

  • Not uncommon to do this now, rather than a laparotomy
  • Very rare for an animal to only have 1 testicle (monorchid)
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6
Q

What is cryptorchidism?

A
  • Failure of normal descent
  • Most common in ponies; most commonly right testis
  • Commonly testis is within inguinal canal

-The vaginal tunic is small and it may be difficult to push testis into scrotum

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7
Q

How do you diagnose cryptorchidism?

A

–Palpation of scrotum / inguinal region

–Rectal palpation of inguinal ring

–Endocrine testing

  • High basal oestrone sulphate
  • Testosterone response to hCG administration
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8
Q

What can poor libido be due to?

A

•Some cases are due to testicular hypoplasia or to testicular degeneration (see later)

–In these cases diagnosis is obvious because of the small size of the testes

•Mounting or thrusting may be prevented by painful conditions

–E.g. trauma, cauda-equina neuritis, ilio-femoral thrombosis, laminitis, arthritis, coital exanthema

  • Some stallions that are ‘over-used’ may temporarily have poor libido (this is more commonly observed in older animals)
  • Observe animal working and perform a careful physical examination
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9
Q

What painful conditions can prevent mounting or thrusting?

A

–trauma, cauda-equina neuritis, ilio-femoral thrombosis, laminitis, arthritis, coital exanthema

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10
Q

Name 3 abnormalities of mating in the stallion

A

•Failure to achieve an erection

–Often associated with earlier severe discipline

  • Free-mating may remove fear of interference by handlers
  • Failure to ejaculate

–Dismounting at the beginning of ejaculation seen in cases of urethritis

  • Stallion may become frustrated and become aggressive to handler
  • Retrograde ejaculation

–Uncommon (see dog for details)

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11
Q

Name some more common abnormalities of the penis

A

In some sort of order relating to how common:

  • Penile tumours
  • Penile infections

–Coital exanthema (EHV3)

–Papilloma virus

–Bacterial infections

  • Pseudomonas (non-venereal)
  • Venereal pathogens
  • Intersex
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12
Q

What are the most common penile tumours?

A

Most common are squamous cell carcinoma (49-88%); other types are papillomas (1.6-8.5%), melanomas (4.8-5.1%) and others (0.3-1.4%)*

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13
Q

What horses and age are penile tumours most likely to be seen in?

A

•Commonly seen in older geldings as smegma appears to be carcinogenic

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14
Q

Where do penile tumours most commonly arise from?

What are penile tumours most commonly thought to be associated with?

A
  • The tumours arise at the urethral fossa/diverticula and there are commonly kissing lesions onto the preputial ring
  • Believed that its associated with carcinogenic component in smegma often
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15
Q

How does the penis and the prepuce fold into the sheath?

A

The folding of the prepuce – has inner fold to it and outer fold. Then when penis is lengthened and extended, the inner fold covers the body of the penis – see component at edge of inner fold (preputial ring), when penis extend – becomes that piece of tissue. Also explains why and where you see penile tumours, particularly penile tumours. So when you see neoplasia, will be on the tip of the penis and then in the preputial ring as you have local metastasis

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16
Q

What do White depigmented plaques on the penis likely show?

A
  • White depigmented plaques probably represent pre-neoplastic changes
  • Initial lesions may be small pink and cauliflower -like
  • Later lesions may become very large and pedunculated
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17
Q

With penile tumours, what may be noticed by the owner to bring this to their attention?

A

–They clean the sheath (if done regularly)

–There is a foul smell

–There is haemorrhage from the sheath

–The lesion is large and protrudes from the sheath

–The lesion is very large and effectively results in phimosis

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18
Q

What is the prognosis and metastasis of penile tumours?

A
  • Prognosis depends on the stage of the tumour – identify early, assess extent of involvement and biopsy lymph nodes
  • Metastasis ->inguinal lymph nodes -> abdomen. No treatment if general metastasis has occurred
  • 44% of G3, 25% of G2 and 3% of G1 tumours have metastasis*
  • 80% of G3 tumours have an unsuccessful outcome**
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19
Q

What are some methods of assessment for abnormalities of the penis?

A
  • Physical examination – nature and extent of lesions, including palpation (+/- usound) of corpus cavernosum and spongiosum and lymph nodes
  • Biopsy penile lesions and FNA lymph nodes
  • Palpate and ultrasound abdomen (inguinal and sublumbar lymph nodes, spleen and liver)
  • Radiograph thorax if evidence of abdominal spread
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20
Q

What are some treatments for penile tumours if there is local lesions with no invasion/spread?

A

–Cryotherapy/ topical treatment with 5-fluorouracil

–or local excision/posthioplasty/partial phallectomy (depends on location and size)

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21
Q

What are some treatments for penile tumours if there is non invasive (G1 or 2 lesions)?

A

local excision/posthioplasty/partial phallectomy (depends on location and size)

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22
Q

What are some treatments for penile tumours if there is extensive spread or invasive (G3 lesions)?

A

Partial phallectomy and sheath ablation/en bloc resection/palliative treatment or euthanasia

23
Q

What are some treatments for penile tumours if there is evidence of abdominal spread?

A

palliative treatment or euthanasia

24
Q

What is the purpose of Penile Reefing / Posthioplasty?

A

–For treatment of kissing metastases of squamous cell carcinoma

–Primary lesions needs to be removed by local excision or amputation of penile tip

25
Q

What is the technique of Penile Reefing / Posthioplasty?

A

–GA lateral recumbency

–Extend the penis

–Incise through the epithelium 2 cm proximal and 2cm distal to the tumour

–Peel the epithelium and tumour away

–You don’t breach the fibrous tunica into the CCP so bleeding is not marked

–Suture edges with absorbable material

26
Q

What is the purpose of a Penile Amputation / Partial phallectomy?

A

–Treatment of penile neoplasia, trauma or non-responsive priapism

27
Q

What is the technique of a Penile Amputation / Partial phallectomy?

A

–GA lateral recumbency

–Introduce catheter into urethra

–Extend penis

–Apply tourniquet to base of penis

–Make triangular incision in base of penis

  • Base of triangle towards penile tip
  • Remove integument in this area

–Incise onto catheter through the ventral urethra

•Fold back urethra into triangle and suture onto integument

–Amputate penis in wedge manner

–Ligate dorsal vessels

–Suture closed penile tunic

–Remove tunic and check for bleeding

28
Q

What causes coital exanthema?

A

Equine herpes virus 3

29
Q

What lesions are seen with coital exanthema?

Can they resolve?

A
  • Results in small vesicles on the penis and sheath
  • Usually resolve spontaneously within a few weeks
30
Q

Can stallions with coital exanthema infect mares?

A
  • May infect mares if active lesions present at the time of breeding
  • Infected mares develop similar lesions but do not develop endometritis or abort
31
Q

What is papilloma virus?

What lesions can be seen with this?

Treatment?

A

Papilloma Virus

  • Not uncommon in young stallions
  • Small, raised florid lesions on the penis
  • Stallions rapidly develop immunity and the lesions are self-limiting
  • No treatment is required
  • At the time of infection breeding may be painful
  • Monitor resolution as can progress to SCC
32
Q

What significance does pseudomonas have in the stallion?

A

–Some stallions have a non-pathogenic Pseudomonas infection that causes problems at the time of pre-breeding swabs. Usually these animals are treated as though they have a venereal pathogen; the only other option is to test breed with some mares owned by the stud

33
Q

What venereal pathogens should we be aware of in the stallion?

A

–Taylorella equigenitalia (CEMO)

–Klebsiella pneumoniae (Types 1,2,5)

–Pseudomonas

34
Q

What is intersex?

What do you see with it?

A
  • Thought to be male but with abnormalities of chromosomal, genetic or phenotypic sex
  • As previously discussed
  • Usually small, under-developed, abnormal external reproductive tract
35
Q

What is wrong here?

A

Intersex

Prepuce facing caudally and tip of penis protruding caudally through animals hind legs

36
Q

How do we treat scrotal trauma?

A

•Treat symptomatically but rapidly and use methods to aims to reduce scrotal temperature and risk of testicular degeneration from occurring

–Local treatment

–NSAIDs

–Systemic broad spectrum antibiotics

–If one side is severely affected it may be prudent to perform a unilateral castration

•Significant problem as may lead to testicular degeneration

37
Q

What is an inguinal hernia?

Diagnosis?

A
  • This condition is not common
  • Usually the owner will have noticed a soft swelling prior to strangulation although some cases occur following significant exertion (presumably as a result of increased abdominal pressure)
  • Inguinal hernia may become strangulated and become a surgical emergency (see cases later today)
  • Diagnosis likely to be made by ultrasound examination of scrotum or rectal palpation where distended intestinal loops may be detected at the inguinal ring

Check colts presented for castration carefully - do not use open castration technique

38
Q

Name some abnormalities of the testes and put in some sort of order as to how common they are

A
  • Difference in size and appearance
  • Abnormalities of testicular descent

–Cryptorchididm (unilateral or bilateral)

–(monorchidism)

–(anorchidism)

  • Testicular degeneration
  • Testicular haematoma
  • Torsion of the spermatic cord
  • Orchitis
  • Testicular neoplasia
  • Testicular hypoplasia
39
Q

What usually causes testicular degeneration?

A

•Usually acquired secondary to thermal injury following previous injury or damage to the scrotum, testis, or ventral abdomen

Including secondary to:

–Scrotal hernia

–Scrotal injury and dermatitis

–Testicular trauma and testicular haematoma

–Torsion of the spermatic cord

–Orchitis

  • May develop secondary to some other inter-current disease such as testicular neoplasia
  • Rarely following systemic disease, drug administration or toxin exposure
40
Q

What do we see with testicular degeneration?

A
  • Testis or testes become soft and gradually decrease in size
  • Appearance depends when presented in the progression of the disease
  • Echogenic stippling often present on ultrasound examination
  • Testosterone may be low or normal but there is normally elevated gonadotrophin and reduced response of testosterone to hCG administration
41
Q
A
42
Q

How can we treat testicular degeneration?

A
  • No treatment
  • The key issues are to recognise the conditions that lead to testicular degeneration and take action to minimise testicular degeneration

–Scrotal and testicular pathology should be treated as quickly as possible

–Treatments include

  • Cold water hosing
  • NSAIDs
  • Disease-specific treatment
  • In some unilateral cases hemicastration

–Systemic disease should be treated quickly to control pyrexia

–

43
Q

What is testicular haematoma and how can we treat it?

A
  • Swelling of the testis usually following trauma
  • Clinical features as described within scrotal trauma
  • May have a significant nodular lesion palpable within the testicular parenchyma
  • Treatments as described in previous slides to include systemic antibiotics since in some cases haematoma can be become infected (?haematogenously) resulting in testicular abscess
44
Q

What can torsion of the spermatic cord cause?

A

•Causes rotation of the testis around its long axis

N.B. In some cases a 180degree torsion occurs without any clinical signs and the stallion has normal fertility

–Noted by unusual position of the epididymal tail

45
Q

With severe torsion of the spermatic cord, what will you see?

A

–Marked scrotal swelling

–Abdominal pain

–Clearly this is one of the DDs for acute scrotal swelling and similar to inguinal hernia may occur after recent exertion

–NB Less common than inguinal hernia

46
Q

What is the treatment for torsion of the spermatic cord?

A

•Prompt removal of the swollen testis is necessary to treat the condition and in attempt to prevent testicular degeneration in the remaining testicle

47
Q

What can cause orchitis?

A
  • The most common cause is local trauma
  • There may or may not be infection, and the condition may be considered mixed inflammation / haematoma
  • Infective orchitis may result from penetrating wound or occasionally from haematogenous spread
  • Viral orchitis may be caused by EVA
48
Q

What so we see with orchitis?

What is the treatment?

A
  • In all cases there is substantial swelling, local oedema and pain
  • Treatment should be aimed at controlling the primary cause and attempting to reduce the testicular temperature to prevent subsequent testicular degeneration

–Unlateral castration may be considered

49
Q

Name some testicular neoplasias

A

•Testicular tumours are rare and commonly unilateral therefore they usually cause unilateral enlargement

–Seminoma

–Lipoma

–Teratoma

–Sertoli cell tumour

50
Q

If we believe there is testicular neoplasia, what should we differentiate it from?

How common is metastasis?

Treatment?

A
  • There may be reduced size of the contra-lateral testis
  • Differentiate from abscess, haematoma etc on basis of slow increase size and using ultrasound
  • Metastases are rare
  • Treatment is castration
51
Q

When is testicular hypoplasia usually first noted?

Hereditary/not hereditary?

Unilateral/bilateral?

A
  • Noted at the time of birth
  • Likely to be hereditary
  • Usually bilateral
52
Q

Diagnosis and treatment for testicular hypoplasia?

A
  • Frequently there are germ cells but no sperm in the ejaculate
  • Diagnosis made on clinical findings
  • Endocrine testing can be helpful

–What would you find?

•There is no treatment

53
Q

What can cause seminal vesiculitis and what can it be associated with?

Clinical signs?

What can stallions be?

Treatment?

A
  • Rare caused be ascending bacterial infection
  • In some cases may be associated with ascending Klebsiella or Pseudomonas and this is the reason for suggesting collection of pre-ejaculatory fluid in venereal swabs
  • Clinical signs are presence and blood in ejaculate
  • Stallions may be persistent shedders
  • Treatment is difficult because of poor antibiotic penetration
  • Endoscopic lavage and antibiotic packing has been attempted with variable success
54
Q

How common is prostate disease in horses?

A

•Disease of the prostate is not seen

Equine Final Year (102 decks)

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