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REPRO2 > Equine 3 > Flashcards

Equine 3 Flashcards

1
Q

What are some intra op complications of castration?

A

Failure to achieve adequate anaesthesia
Failure to remove testis
Haemorrhage
Incision into penile tissue

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2
Q

What are some immediate post op complications of castration?

A 
Penile damage, protrusion/haemorrhage post op
Post op swelling
Scrotal abscess/ post op infection
Herniation of omentum
Herniation of intestinal contents
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3
Q

What are some delayed onset complications of castration?

A

Champignon
Schirrous cord
Hydrocoele

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4
Q

What should pre op assessment of castration include?

A

Full pre-anaesthetic exam
Tetanus vaccination
Current health problems

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5
Q

What are some indications for performing castration under GA?

A

Small pony
Mature large breed horse
Donkeys
Large inguinal ring (fits >3 fingers)
Testicle retained in inguinal canal
History of soft fluctuant swelling of testes
Other structures palpable in scrotal region
Horse persistently kicks despite sedation

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6
Q

What is teh correct way round to position the emasculators?

A

flat side facing the inguinal area so that the protruding wing nut is pointing to the testicle (‘nut to nut’).

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7
Q

How long should you leave emasculators on?

A

2 mins minumum

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8
Q

What would a skin bleeder look like?

A

Stready drip of blood - can count the drips

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9
Q

What major vessels are likely to be bleeding if severe haemorrhage seen?

A

Inguinal artery or more commonly testicular artery

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10
Q

What should you approach be to a colt with continuous stream of blood spurting from incision?

A

Assess animals CVS status and degree of blood loss
Re-sedate the animal and more LA
Clamp bleeding vessel with haemostats and ligate with absorbable suture material

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11
Q

What can you do in a colt post op if bleeding is present but not excessive?

A

Can pack the scrotum with swabs

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12
Q

What should be done if you cannot identify haemorrhage origin?

A

GA

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13
Q

How can you prevent haemorrhage during/post op castration?

A

Donkeys and mature ponies should have GA and closed technique
Place emasculators nuts to nuts
Keep emasculators for at least 3 mins
Check stump before releasing

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14
Q

What is the approach for intestinal hernia post castration?

A

Administer first aid (sling or pack scrotum with moist towels or swabs, retained by towel clamps or sutures placed in the skin) and refer immediately
Administer broad spec antimicrobials, NSAIDS, fluids for shock

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15
Q

How can you prevent intestinal herniation?

A

Closed castration

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16
Q

What post op care should be given to colts following castration?

A

Keep in restricted area for 12-24hrs post op to reduce movement of inguinal ring, risk of haemorrhage and to keep close eye
After 24hours- exercise should be encouraged

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17
Q

Why is exercise important after 24hours following castration?

A

reduces scrotal swelling and promotes drainage, and is important in preventing excessive oedema and scrotal infection

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18
Q

Why are most male horses castrated?

A

Behavioural reasons - to reduce aggression towards other horses and people, mounting mares, ability to handle and training

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19
Q

When is castration preffered?

A

6-12mo

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20
Q

What are some advantages of modified techinuqe?

A

Vasculature ligated directly

Vasculature does not protrude through sac

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21
Q

What are some disadvantages of the modified technique?

A

Takes longer and needs good sterility

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22
Q

What are some techniques for crytorchid castration?

A

Enlarge and explore the inguinal ring
Para-inguinal laparotomy
Laparoscopically

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23
Q

Where is the testicle most commonly found in cryptorchidism in the stallion?

A

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

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24
Q

How can you diagnose cryptochidism?

A

Palpation of scrotum/inguinal region
Rectal palaption of inguinal ring
Endocrine testing

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25
What endocrine tests can be used to diagnose cryptorchidism?
High basal oestrone sulphate | Testosterone response to hCG administration
26
What is the treatment of cryptochidism?
Surgery
27
What are some causes of poor libido?
Testicular hypoplasia Testicular degeneration Painful conditions Overused stallions
28
How can you establish the cause of poor libido in the stallion?
Observe animal working and perform careful physical exam
29
What is failure to ejaculate commonly associated with?
Urethritis
30
What are the most common tumours of the penis?
Squamous cell carcinoma
31
What is a cause of penile tumours
Smegma carcinogenic
32
Where do tumours arise in the penis in the stallion?
Urethral fossa/ diverticula | Commonly kissing lesions onto preputial ring
33
What are the appearance of penile tumours?
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
34
What are some signs owners may notice in stallion with penile tumour?
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
35
What is the prognosis of stage 3 lesions (penile tumours)?
Poor - have LN involvement, require complete resection
36
How can you diagnose penile tumours?
Physical exam Biopsy and FNA LNs Palpate and u/s abdomen- inguinal, sublumbar LNs, spleen and lviver) Rd if evidence of abdominal spread
37
How can you treat local lesions with no invasion/spread (penile tumurs)
Cryotherapy/ topical treatment with 5-fluorouracil | or local excision/posthioplasty/partial phallectomy (depends on location and size)
38
How can you treat non invasive (G1-G2 penile lesions)
local excision/posthioplasty/partial phallectomy (depends on location and size)
39
How can you treat extensive spread or invasive (G3 lesions)
Partial phallectomy and sheath ablation/en bloc resection/palliative treatment or euthanasia
40
How can you treat a stallion with evidence of abdominal spread with penile tumour?
Palliative tx or euthanasia
41
What is the purpose of penile reefing/ posthioplasty?
Tx of kissing metastases of SCC | Primary lesions needs to be removed by local excision or amputation of penile tip
42
What is the technique for posthioplasty?
1. GA lateral recumbency 2. Extend the penis 3. Incise through epithelium 2cm proximal and 2cm distal to tumour 4. peel epithelium and tumour away 5. suture edges with adbsorbable material
43
What is the purpose of penile amputation/ partial phallectomy?
Treatment of penile neoplasia, trauma or non-responsive priapism
44
When is an enbloc resection indicated?
Grade 3 lesions
45
What is a consequence of enbloc resection
Long surgical time, anaesthetic compications can be high
46
How does coital exantema present in the stallion?
Small vesicles on penis and sheath | Stallions may be unwilling to mate as painful
47
What is the appearnce of papilloma virus on the penis?
Small, raised florid lesions
48
What is the treatment of papilloma virus?
Stallions rapidly developing immunity and lesions self limited. None needed
49
Why do you need to monitor resolution of papilloma virus?
Can progress to SCC
50
What is intersex?
Thought to be male but with abnormalities of chromosomal, genetic or phenotypic sex
51
What are the signs of intersex?
Usually small, under-developed, abnormal external reproductive tract
52
What is a common cause of scrotal trauma?
Kick from mare
53
How can you treat scrotal trauma?
``` Symptomatically Local tx NSAIDs Systemic broad antibiotics Unilateral castration in some cases ```
54
Why is scrotal trauma a significant problem?
May lead to testicular degeneration
55
How can diagnose scrotal (inguinal hernia)
ultrasound examination of scrotum or rectal palpation where distended intestinal loops may be detected at the inguinal ring
56
What are some causes of testicular degeneration?
``` Scrotal hernia Scrotal injury and dermatitis Testicular trauma and testicular haematoma Torsion of the spermatic cord Orchitis Neoplasia Thermal injury (usually) ```
57
What is the ultrasonographic apperaance of testicular degeneration
Echogenic stippling
58
What is the treatment of testicular degneration?
``` None Address primary causes Cold water hosing NSAIDs Hemicastration ```
59
What is the ultrasonographic appearance of testicular haemotoma?
Mixed echogenicity (almost marbled) appearance
60
What are some signs of severe torsion of spermatic cord?
Marked scrotal swelling | Abdominal pain
61
How can you treat torsions of spermatic cord?
Prompt removal of the swollen testis is necessary to treat the condition and in attempt to prevent testicular degeneration in the remaining testicle
62
In what case can torsion of spermatic cord not be assocaited with clinical signs and have normal fertility?
180 degree torsions - can be detected by unusal position of epipdymal tail
63
What is the most common cause of orchitis?
Trauma
64
What are the clinical signs of orchitis?
Substantial swelling, local oedema, pain
65
How can you treat orchitis?
Control primary cause Reduce testicular temperature Unilateral castration may be considered
66
What is the cause of seminal vesiculitis?
Ascending bacterial infection | In some cases may be associated with ascending Klebsiella or Pseudomonas
67
What are the clinical signs of seminal vesciultis?
presence of blood in ejaculate
68
What is the treatment for seminal vesicultis?
Treatment is difficult because of poor antibiotic penetration Endoscopic lavage and antibiotic packing has been attempted with variable success
69
What must you ensure for any rectal examination?
Must have horse adequately restrained Must have good technique Must inform owner of procedure and risks
70
What should you do if you suspect a rectal tear?
Must assess severity of lesion Must inform owner Must take appropriate action
71
What are some clinical signs of rectal tears?
Blood on rectal glove (usually large amounts) Sudden release of pressure on rectal examination Ability to feel abdominal organs directly After few hours - peritonitis and endotoxic shock
72
What is a grade 1 rectal tear?
mucosa and submucosa torn
73
What is a grade 2 rectal tear?
muscular layer only torn (mucosa and submucosa prolapse through)
74
What is a grade 3 rectal tear?
all layers except serosa (IIIa), or mesorectum and retroperitoneal tissue (IIIb) torn
75
What is a grade 4 rectal tear?
All layers torn
76
What should be your assessment for a rectal tear be?
1. Stop horse from straining 2. Epidural anaesthesia 3. Sedation (alpha 2 +/- burtorphanol) 4. Hysocine 5. Lidocaine enema 6. Peritoneal tap 7. Assess with ungloved, well lubricated hand
77
What are the first aid procedures for a rectal tear?
Stop horse straining Gentle removal of faeces from rectum and tear Treatment of septic shock and peritonitis Epidural anaesthesia and packing of rectum with clean swabs Referral to surgical centre
78
What are the treatment options for grades 3 and 4 rectal tears?
Surgery | Some success with frequent manual evaluation for grade 3
79
How can you manage grade 1 and 2 rectal tears?
monitoring, administering laxatives and reducing feed intake
80
What are some surgery options for rectal tears?
Surgical closure (per rectum or at celiotomy - depends on location of tear) Temporary indwelling rectal liner Loop colostomy End colostomy
81
What is the prognosis of grade 1 rectal tears?
80-93% survival
82
What is the prognosis for graade 3 rectal tears?
60% long term survival

REPRO2 (31 decks)

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