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VMS 4001 > Equine Castration > Flashcards

Equine Castration Flashcards

1
Q

Double peritoneal fold around testis and SC is called?

A

Tunica vaginalis

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2
Q

What links parietal tunic onto epididymis ?

A

Ligament of tail of the epididymis

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3
Q

Spermatic Cord =

A

Tunica vaginalis, BVs, nerves and lymphatics

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4
Q

Patient Selection for Castrate?

A
  • Age: traditionally spring of yearling year
  • Can be done before weaned; consideration if older
  • Handling/temp
  • Palpation -> two testes? scrotal/inguinal hernia?
  • Tetanus vaccination (ideally first 2)
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5
Q

Describe open castration -

A
  • Parietal tunic incised to expose testis, epididymis and cord structure before emasculating
  • No ligatures skin is left open to heal by 2nd intention
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6
Q

Describe closed castration

A

Parietal tunic is not incised - Portion of tunic surrounding testis and distal sperm cord is removed
- Ligatures used. Skin may be sutured close

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7
Q

Describe Semi-closed castrate?

A
  • Parietal tunic opened to allow for inspection inside parietal tunic
  • Ligatures used. Skin close as for closed castrate. Tunic can also be closed
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8
Q

Advantage of Open?

A

: Simple, quick, excellent drainage, can
be done in standing sedated horse (so
cheapest). Best option when incomplete
sterility.

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9
Q

Disadvantage of Open Castrate?

A

Higher risk of some complications
(haemorrhage, infection, eventration)

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10
Q

Closed - Advantages?

A

: Reduced incidence of haemorrhage,
infection and eventration. May be more
suitable for older horses, donkeys, mules
and draft breeds (extra haemostasis
provided by ligatures).

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11
Q

Closed - Disadvantages?

A

Ideally performed in sterile
environment. Requires general
anaesthesia (cost, anaesthetic
complications). Ligatures can act as a
focus for infection. Poor drainage. Unable
to visually check inside parietal tunic

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12
Q

Adv - SEMI open?

A

: As for closed castration, plus visual
check inside tunic, allows more accurate
ligature placement therefore further
reduced risk of haemorrhage.

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13
Q

Disadvantages of Semi-closed?

A

Requires general anaesthesia
(cost, anaesthetic complications). Slightly
increased surgical complexity

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14
Q

When do we do Standing Sedation?

A
  • Open castrate
  • Well handled patients, no tiny ponies or difficult to palpate testes
  • Most common approach inUK
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15
Q

Adv of Standing sedation?

A

Cheapest, no anaesthetic risk, least time -consuming

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16
Q

Disadvantage of Standing Sedation?

A

Poor surgical conditions, risk of injury to vet

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17
Q

When do we do Field Anaesthesia?

A
  • usually open but can be any
  • Good for small ponies or small testes
  • Common in UK
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18
Q

Adv of Field Anaesthesia?

A

Cheap, easier to see/ feel/ access testes

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19
Q

Disadv of Field Anaesthesia?

A

Basic anaesthesia/ monitoring, risk of injury to personnel during anaesthetic recovery. Clean safe area required to anaesthetise and recover horse

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20
Q

When do we use theatre anaesthesia?

A
  • CLosed or Semi-closed
  • Mature stallions (also consider for mules, donkeys, draft breeds)
    GOLD STANDARD
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21
Q

Adv of Theatre anaesthesia?

A

High quality anaesthesia/ monitoring, excellent surgical conditions, minimal danger to personnel

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22
Q

Disadv of Theatre Anaesthesia ?

A

More expensive

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23
Q

How to use Emasculators?

A
  • crush (haemostasis) and cut
    prior to use:
  • Ensure emasculators open normally
  • Ensure ratchet engaged
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24
Q

What are the two types of Emasculators?

A
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25
Q

Step 1 of Open Castrate

A
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26
Q

Step 2 open castrate

A
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27
Q

STEP 3 open castrate ?

A
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28
Q

STEP 4 OPEN CASTRATE?

A
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29
Q

STEP 5 OPEN CASTRATE?

A
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30
Q

Step 1 Closed Castrate?

A
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31
Q

Step 2 Closed C?

A
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32
Q

STEP 3 CLOSED C?

A
33
Q

STEP 4 CLOSED C?

A
34
Q

STEP 5 CLOSED CASTRATE ?

A
35
Q

What technique for Semi-closed castration?

A
36
Q

What general considerations to think about?

A
  • Facilities/ hygiene?
    Time of day
    Weather? / shelter
    Signed consent
37
Q

Peri-operativeMEdications?

A
  • IV fluxinin or phenylbutazone
  • Oral phenylbutazone for 5 days
  • Prophylactic ABs, -> IM procaine penicillin, IV oxytetracycline, oral TMPS?
  • Tetanus antitoxin
  • Toxoid vaccine booster if not recent vacc
38
Q

what sedation for standing sedation?

A

Alpha 2 agonist and butorphanol

39
Q

What practical things to do for standing castrate?

A
  • Tail bandage, scrotum scrubbed
  • Competent handler on same side
  • Nose twitch?
  • surgeon close to horse’s shoulder
40
Q
A
41
Q

What local anaesthesia can we use?

A

Lidocaine or Mepivicaine
10-20ml along planned incision sites
5-10ml into each testis

42
Q

What considerations for Field Anaesthesia?

A
  • Care risk to humans
  • Suitabel space
  • IV catheter
  • Tail bandage, scrotum scrubbed, mouth washed out
43
Q

What ANAESTHETIC considerations with field anaesthesia?

A
  • Second vet/ nurse to monitor
  • Alpha 2 agonist plsu butorphanol pre-med then Ketamine and Diazpam induction
    -> ket or sedative top ups
    -> local
44
Q

What positioning for field anaesthesia?

A

Lateral recumbency wth upper pelvic limb pulled forwards and secured with a rope

45
Q

What Post op care for open castrate?

A
  • Confinement in clean stable for 24h to allow clots to stabilize
  • Thereafter, exercise is vital!
  • Paddock turnout best
  • Owner should observe the site but should not clean it
46
Q

Post-op care for closed or semi-closed castrate?

A
  • Confinement in clean stable for several days
  • Gradual return to exercise over the next ~week
  • Owner should observe the site but should not clean it
47
Q

What is Cryptorchidism colloquially known as?

A

‘Rigs’

48
Q

Describe cryptorchidism in horses

A
  • Retention of one common
  • Complete retention of both is rare
  • Can be complete abdominal, partial abdominal, inguinal or completely absent
49
Q

How do we diagnose Cryptorchidism ?

A
  • Sedation & deep palpation into inguinal ring
  • US (transabdo & transrectal)
  • Serum AMH
    (Oestrone sulphate)
    -> if equivoal AMH -> dynamic testing (hcG stim test)
50
Q

What surgery can we do for cryptorchidism?

A
  • Para-inguinal
  • Inguinal
  • Laparoscopic
51
Q

What are common Castration complications?

A
  • Haemorrhage
  • Swelling, Oedema, Seroma formation
  • Infection
  • Evisceration of omentum or intestine
  • Septic funiculitis
  • Iatrogenic penile trauma
  • Hydrocele (Vaginocele)
  • Peritonitis, colic
  • Lameness
  • Incomplete castration (‘rig’)
  • Continued masculine behaviour (‘false rig’)
52
Q

Describe NORMAL haemorrhage in open castrations?

A
  • Drip blood (slowly) for several hours -> should be able to count the drips
53
Q

What source of bleeding ?

A

Testicular artery

54
Q

What risk factors to haemorrhage?

A
  • Improper application of emasculators
  • Catching scrotal skin
  • Nuts not tight
  • Assemble incorrectly
  • hick cords: rq double ligation
55
Q

How do we assess blood loss?

A
  • demeanor
  • HR/ pulse
  • MM/CRT
  • Subjective quantitiy assessment
  • Haematology parameters (PCV less than 20% -> acute)
56
Q

What is the blood volume of a horse?

A

9% of Bodyweight -> 45L for 500kg horse

57
Q

How do we prevent haemorrhage?

A
  • Keep hold of spermatic cord until assessed haemorrhage -> aliss tissue forceps
  • Large horses, older horses, donkeys & mules: castrate closed or semi-closed under anaesthesia with ligatures
58
Q

What TX for haemorrhage ?

A
    1. Don’t panic – give time!
    1. Try clamping a vessel
  • Mixter right angled forceps
    1. Pack with unrolled bandage
    1. Anaesthetise and clamp/ligate artery
  • Referral if possible
59
Q

Describe Swelling/ oedema

A
  • ‘Some’ is normal
  • ‘Too much’ swelling and/or oedema is relatively common
  • Can occur with or without seroma formation and/or infection
60
Q

How to prevent a seroma in open castrate?

A

exercise following open castrate & big surgical incision

61
Q

How to prevent seroma in closed ?

A
  • reduce dead space
  • Goof surgic&l technique
  • rest and slow return to exercise post surgery
62
Q

How to manage open castrate seroma?

A
  • Re-open wounds with sterile gloved finger and re-establish drainage
  • Consider AMs if suspect infection
63
Q

How to manage seroma in closed castrate?

A
  • Do not open wound if not believed to be infected
  • Focus on reducing risk of secondary infection
  • Antimicrobials?
  • Wound care
64
Q

Describe scrotal infection

A
  • COmmon with open castrate
  • Often minor, but check for: fever, dull demeanour, inappetance
65
Q

Is infection less common in closed?

A

YES but potentially worse bc -> lack of drainage & presence fo Implant

66
Q

Tx for Scrotal infection?

A
  • Swab and submit for culture and sensitivity
  • Clean with antiseptic
  • Re-open wounds with a sterile gloved finger as per seroma
  • Sytemic antimicrobials and anti-inflammatories
67
Q

IF protruding skin, fascia or blood clot .. worried?

A

NO

68
Q

What can eviscerate?

A

Omentum > via inguinal hernia - not emergency

69
Q

Tx for clots/skin/fascia/ omentum ?

A
  • High degree fo sterility
  • Pull out as far as poss
  • Emasculate
  • Monitor closely
70
Q

Describe evisceration of SI ?

A
  • Via inguinal hernia
  • Rare but very serious
  • Likely fatal
    Draft & standardbreds predisposed ?
71
Q

Tx for evisceration of intestines ?

A
  • Initial aim: protect bowel from further damage and contamination
    and get ready for transportation
  • Protective sling and urgent transport to clinic with surgical facilities
  • Possibly indicated: Field anaesthetic, lavage, place back in scrotum
    and suture skin prior to transportation
72
Q

What is Septic Funiculitis?

A

‘Scirrhous cord’ -> chronic non healign inflammation that keeps recurring and forms a discharging sinus tract

uncommon

73
Q

Cause & prevention of septic funiculitis?

A
  • Underlying cause? “absorbable” suture can be a focus of infection
  • Prevention: avoid use of ligatures in non-sterile surgery if possible
74
Q

Initial management of Septic funiculitis?

A
  • Culture and sensitivity
  • First line: antimicrobials
  • Recurrent failure of appropriate antimicrobials is diagnostic
    Ultimately:
  • Bold surgical excision of thickened avascular and necrotic tissue
75
Q

Describe iatrogenic penile trama

A
  • Root of penis mistaken for testis > emasculation of root of penis
  • More a problem with closed castration, inexperienced surgeons
  • Treatment: Emergency referral for repair or phallectomy
76
Q

describe Incomplete Castratio

A
  • Drawback of closed castration: can’t see what you’re emasculating
  • Young colt foals can have relatively large gubernaculum – can be
    mistaken for testis
  • Partial abdominal cryptorchids – tail of the epididymis can lie in the
    inguinal region and may be mistaken for a small inguinal testis
77
Q

Prevention for incomplete castration?

A
  • Check the testes – before emasculating (by using semi-closed or open
    technique) and afterwards (always, regardless of technique used)
  • Cryptorchid castration: open the vaginal process to visual contents and
    ensure the presence of an epididymis prior to castrating
78
Q

Describe peritonitis?

A
  • Rare complication
  • Abdominal pain/colic signs
  • Pyrexia
  • Very dull
  • Weight loss
  • Diagnosis: abdominocentesis
  • Referral for intensive care
  • IVFT, supportive care, injectable antibiotics, anti-inflammatories, +/-
    peritoneal lavage

VMS 4001 (17 decks)

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