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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
Step 1 of Open Castrate
26
Step 2 open castrate
27
STEP 3 open castrate ?
28
STEP 4 OPEN CASTRATE?
29
STEP 5 OPEN CASTRATE?
30
Step 1 Closed Castrate?
31
Step 2 Closed C?
32
STEP 3 CLOSED C?
33
STEP 4 CLOSED C?
34
STEP 5 CLOSED CASTRATE ?
35
What technique for Semi-closed castration?
36
What general considerations to think about?
- Facilities/ hygiene? Time of day Weather? / shelter Signed consent
37
Peri-operativeMEdications?
- 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
what sedation for standing sedation?
Alpha 2 agonist and butorphanol
39
What practical things to do for standing castrate?
- Tail bandage, scrotum scrubbed - Competent handler on same side - Nose twitch? - surgeon close to horse's shoulder
40
41
What local anaesthesia can we use?
Lidocaine or Mepivicaine 10-20ml along planned incision sites 5-10ml into each testis
42
What considerations for Field Anaesthesia?
- Care risk to humans - Suitabel space - IV catheter - Tail bandage, scrotum scrubbed, mouth washed out
43
What ANAESTHETIC considerations with field anaesthesia?
- Second vet/ nurse to monitor - Alpha 2 agonist plsu butorphanol pre-med then Ketamine and Diazpam induction -> ket or sedative top ups -> local
44
What positioning for field anaesthesia?
Lateral recumbency wth upper pelvic limb pulled forwards and secured with a rope
45
What Post op care for open castrate?
* 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
Post-op care for closed or semi-closed castrate?
* 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
What is Cryptorchidism colloquially known as?
'Rigs'
48
Describe cryptorchidism in horses
- Retention of one common - Complete retention of both is rare - Can be complete abdominal, partial abdominal, inguinal or completely absent
49
How do we diagnose Cryptorchidism ?
- Sedation & deep palpation into inguinal ring - US (transabdo & transrectal) - Serum AMH (Oestrone sulphate) -> if equivoal AMH -> dynamic testing (hcG stim test)
50
What surgery can we do for cryptorchidism?
- Para-inguinal - Inguinal - Laparoscopic
51
What are common Castration complications?
* 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
Describe NORMAL haemorrhage in open castrations?
- Drip blood (slowly) for several hours -> should be able to count the drips
53
What source of bleeding ?
Testicular artery
54
What risk factors to haemorrhage?
- Improper application of emasculators - Catching scrotal skin - Nuts not tight - Assemble incorrectly - hick cords: rq double ligation
55
How do we assess blood loss?
- demeanor - HR/ pulse - MM/CRT - Subjective quantitiy assessment - Haematology parameters (PCV less than 20% -> acute)
56
What is the blood volume of a horse?
9% of Bodyweight -> 45L for 500kg horse
57
How do we prevent haemorrhage?
- 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
What TX for haemorrhage ?
* 1. Don’t panic – give time! * 2. Try clamping a vessel * Mixter right angled forceps * 3. Pack with unrolled bandage * 4. Anaesthetise and clamp/ligate artery * Referral if possible
59
Describe Swelling/ oedema
* ‘Some’ is normal * ‘Too much’ swelling and/or oedema is relatively common * Can occur with or without seroma formation and/or infection
60
How to prevent a seroma in open castrate?
exercise following open castrate & big surgical incision
61
How to prevent seroma in closed ?
- reduce dead space - Goof surgic&l technique - rest and slow return to exercise post surgery
62
How to manage open castrate seroma?
- Re-open wounds with sterile gloved finger and re-establish drainage - Consider AMs if suspect infection
63
How to manage seroma in closed castrate?
* Do not open wound if not believed to be infected * Focus on reducing risk of secondary infection * Antimicrobials? * Wound care
64
Describe scrotal infection
- COmmon with open castrate - Often minor, but check for: fever, dull demeanour, inappetance
65
Is infection less common in closed?
YES but potentially worse bc -> lack of drainage & presence fo Implant
66
Tx for Scrotal infection?
* 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
IF protruding skin, fascia or blood clot .. worried?
NO
68
What can eviscerate?
Omentum > via inguinal hernia - not emergency
69
Tx for clots/skin/fascia/ omentum ?
- High degree fo sterility - Pull out as far as poss - Emasculate - Monitor closely
70
Describe evisceration of SI ?
- Via inguinal hernia - Rare but very serious - Likely fatal Draft & standardbreds predisposed ?
71
Tx for evisceration of intestines ?
* 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
What is Septic Funiculitis?
'Scirrhous cord' -> chronic non healign inflammation that keeps recurring and forms a discharging sinus tract uncommon
73
Cause & prevention of septic funiculitis?
* Underlying cause? “absorbable” suture can be a focus of infection * Prevention: avoid use of ligatures in non-sterile surgery if possible
74
Initial management of Septic funiculitis?
* Culture and sensitivity * First line: antimicrobials * Recurrent failure of appropriate antimicrobials is diagnostic Ultimately: * Bold surgical excision of thickened avascular and necrotic tissue
75
Describe iatrogenic penile trama
* 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
describe Incomplete Castratio
* 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
Prevention for incomplete castration?
* 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
Describe peritonitis?
* 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 (24 decks)

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