Equine osces (castration, emergency tracheostomy) Flashcards
How long will haemorrhage from stomach tubing last? How to avoid?
Usually stops within 5-10 mins
Ensure place in ventral meatus
Use smooth tube with lubricant on end
Do not force tube if resistance
Methods of castration?
Standing/GA
Open (vaginal tunic excised) or closed
Field/theatre
+/- Placement of a ligature - place as high up as close to external inguinal ring as possible - used to prevents omental prolapse, evisceration etc, rather than for haemostasis
Emasculators most frequent technique for haemostasis
- crushing blade
- ‘nut to nut’
- as high as possible
- in place for 1-2 mins (min 2 mins if large testicles)
- check for haemorrhage when removing, re-emasculate if needed
- must be applied transversely
Lower/further away testicle first
Incision parallel to median raphe (pigmented line)
What must be checked on pre-castration evaluation of a colt/stallion?
History: - age and breed - previous inguinal/scrotal herniation Clinical exam: - presence of 2 descended testes - no significant disparity between the 2 scrotal sacs (if one very small, could be cryptorchid with descent of just epididymis) - auscultate heart
Difference between inguinal and scrotal herniation in colts/stallions?
In both: intestines lying between testicle and vaginal tunic
Scrotal: non painful, no signs of colic
Inguinal: strangulation of small intestines, pain, colic
What do you need for castration?
Emasculators Local anaesthetic Surgical scrub Gloves Sedation/anaesthetic agents Antibiotics Tetanus status NSAIDs Catheter
Local anaesthetic for castration?
10ml for each testicle: into testicle, tunica dartos and scrotal skin
Aftercare for castration?
Box rest for first 24h
Then turned out/light exercise (30 mins twice daily)
Full work can be resumed in 1-2 weeks
Keep away from mares for first 1-2 weeks
Why must castration incisions not be too small?
Increases risk of seroma if too small
When should vet advice be sought following equine castration?
Dripping that persists for >4h or where there is a steady stream of haemorrhage
Evidence of tissue hanging from the incision
Marked swelling of the scrotum or stiffness that persists >3-4 days post-op
Depression, inappetance or colic
Haemorrhage post-castration: Initial assessment? What should you do?
Check HR, mm, CRT Sedation Clamp vessel if able to with artery forceps Pack with swabs May need to GA to ligate artery Blood transfusion in hospital if needed
Scrotal oedema/swelling post-castration: Cause? What should you do?
Causes:
- inadequate drainage
- inadequate exercise following surgery
- excessive tissue trauma during surgery
- infection of scrotal wound
Check temperature (likely infection if pyrexic)
+/- C and S
Penicillin if signs of infection (e.g. purulent discharge, pyrexia)
If been on too much box rest and not pyrexic, probably no antibiotics needed
Open up wound by massaging or inserting gloved finger into scrotal cavity
NSAIDs
Increase exercisse
Lavage scrotum
Surgical resection if doesn’t resolve with medical treatment
Omental herniation following castration: What does it look like? What should you do?
Lace like tissue hanging from scrotum
Sedate, antibiotics, NSAIDs
Clean site and exposed omentum
Emasculate/scissors as high up as possible using gentle traction to pull out
Monitor for excessive swelling/further prolapse
Poss resection and closure of vaginal tunics under GA
Evisceration following castration: When happens? Prevention? Prognosis? What should you do?
Life threatening emergency - poor prognosis
Happens with open castration
Preveneted with open-closed or closed techniques
Assess CV status
Flunixin and antibiotics
+/- Sedation
Lavage intestine with sterile saline
Prevent intestinal trauma and further prolapse - replace into scrotum if can and temporarily close scrotal skin
If can’t, use sling between legs with clean sheet
Poss surgery but expensive and poor prognosis - may die in transport
Euthanasia straight away is good iption
If just one loop of intestine soon after castration, can quickly push back in, close tunic and send to a hospital - better prognosis
Septic funiculitis post castration: How does it prevent? What is it? Why? Treatment?
= Infection of spermatic cord (extension of scrotal infection)
Scrotal incisions have healed but stump of cord is infected and abscess can form and have a draining tract
Presents as scrotal swelling which seems to resolve with NSAIDs and antibiotics but keeps re-curring, discharging sinus tract, thick cord like structure extending up inguinal canal
Penicillins (usually Staph)
C and S of discharging tract
Re-establish drainage
Excise infected portion of spermatic cord if chronic/not resolving with antibiotics
Acute and chronic forms (can be years later)
Hydrocele following castration: What is it? When happens? What to do?
Uncommon
Accumulation of peritoneal fluid within the vaginal tunic
More common following open castration
Cosmetic defect - owner may want to treat as when selling, looks like uncastrated
