SURGERY - Equine Castration Flashcards
What is a key history question to ask the owners before carrying out rquine castration?
Has your horse had an inguinal hernia (swelling in inguinal region/groin)?
Also need to check for this on clinical exam
What is a risk factor for evisceration/eventration post castration?
Inguinal hernia is a risk factor for evisceration/eventration post castration
What are the potential surgical approaches to equine castration?
Open standing castration
Closed castration
Semi-open castration
Henderson castration
Laparoscopic castration
Which factors should you consider to determine if open standing castration is appropriate?
Are both testes in the scrotum?
Is there or has there been an inguinal hernia?
Size of the patient?
Demeanour of the patient?
Why is it important to consider the demeanour of the patient before carrying out an open standing castration?
Considering the demeanour of the patient is essential as open standing castrations are carried out with sedation and local anaesthetic rather than general anaesthesia so you have to consider your safety
Why should you never do an open castration on a horse under general anaesthetic?
If you do an open castration on a horse under general anaesthetic, when the horse stands during recovery the intrabdominal pressure will increase and the intestine can be eviscerated through the inguinal canals
How should you prepare for an open standing castration?
- Heavily sedate the patient and ensure you have someone you trust controlling their head
- Identify the anatomical structures (penile shaft and both testicles)
- Surgically scrub the testicles
- Carry out a testicular local anaesthetic block using a 1.5 inch, 21G need and 5ml for the testicle and 5ml subcutaneously for a line block. (Before injecting the testicle, make sure to secure in with your fingers to prevent the cremaster muscle from pulling the testicle too far up into the abdomen when you inject it)
- Repeat this for the other testicle
- Surgically scrub the site again
- Sterile prep and put on gloves
How do you carry out an open standing castration?
- Start with the testicle furthest away from you and make an incision with the scalpel directly over the testicle through the skin, subcutaneous tissue and vaginal tunic
- Exteriorise the testicle through the incision
- Seperate the spermatic cord into cranial and caudal poles and emasculate each portion of the spermatic cord for 2 minutes
- Repeat for the other testicle
- Leave the wound to heal by second intention
(T/F) It is not normal for open castrations to drip blood
FALSE. It is normal for open castrations to drip blood and this can last for even 24 hours. Make sure to tell the owners this
(T/F) Closed equine castrations can only be performed under general anaesthesia
TRUE.
How do you carry out a closed equine castration?
- Place your patient in dorsal recumbency
- Make an incision with the scalpel directly over the testicle through the skin and subcutaneous tissue
- Exteriorise the testicle through the incision within the vaginal tunic
- Bluntly separate the cremastor muscle and emasculate it seperately from the rest of the spermatic cord
- Place an encircling ligature around the remainder of the spermatic cord and emasculate it distal to the ligature
- Repeat for the other testicle
- Leave the wounds to heal by second intention
What is the inguinal technique that can be used for a closed castration?
The inguinal technique is the same as a closed equine castration however the initial incision is made inguinally and the testicle is pulled out of the scrotum and exteriorised via the injuinal incisions
What are the benefits of an inguinal closed castration?
Reduced complications
Reduced swelling
Ideal for older and larger stallions
What is a semi-open castration?
A semi-open castration is where the vaginal tunic is incised, the spermatic cord is ligated and the vaginal tunic is sutured closed at the end of the procedure
When can a semi-open castration be a particularly useful technqiue?
A semi-open castration can be a particularly useful technique if you are concerned about or there is a history of an inguinal hernia
What is the main risk of a semi-open castration?
There is an increased risk of infection with a semi-open castration
What is Henderson castration?
The Henderson castration is a closed castration technique in which crushing forceps are attached to the vaginal tunic and spermatic cord. These forceps fit into a drill and you achieve haemostasis through the crushing and elastic recoil of the arterial wall
What post operative care is required following castration?
Pasture rest
Box rest with walk for 10 minutes 2-3 times daily
Antinflammatory drugs
Antibiotics (only if indicated)
Why is pasture rest ideal post castration in horses?
Pasture rest is ideal post castration as horses are very prone to swelling and oedema but pasture rest will allow the horse to move around and disperse any swelling at the surgical site to try and minimise discomfort
How should you castrate donkeys?
You should always do closed castrations in donkeys with general anaesthesia
What are the potential complications of castration in equids?
Haemorrhage
Evisceration/eventration
Oedema
Infection
Scirrhous cord
Champignon
Tetanus
Penile problems
What is the most common complication of castration in equids?
Haemorrhage
How can you quantify the blood loss following a castration?
If owners call about post castration haemorrhage, it can be very useful to ask owners to count the drops of blood. If they are very few, slow drops this isn’t likely cause fir alarm
When should you be concerned about a post castration haemorrhage?
Stream or pulsing of blood from the castration site
