Surgery of the Male Equine Urogenital Tract Flashcards
When is castration done?
1-2 years
What should you make sure is done when you castrate?
that the animal is vaccinated–don’t want them getting tetanus
What must you remember about the inguinal ring?
it is only the external ring, there is also an inguinal canal and a vaginal ring on the peritoneal side. It is not the size of the external ring (that you can palpate) that is important with regards to herniation, it is the vaginal ring that is important and you cannot palpate that from the outside
What is another name for vaginal tunic?
parietal tunic
WHat must you remember when you cut through the vaginal tunic?
you are in the abdminal cavity–abdominal peritoneal fluid
Why will all castrated animals end up with a degree of inflam peritonitis?
because you are entering the abdominal cavity technically
so if horse is really sick and you do an abdominal tap then you will get abnormal results even if the horse is not sick due to a peritonitis
If a testicle is intrabdominal at birth will it go to a normal position?
no
Why is important to know proper anatomy for cryptorchids?
need to remove testicle! not something else
What does the proper ligament join?
tail of epidydmdus to testicle
What does ligament of tail join?
tail of epididymus to vaginal tunic
What is castration NOT a treatment for?
bad behaviour
How is routine sharp surgery done?
standing-sedation
recumbent-GA
Which is preferable, standing or recumbent?
recumbent
What are the benefits of standing castration
less expense
less assistance (not necessarily and need good handling)
less time consuming (not really)
What animals should you avoid standing castration in?
donkeys, mules, short horses–less working space
have a habit of kicking
donkeys and mules bleed more
Why should you always palpate the testicles?
if one much larger than the other or think neoplastic process you want to know that because may bleed more or not prepared to deal with that.
Make sure there are two!!!
Right retained testicles are typically what? Left?
right–inguinal
left–abdominal
What plants horse feet better than rompin?
detomidine
What do horses react to more when with detomidine than xylazine?
flies/light touch
What do you have to inject lidocaine into?
- spermatic cord
- testicle
- scrotum
he doesn’t like to inject into spermatic cord into GA is because it creates puncture, when applying traction can rupture at that point
What should you expect when injecting lidocaine into testi le?
a bad reaction
Why do you have to watch out for the penis while doing a standing castration?
it is always dirty
What does open and closed refer to with castration?
Whether or not you open the vaginal tunic
What side do you want to crush, what side do you want to cut with emasculators?
crush the horse side, cut the testicle side
Want crushing so get hemostasis and cut the other side
Double check!!!!
What is the increased rate of complication with standing?
30%
What do you use for GA for castratrion?
Rompun and ketamine and diazepam for recovery
What does he have in the jugular?
a needle with a half dose of rompun and ketamine–can tell owner to push in if horse starts to wake up
Where could you put a top up dose of rompun and ketamine other than neck?
have on surgery pack aseptically and give in groin–big vessels
With an open castration what is incised?
scrotum and parietal tunic
When do you ligate?
before you apply the emasculators (otherwise pressure high and then when take emasculator off then ligature is loose)
how long do you leave emasculator on?
a minute per year plus 1 minute
If you ligate, do you leave the emasculator on?
no
IF see a trickle of blood, where is it usaully coming from? if it is coming from where else then you are worried?
scrotal incision. worried if coming from depths
IF you leave your incision open what should you do?
cut or emasculate tissue that is left hanging. if you can pull it out while horse is on back then it will definitely come out when he is standing
cut off now! not when standing
When should you check for hemorrhage?
not only immediately after emasculating but also in 15-20 seconds because there is arteirovasospasm when you crush/cut. if not appropriately ligated/thrombosed then get relaxation of the vasospasm and will start to bleed
Is it necessary to take out the median raphe?
not usually
he doesn’t do it because it bleeds
What is the aftercare for castration?
restricted activity for 24hrs
excerised–forced (+/- hydrotherapy–but may push bacteria in!!!)
isolate from mare-1wk
Why should you isolate castrated animal for 1 wk from mares?
because may have semen left over
don’t want them all excited–too much movement around scrotal tissue–blood drawn to region and moving thrombosed vessel around
What are the indications for laparoscopic castration?
cryptorchid surgery
–“2nd look”—previous sx
Why should you expect tools will fail?
because the emasculator may not work–e.g. keep a clamp on so when cut off have a clamp in case bleeding occurs–can pull cord back up
What is the trendelenburg position?
15 degree head down position
What do you want to avoid with laparoscopic castration?
the bladder
What are complications of castration?
hemorrhage evisceration edema septic funiculitis septic peritonitis/clostridial dz penile damage/hydrocele continued masculine behavior
What vessels bleed in castration?
usually testicular artery
scrotal vessel–incomplete transection
veins–but they have valves
What is an issue with castrating an older animal?
have large testicles, may be difficult to get adequate crushing?
WHat is treatment for hemorrhag during castration?
1) quiet for 20-30min
2) emasculate or clamp cord but can be very painful if cord not blocked, not under GA
3) pack incision (24hr)
4) GA and find the bleeder
what is an issue with packing a bleeder?
don’t know what is going on below it
Why do you have to be careful clamping vessels?
nerves are often close to vessels–get kicked
How do you treat evisceration (complication of castration)
- protect and replace content
2. treat for septic peritonitis
What breeds may be predisposed to evisceration after castration?
standardbreds
drafts
Where should you prevent internal organs from getting down to in evisceration?
below hocks
Will an animal with evisceration always get septic peritonitis?
YES severity may vary
Why should you do laparotomy for evisceration/castration?
can make sure the intestine is out of the canal and that it is still healthy
Why is edema not usually considered a complication of castration?
normal and peaks on day 3
What is the treatment for edema after castration?
- exercise
- hydrotherapy
- drainage
What is septic funiculitis?
infection of cord–inadequate drainage (not that much drainage)
What is teatment for septic funiculitis?
- abtibiotics
- drainage!!!–is a very thickwalled abscess
- excision of scirrhous cord until get above infected region but that can be deep and it bleeds a lot!!!
What is a possible sequelae of septic funiculitis?
septic peritonitis
Why do you not get a septic tunic with closed castration?
because it is gone
How do you preven clostridial dz from castration?
vaccination
What is treatment for septic peritonitis from castration?
antibiotics
NSAIDs
lavage
What is a proud cut horse?
continued masculine behavior?
epididymis left behind?
psychic
maturity not an issue
what persent of left testicles are intrabdominal? what about right?
left: 75%
right: 42%
How do you diagnose cryptorchids?
- inguinal palpation
- rectal palpation
- transabdominal ultrasound
- exploratory
- hormonal assays
What is the inguinal approach for cryptorchidism?
incision over inguinal ring
blunt dissection to ring
locate vaginal process
With an inguinal approach, why do you not want pull too hard on the tail of the epididymis to get the testicle?
could break off and the testicle will fall into the abdomen
If you have to damage the internal ring during inguinal approach to cryptorchid what should you do?
close the external ring
What is parainguinal approach to cryptorchid?
go through muscle, peritoneum into abdomen and fish with two fingers
What are 3 other approaches to cryptorchidism (less common)
flank
suprapubic?
laparoscopic
urolithiasis is what % of urinary tract diseases?
8%
Where are stones usually?
bladder (60%)
urethra 24%
What might be a cause of blood in urine post exercise?
stone in the bladdero
BUT could have rhabdomylosis or oxidation of urine on snow
What is the best thing to do with horses with urolithiasis?
scope the bladder
90% of stones are what?
spiculated CaCO3 (diffiuclt to get out!)
10% of stones are what?
smooth
What are clinical signs of cystolithiasis?
intermittent pain
hematuria
What is the treatmennt for cystolithiasis?
- retrieval-manual in female, endoscope with snare
- surgical–laparotomy, perineal urethrostomy
- stone reduction (lithotripsy, laser)
