Written Exam - Large Animal Castration Complications Flashcards
T/F: castration is a common cause of malpractice claims against vets
true
when may you do castration with the animal recumbent? what about standing?
recumbent - feral, young, or poorly trained horses
standing - racehorses
what are the advantages & disadvantages of standing castration in horses?
advantages - avoid risk of GA, not all facilities will be clean, use a handler, shortened time of procedure, & cheaper
disadvantages - higher degree of difficulty for the surgeon (done by feel, visualization isn’t as good), primary closure can’t be done
what are the advantages & disadvantages of recumbent castration in horses?
advantages - better visualization, better control, complications are easier to fix, primary closure
disadvantages - horse must survive anesthesia & recovery, more time, costly, 2 week recovery period with hand-walking for 2 weeks
what are the general complications of castration?
hemorrhage, evisceration/eventration, peritonitis, swelling, penile damage, & continued masculine behavior
what may cause hemorrhage?
improperly applied emasculator, too much tissue to adequately crush the cord, excessive fat in donkeys
when is a henderson equine castrating tool used?
horses or donkeys with small testicles - don’t use on larger horses
what is too much hemorrhage?
unabated streaming of blood for 15 minutes - testicular artery usually the problem
how do you treat excessive hemorrhage?
application of forceps or emasculator, place another ligature, gauze packing - scrotum is closed with gauze packed into inguinal canal/scrotum & then removed 24-28 hours later
what is eventration?
prolapse of omentum through the scrotum - not necessarily an emergency, do a rectal exam to make sure there is no bowel in the inguinal ring
what are the treatment options used for eventration?
surgical correction - transect omentum proximally, & suture the superficial inguinal ring only is the rectal indicated the need
what is evisceration?
prolapse of the bowel from the internal ring that descends into the scrotum or inguinal canal
very uncommon - potentially fatal
why does evisceration happen?
results from pre-existing, unapparent congenital inguinal hernia = large inguinal rings
what breeds are most commonly affected by large inguinal rings?
standardbreds, arabians, draft breeds, american saddlebreds, & tennessee walking horses
what is the treatment for evisceration?
euthanasia, referral to surgical center
what is the most common complication of castration?
excessive edema - generally greatest around 3-5 days
how do you prevent excessive edema in castrations?
remove a large portion of the scrotum, 2 large scrotal incisions, or vigorous exercise for several weeks to promote drainage of fluid (also prevents wound from sealing)
when should testosterone decrease after castration?
within 6 days, libido declines over 50
what hormones may cause continued masculine behavior?
testosterone, estrone sulfate, & anti-mullerian hormone
what is septic funiculitis?
infection of the spermatic cord contained within the parietal tunic caused by extension of scrotal infection & contaminated instruments
what is botryomycosis?
septic funiculitis caused by staph spp.
what is champignon?
abscess in the stump of the spermatic cord caused by strep spp.
what are some clinical signs of septic funiculitis?
preputial swelling/scrotal edema, lameness, fever, lesion may not be apparent for years, enlarged cord
what is the treatment for septic funiculitis?
medical - early on
surgical - en bloc removal, leave open to drain, & antibiotics
why can horses develop septic peritonitis after castration?
communication between parietal & peritoneal cavities
what lab values are consistent with septic peritonitis in a horse following castration?
> 10,000 cells/uL for 5-7 days after castration
elevated nucleated cell count in peritoneal fluid, degenerate neutrophils, & intracellular bacteria
what can cause penile trauma?
mistake the penis for a testicle or crushed with an emasculator
if you have a cryptorchid horse with a testicle in the inguinal region, what is your approach?
inguinal
what is a high flanker cryptorchid?
testis & epididymis within the inguinal canal
when should you close the external inguinal ring in a cryptorchid horse?
only if partial or completee
when may you have to do a standing surgical approach for a cryptorchid horse?
abdominal or complete cryptorchids - standing laparoscopic
if doing a standing laparoscopic surgery, what should you be careful to avoid on the left & right sides of the horse?
left - retroperitoneal space & spleen
right - cecum & duodenum
what is post-anesthetic myelomalacia?
paralysis of the hind limbs after a short anesthetic period typically in healthy horses
