Written Exam - Large Animal Castration Complications

Question 1

T/F: castration is a common cause of malpractice claims against vets

Answer 1

true

Question 2

when may you do castration with the animal recumbent? what about standing?

Answer 2

recumbent - feral, young, or poorly trained horses

standing - racehorses

Question 3

what are the advantages & disadvantages of standing castration in horses?

Answer 3

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

Question 4

what are the advantages & disadvantages of recumbent castration in horses?

Answer 4

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

Question 5

what are the general complications of castration?

Answer 5

hemorrhage, evisceration/eventration, peritonitis, swelling, penile damage, & continued masculine behavior

Question 6

what may cause hemorrhage?

Answer 6

improperly applied emasculator, too much tissue to adequately crush the cord, excessive fat in donkeys

Question 7

when is a henderson equine castrating tool used?

Answer 7

horses or donkeys with small testicles - don’t use on larger horses

Question 8

what is too much hemorrhage?

Answer 8

unabated streaming of blood for 15 minutes - testicular artery usually the problem

Question 9

how do you treat excessive hemorrhage?

Answer 9

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

Question 10

what is eventration?

Answer 10

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

Question 11

what are the treatment options used for eventration?

Answer 11

surgical correction - transect omentum proximally, & suture the superficial inguinal ring only is the rectal indicated the need

Question 12

what is evisceration?

Answer 12

prolapse of the bowel from the internal ring that descends into the scrotum or inguinal canal

very uncommon - potentially fatal

Question 13

why does evisceration happen?

Answer 13

results from pre-existing, unapparent congenital inguinal hernia = large inguinal rings

Question 14

what breeds are most commonly affected by large inguinal rings?

Answer 14

standardbreds, arabians, draft breeds, american saddlebreds, & tennessee walking horses

Question 15

what is the treatment for evisceration?

Answer 15

euthanasia, referral to surgical center

Question 16

what is the most common complication of castration?

Answer 16

excessive edema - generally greatest around 3-5 days

Question 17

how do you prevent excessive edema in castrations?

Answer 17

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)

Question 18

when should testosterone decrease after castration?

Answer 18

within 6 days, libido declines over 50

Question 19

what hormones may cause continued masculine behavior?

Answer 19

testosterone, estrone sulfate, & anti-mullerian hormone

Question 20

what is septic funiculitis?

Answer 20

infection of the spermatic cord contained within the parietal tunic caused by extension of scrotal infection & contaminated instruments

Question 21

what is botryomycosis?

Answer 21

septic funiculitis caused by staph spp.

Question 22

what is champignon?

Answer 22

abscess in the stump of the spermatic cord caused by strep spp.

Question 23

what are some clinical signs of septic funiculitis?

Answer 23

preputial swelling/scrotal edema, lameness, fever, lesion may not be apparent for years, enlarged cord

Question 24

what is the treatment for septic funiculitis?

Answer 24

medical - early on

surgical - en bloc removal, leave open to drain, & antibiotics

Question 25

why can horses develop septic peritonitis after castration?

Answer 25

communication between parietal & peritoneal cavities

Question 26

what lab values are consistent with septic peritonitis in a horse following castration?

Answer 26

> 10,000 cells/uL for 5-7 days after castration

elevated nucleated cell count in peritoneal fluid, degenerate neutrophils, & intracellular bacteria

Question 27

what can cause penile trauma?

Answer 27

mistake the penis for a testicle or crushed with an emasculator

Question 28

if you have a cryptorchid horse with a testicle in the inguinal region, what is your approach?

Answer 28

inguinal

Question 29

what is a high flanker cryptorchid?

Answer 29

testis & epididymis within the inguinal canal

Question 30

when should you close the external inguinal ring in a cryptorchid horse?

Answer 30

only if partial or completee

Question 31

when may you have to do a standing surgical approach for a cryptorchid horse?

Answer 31

abdominal or complete cryptorchids - standing laparoscopic

Question 32

if doing a standing laparoscopic surgery, what should you be careful to avoid on the left & right sides of the horse?

Answer 32

left - retroperitoneal space & spleen

right - cecum & duodenum

Question 33

what is post-anesthetic myelomalacia?

Answer 33

paralysis of the hind limbs after a short anesthetic period typically in healthy horses