ISSN 2398-2977      

Testis: castration - post-operative complications

pequis
Contributor(s):

David Moll


Hemorrhage

  • Excessive hemorrhage is the most common immediate post-operative complication of castration.

Causes

  • Improper application of emasculator   Testis: castration - technique  :
    • Reversing emasculator (not 'nut to nut')   →   crushing distal to site of transection.
    • Application other than perpendicular   →   increased diameter of severed testicular vessels.
    • Inadvertently including scrotal skin may   →   insufficient vessel crushing.
    • Older stallions with thick cords may require double emasculation (ie vaginal tunic and cremaster muscle transected separately from ductus deferens and testicular vessels) plus ligation.
    • Emasculator incorrectly maintained: the Reimer and Serra emasculators are commonly used to achieve effective hemostasis - the blades of the emasculator should not be too sharp otherwise vessel severance occurs before crushing.

Clinical signs

  • Dripping of blood from the scrotal wound is quite common for several minutes after emasculation and should not be of concern.
  • A constant streaming of blood for >15 min is cause for concern.
  • The most likely source is the testicular artery.
  • Hemorrhage from scrotal vessels can occur but is unlikely to be serious and usually ceases spontaneously unless the horse is stressed or has clotting deficiency.

Treatment

  • Stand horse in quiet environment for 15-30 min and monitor.
  • If hemorrhage does not diminish:
    EitherPreferably, attempt to grasp end of cord with gloved hand or forceps and gently pull out from scrotal wound before applying large forceps or re-emasculating.

Forceps may be left on cord overnight before removal.

In standing castration the cord is often still anesthetized and the horse may not object too strongly. If a recumbent castration procedure was used, deep sedation   Anesthesia: standing chemical restraint  or re-anesthesia   Anesthesia: general - overview  may be required to achieve access to the cord.

  • Ligate the hemorrhaging vessel if visible or in cases where the cord is not accessible: Tightly pack sterile gauze bandage or towels into the inguinal canal and scrotum. Retain by temporary sutures or towel forceps for 24 hours.

Use this option only as a last resort.

  • IV formalin has been suggested to control hemorrhage but its safety and action are unknown: use 8-16 ml of 4-12% per average horse preferably diluted in a liter of saline to decrease side-effects.
  • Fluid therapy   Fluid therapy: hemorrhage  and blood transfusions   Blood: transfusion  .

Herniation and evisceration

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Swelling

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Clostridial infection

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Infection of the spermatic cord

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Peritonitis

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Caniglia C J et al (2014) Septic funiculitis caused by Streptococcus equisubspecies equi infection with associated immune-mediated haemolytic anaemia. Equine Vet Educ 26 (5), 227-235.
  • Pollock P J (2012) Complications of castration: Part 2. UK Vet 17 (6), 4-8 VetMedResource.
  • Pollock P J (2012) Complications of castration: Part 1. UK Vet 17 (5), 9-13 VetMedResource.
  • Moll H D et al (1995) A survey of equine castration complications. J Eq Vet Science 15 (12), 18-22 VetMedResource.
  • Nickles F A (1988) Complications of castration and ovariectomy. Vet Clin North Am Equine Pract (3), 515-523 VetMedResource.

Other sources of information

  • Auer J A & Stick J A (1998) Eds. Equine Surgery. W B Saunders, USA.

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