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MODULE 19 - Reproduction and Fertility > SURGERY - Equine Castration and Rigs > Flashcards

SURGERY - Equine Castration and Rigs Flashcards

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1
Q

What is a key history question to ask the owners before carrying out equine castration?

A

Has your horse had an inguinal hernia (swelling in inguinal region/groin)?

Also need to check for this on clinical exam

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2
Q

What is a risk factor for evisceration/eventration post castration?

A

Inguinal hernia is a risk factor for evisceration/eventration post castration

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3
Q

What are the potential surgical approaches to equine castration?

A

Open standing castration
Closed castration
Semi-open castration
Henderson castration
Laparoscopic castration

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4
Q

Which factors should you consider to determine if open standing castration is appropriate?

A

Are both testes in the scrotum?
Is there or has there been an inguinal hernia?
Size of the patient?
Demeanour of the patient?

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5
Q

Why is it important to consider the demeanour of the patient before carrying out an open standing castration?

A

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

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6
Q

Why should you never do an open castration on a horse under general anaesthetic?

A

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

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7
Q

How should you prepare for an open standing castration?

A
  1. Heavily sedate the patient and ensure you have someone you trust controlling their head
  2. Identify the anatomical structures (penile shaft and both testicles)
  3. Surgically scrub the testicles
  4. 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)
  5. Repeat this for the other testicle
  6. Surgically scrub the site again
  7. Sterile prep and put on gloves
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8
Q

How do you carry out an open standing castration?

A
  1. 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
  2. Exteriorise the testicle through the incision
  3. Seperate the spermatic cord into cranial and caudal poles and emasculate each portion of the spermatic cord for 2 minutes
  4. Repeat for the other testicle
  5. Leave the wound to heal by second intention
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9
Q

(T/F) It is not normal for open castrations to drip blood

A

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

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10
Q

(T/F) Closed equine castrations can only be performed under general anaesthesia

A

TRUE.

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11
Q

How do you carry out a closed equine castration?

A
  1. Place your patient in dorsal recumbency
  2. Make an incision with the scalpel directly over the testicle through the skin and subcutaneous tissue
  3. Exteriorise the testicle through the incision within the vaginal tunic
  4. Bluntly separate the cremastor muscle and emasculate it seperately from the rest of the spermatic cord
  5. Place an encircling ligature around the remainder of the spermatic cord and emasculate it distal to the ligature
  6. Repeat for the other testicle
  7. Leave the wounds to heal by second intention
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12
Q

What is the inguinal technique that can be used for a closed castration?

A

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

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13
Q

What are the benefits of an inguinal closed castration?

A

Reduced complications
Reduced swelling
Ideal for older and larger stallions

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14
Q

What is a semi-open castration?

A

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

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15
Q

When can a semi-open castration be a particularly useful technqiue?

A

A semi-open castration can be a particularly useful technique if you are concerned about or there is a history of an inguinal hernia

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16
Q

What is the main risk of a semi-open castration?

A

There is an increased risk of infection with a semi-open castration

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17
Q

What is Henderson castration?

A

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

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18
Q

What post operative care is required following castration?

A

Pasture rest
Box rest with walk for 10 minutes 2-3 times daily
Antinflammatory drugs
Antibiotics (only if indicated)

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19
Q

Why is pasture rest ideal post castration in horses?

A

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

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20
Q

How should you castrate donkeys?

A

You should always do closed castrations in donkeys with general anaesthesia

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21
Q

What are the potential complications of castration in equids?

A

Haemorrhage
Evisceration/eventration
Oedema
Infection
Scirrhous cord
Champignon
Tetanus
Penile problems

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22
Q

What is the most common complication of castration in equids?

A

Haemorrhage

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23
Q

How can you quantify the blood loss following a castration?

A

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 for alarm

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24
Q

When should you be concerned about a post castration haemorrhage?

Study These Flashcards
A

Stream or pulsing of blood from the castration site

25
What are the causes of haemorrhage post castration?
Haemorrhage is usually caused by an improperly applied or defective emasculator
26
How can you treat post castration haemorrhage?
If it is not an arterial bleed, you can pack the wound with gauze, making sure to count the gauze that you put in to make sure you take them all out. If it is an arterial bleed, refer the patient if possible or do a general anaesthetic and identify the vaginal tunic and attempt to clamp off and ligate the bleeding artery *(this is very challenging)*
27
What are the signs of an extravaginal tunic haemorrhage?
An extravaginal tunic haemorrhage post castration will prevent as a swelling, often with the penis turned in and the patient may have difficulty urinating. To confirm this is a haemorrhage, you can take a sample with a needle and syringe
28
How do you treat an extravaginal tunic haemorrhage?
Reopen the incision and drain all of the blood and blood clots and administer NSAIDs and antibiotics
29
What are the risk factors for an evisceration/eventration?
Current or previous inguinal hernia Open castration under general anaesthesia
30
How do you manage an evisceration of the small intestine?
Minimise contamination and further evisceration of the small intesine through packing it back into the scrotum and placing a purse string suture if possible. A belly wrap can also be used if there is more eviscerated intestine. Antibiotics and NSAIDs should also be administered. The horse will then need to be referred for surgery
31
How do you manage an evisceration of the omentum?
Clean the surgical side and the omentum as much as possible, and emasculate the omentum as proximally as possible
32
How can you reduce post castration oedema?
Exercise the horse NSAIDs Scrotal massage Hosing the scrotal wound with cold water
33
What is scirrhous cord?
Scirrohous cord is an infection with Staphylococcus aureus resulting in microabscessation and pyogranulomatous inflammation of the remainder of the spermatic cord
34
How do you treat a scirrhous cord?
Surgical removal of the infected stump
35
What is champignon?
Champignon is a pyrogranulomatous inflammation and microabscessation of the remainder of the spermatic cord
36
How do you treat champignon?
Surgical removal of the infected stump
37
What is paraphimosis?
Paraphimosis is the inability to retract its penis into the prepuce
38
What is phimosis?
Phimosis is the inability to protrude the penis from the prepuce
39
What is priapism?
Priapism is a persistent erection
40
What is a monorchid?
A monorchid is a horse with one testicle | This is NOT a unilateral cryptorchid
41
What is a rig?
A rig is a term used to describe cryptorchids
42
What are the three classifications of cryptorchidism?
Inguinal Abdominal Partial abdominal
43
What is an inguinal cryptorchid? | Also known as a 'high flanker'
An inguinal cryptorchid is where the testicle(s) are retained within the inguinal canal
44
Which testicle is more likely to be an inguinal cryptorchid?
The right testicle is more likely to be an inguinal cryptorchid
45
What is an abdominal cryptorchid?
An abdominal cryptorchid is when both the testes and the epididymus is retained in the abdomen
46
Which testicle is more likely to be an abdominal cryptorchid?
The left testicle is more likely to be an inguinal cryptorchid
47
What is a partial abdominal cryptorchid?
A partial abdominal cryptorchid is where the epididymus, but not the testis, has descended through the vaginal ring
48
What are the risks of a partially abdominal cryptorchid?
A partially abdominal cryptorchid can be mistaken as testicular hypoplasia at castration, so only the epididymus is removed and the testis is left in the body, so the horse will be infertile however will still have stallion like behaviours
49
What are the consequences of cryptorchidism in equids?
Cryptorchids are subfertile to infertile *(abdominal don't produce functional sperm at all)* due to the high temperatures that the testis are exposed to. However, they can still produce testosterone *(at a reduced concentration)* and thus have stallion-like behaviours. Furthermore, cryptorchids have an increased risk of neoplasia
50
(T/F) Cryptochidism is heritable
TRUE. Cryptorchidism is heritable so horses with untilateral cryptorchidism which could still be fertile should not be bred
51
How can you diagnose a rig?
History Clinical examination Diagnostic imaging Hormonal assays
52
Which factors should you focus on when doing a clinical examination to diagnose a rig?
Carefully palpate the scrotum and inguinal rings, using sedation to relax the cremaster muscle
53
When are hormonal assays particularly beneficial to diagnose a rig?
Hormonal assays are useful in horses with no testicles in their scrotum and determining if the stallion like behaviour is psychic or hormonal
54
What is the most common hormonal assays used to diagnose a rig?
Antimullerian hormone (AMH)
55
How do antimullerian hormone (AMH) levels differ between rigs, stallions and geldings?
Antimullerian hormone (AMH) levels are higher in the rig than a stallion, and geldings have almost no antimullerian hormone (AMH)
56
Which surgical techniques are used for cryptorchid testicles?
Inguinal exploration to identify if there are any scars which could indicate castration surgery, or key indicators of a cryptorchid such as the inguinal extension of the gubernaculum testis. If the testicle is identified, it can be removed inguinally
57
Which surgical technique can be done if inguinal removal of the cryptorchid testicle is not possible?
Laproscopic cryptorchidectomy
58
Why should you never remove a scrotal testicle before removing the retained testicle?
You should never remove the scrotal testicle before removing the retained testicle as there will be compensatory hypertrophy of the retained testicle which can make removal more challenging, and the owner can potentially fraudulantly sell the horse as a gelding
59
What are false rigs?
False rigs are castrated males with stallion-like behaviours. These horses are just badly behaved | Advise these owners to look into training

MODULE 19 - Reproduction and Fertility (18 decks)

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