Laparoscopic cauterisation of the testicular arteries to manage haemoperitoneum in a gelding

A Thoroughbred gelding had chronic episodic intra‐abdominal haemorrhage following standing castration, presumed to originate from a testicular artery. No coagulopathy could be detected and resolution of haemorrhage was achieved by laparoscopic electrocoagulation of both testicular arteries 6 weeks after castration. Blood drained from the abdomen during surgery was filtered then auto‐transfused. Post operative complications included pigmenturia, incisional pain and large colon impaction.     

Evaluation of ‘Section‐Ligation‐Release (SLR)’ Technique Devised for Castration in the Stallion

A novel technique [Section‐Ligation‐Release (SLR)] was evaluated for castration in the horse. Clinical traits, serum testosterone concentrations after challenge with human chorionic gonadotrophin (hCG), and histopathological changes of the testicular tissue were assessed. Five stallions, aged 24–48 months, were castrated using SLR technique under general anaesthesia. Both spermatic cords in each stallion were exposed at the scrotal neck by two 5‐cm long incisions, followed by sharp dissection through the parietal vaginal tunic. Both vascular and non‐vascular structures in the cords were triple clamped, transected and ligated. Both testes were left in situ. Serum testosterone concentrations were measured pre‐operatively and at 2 months after castration following IV administration of 1 × 10⁴ IU of hCG. Both testes from each castrate were collected at 2 months for histopathologic examination. SLR castration was successfully achieved. Moderated scrotal and preputial swelling was the only experienced short‐term complication. Serum testosterone concentrations were significantly lower than basal pre‐operative levels at 2 months after castration, and did not respond to hCG. On histopathology, hyalinization of the seminiferous tubules and loss of testicular interstitial tissue were indicative of complete avascular necrosis. This novel primary closure castration technique of stallion is a simple practical method, with minimal post‐operative complications; and could be safely advocated as an alternative to the traditional castration techniques allowing for second intention healing of scrotal wounds.     

Simultaneous presence of a seminoma and a leiomyoma in the testes of a horse

An 18‐year‐old stallion was presented for castration because of insidious, bilateral scrotal enlargement of one year's duration. The left testis was firm, while the right was soft and lobulated; both were larger than normal. Palpation of the scrotum and its contents did not cause the horse to show signs of discomfort. Ultrasonography of scrotal contents revealed abnormal, heterogeneous tissue with ill defined regions of hyper‐ and hypoechogenity throughout both testes. Several hours after admission the horse developed severe signs of colic. On the basis of anamnesis, clinical findings, and results of ultrasonography and transrectal palpation bilateral testicular neoplasia and incarcerated inguinal hernia were tentatively diagnosed. Because the horse's owner did not consent to surgical treatment, the stallion was subjected to euthanasia. Histological and immunohistochemical examination of the testicular tissue collected post mortem revealed a seminoma in the left testis and a leiomyoma in the right testis. The post mortem examination also revealed incarceration of the small intestine in addition to the testicular tumours. To our knowledge, this is the first report of the simultaneous presence of bilateral, yet different testicular tumour types in a stallion.     

Herniation of the small intestine through the femoral canal after castration in a 3‐year‐old Thoroughbred

Complications following castration are a potential problem in equine practice. Intestinal evisceration is a life‐threatening condition requiring immediate correction. The following case report describes a rare condition associated with post castration evisceration in a 3‐year‐old Thoroughbred. Shortly after the eviscerated small intestine was repositioned in the abdomen, the horse showed signs of colic and at the second surgery a 4.5 m jejunal loop was found incarcerated in the femoral canal. After resection and anastomosis, the femoral canal was obliterated using large moistened gauze sponges. The horse made a complete recovery and returned to race training. The occurrence of femoral hernia, a condition fairly common in man, has been described but no clinical cases have been reported in horses. This is a severe, although rare, complication after castration.     

Normal and cryptorchid castration

Surgical exploration of the horse that has presumably had a normal castration or a previously successful cryptorchid surgery remains a distinct challenge. No hard and fast rules dictate a proper course of action for each case. If a horse was anesthetized for routine castration, discovered to have only one scrotal testis, had a brief exploratory on the nondescended side and was recovered, trauma to the inguinal region would probably be sufficiently minimal that an inguinal approach could be used at subsequent exploratory surgery. If the inguinal canal was extensively manipulated and the tail of the epididymis was inadvertently removed, however, one of the alternate approaches would be advisable. Where previous history is unknown, external and rectal palpation, hormonal assays, and careful evaluation of the scrotal/inguinal scars under anesthesia are advisable prior to proceeding with a specific course of action. As previously cited, "one hopes for the best but prepares for the worst." Where inguinal canals are being explored in the supposedly previously castrated horse that still has aggressive male behavior, the surgeon is searching for vaginal process and contents or the stump of the spermatic cord. If the stump is identified to suggest complete previous castration, the stump should contain cremaster muscle, parietal vaginal tunic, testicular vessels, and ductus deferens. If a second nonvascular tubular structure is found but no testicular vessels are found, the tail of the epididymis was inadvertently removed and assumed to be hypoplastic testis. This determination can be difficult to make on gross observation of the stump. Again, a thorough case workup helps one plan in advance for what should be found at surgery.     

Effect of intratesticular injection of lidocaine on cardiovascular responses to castration in isoflurane-anesthetized stallions

OBJECTIVE: To evaluate the effect of intratesticular administration of lidocaine on cardiovascular responses and cremaster muscle tension during castration of isoflurane-anesthetized stallions. ANIMALS: 28 healthy stallions (mean +/- SD age, 4.2 +/- 2.8 years) with no testicular abnormalities that were scheduled for castration. PROCEDURE: Each horse was given acepromazine (20 microg/kg, IM), romifidine (50 microg/kg, IV), and butorphanol (20 microg/kg, IV). Anesthesia was induced with ketamine (2.5 mg/kg, IV) and midazolam (50 microg/kg, IV) and maintained with isoflurane (1.7% end-tidal concentration). After 10 minutes at a stable anesthetic plane, a needle was placed in each testicle and either no fluid or 15 mL of 2% lidocaine was injected; 10 minutes after needle placement, surgery was commenced. Pulse rate and arterial blood pressures were measured invasively at intervals from 5 minutes prior to castration (baseline) until 5 minutes after the left spermatic cord was clamped. The surgeon subjectively scored the degree of cremaster muscle tension. In 2 horses, lidocaine labeled with radioactive carbon (C(14)) was used and testicular autoradiograms were obtained. RESULTS: Compared with baseline values, castration significantly increased blood pressure measurements; intratesticular injection of lidocaine decreased this blood pressure response and cremaster muscle tension. In 2 horses, autoradiography revealed diffuse distribution of lidocaine into the spermatic cord but poor distribution into the cremaster muscle. CONCLUSIONS AND CLINICAL RELEVANCE: In isoflurane-anesthetized stallions, intratesticular injection of lidocaine prior to castration appeared to decrease intraoperative blood pressure responses and cremaster muscle tension and may be a beneficial supplement to isoflurane anesthesia.     

Ultrasonographic and morphological sequelae to repeated testicular biopsies in stallions in relation to the lateral branching of the testicular artery

The objectives of this study were to investigate the sequelae to repeated testicular biopsies in stallions and to determine if arterial injuries can be prevented. This study was part of a larger project focused on the antispermatogenic effects of an oral contraceptive compound, RTI‐4587‐073(l), which was given to 3 mature Miniature horse stallions, while another 3 received a placebo treatment. Testicular biopsies were taken once before treatment and 3 times after treatment. They were obtained from alternating testes, 2 procedures per testis, 2 samples each time, using a 18 gauge split‐needle core biopsy instrument (penetration depth: 22 mm). Colour Doppler ultrasonography was performed prior to the procedure to detect and thus avoid lateral branches of the testicular artery. Testicular parenchyma was evaluated ultrasonographically just before, and 2–6 h, 3 days and weekly after the biopsies were obtained. Changes in testicular volumes and semen parameters were monitored. All stallions were then castrated and the testes were evaluated for any gross pathology. There was no major scrotal swelling or gross haemorrhage after the procedures. Only mild, focal lesions were found in the testicular parenchyma 3 and 7 days after taking the biopsies. Three lateral branches of the testicular arteries were punctured, but there was no evidence of significant bleeding or other complications associated with these injuries. We conclude that repeated testicular biopsies may be taken from stallions without causing major complications, regardless of a presence or absence of the lateral branches of the testicular artery. Furthermore, we conclude that using colour Doppler ultrasonography to detect the lateral branches of the testicular arteries is unreliable; however, puncturing these vessels during a biopsy procedure does not necessarily result in significant haemorrhage.     

Active immunization of prepubertal colts against estrogens: hormonal and testicular responses after puberty

Prepubertal Quarter horse colts were immunized at 6 mo of age with either estrone-17-oxime-bovine serum albumin (n = 4; treated) or with albumin only (n = 5; controls). All colts received booster injections of the appropriate antigen at 8, 10, 12, 16 and 20 mo of age. Blood samples were drawn every 20 d from 6 to 26 mo of age; body weights were determined monthly. Immunization against estrone-albumin resulted in increased binding of [3H]-estradiol in serum within 40 d that was maintained through 24 mo of age. Antisera from treated colts crossreacted equally well with estrone and estradiol and moderately with other estrogens; androgens, progesterone and glucocorticoids all cross-reacted less than .005%. Body weights were not affected by treatment. Concentrations of testosterone were generally higher (P less than .05) in estrogen-immunized colts compared with controls after immunization. Concentrations of luteinizing hormone were not affected by treatment, whereas concentrations of follicle-stimulating hormone were initially increased (P less than .05) in treated colts after immunization. At castration at 27 mo of age, estrogen-immunized colts had greater (P less than .05) testicular and parenchymal weights and produced more (P approximately equal to .055) spermatozoa per horse than did control colts. Seminal characteristics immediately before castration were not affected by treatment. It appears that estrogens are involved in the regulation of several reproductive traits in the colt. Moreover, active immunization against estrogen in the prepubertal colt may be a useful method of increasing testicular size and sperm production rates in the stallion after puberty.     

La vascularisation artérielle du testicule chez le cheval

The arterial pattern of 134 horse testicles has been studied from different methods. The testicle was supplied by a single testicular artery in 79,10% of the cases. The division into two branches before entry into the organ was seen in 17,16% of the cases. The other testicles studied were supplied by three separate branches all originating from the extratesticular part of the testicular artery. Different connections of variable importance exist mainly between the vessels supplying the epididymis and the mesorchium (deferential artery and branches of testicular artery) and the significant arteries of the testicle.     

Bilateral leiomyoma in the testes of a horse

A 19‐year‐old Hackney pony was referred to a veterinary teaching hospital for further investigation of left‐sided scrotal enlargement. Both testes were normally positioned within the scrotum and there was no pain on palpation. Ultrasonography revealed multiple masses of soft tissue echogenicity, located adjacent to the testicular parenchyma. They were hyperechoic when compared to the testicular parenchyma and affected both testes. Surgical excision was performed by closed castration. Gross examination revealed firm, white, nodular masses of varying size on the surface of both testes. The cut surface of individual masses had a dense, whorling, fibrous and somewhat shiny appearance. The histopathological diagnosis was bilateral, multicentric, well differentiated leiomyoma of the tunica albuginea. The smooth muscle origin was confirmed by immunohistochemical staining with an anti‐human monoclonal antibody reactive to smooth muscle actin. This is the first report of a bilateral, multicentric, leiomyoma in the testes of a horse confirmed by histopathology and immunohistochemistry. This case highlights that neoplasia should be considered as a differential for bilateral testicular enlargement.     

Unsuccessful laparoscopic castration in a cryptorchid Frisian stallion

A 2-year-old unilateral inguinal cryptorchid Frisian stallion was castrated by bilateral laparoscopic intra-abdominal spermatic cord transection. Because blood testosterone levels were still high on postoperative day 7, both testicles were removed using an open approach. Pathology revealed the presence of vital Leydig-cells in both testes. Failure of the laparoscopic castration in this horse was attributed to an alternate blood supply to the testes by vessels derived from the cremaster and/or external pudendal artery.     

Guttural pouch hemorrhage associated with lesions of the maxillary artery in two horses

A two year old Thoroughbred gelding, presented with guttural pouch hemorrhage, had the internal and external carotid arteries ligated. Guttural pouch mycosis was detected on endoscopic examination. After one month of topical antifungal therapy, the horse was returned and euthanized because of recurrent epistaxis. A bacterial infection of the guttural pouch with associated ulceration and hemorrhage from the maxillary artery was found at necropsy.

A two year old grade gelding had ulceration and hemorrhage from the external carotid artery. Utilizing balloon-tipped catheters and arterial ligation, hemestasis was achieved in the internal carotid artery and the external carotid artery and its branches. Mycotic ulceration of the internal carotid artery was detected endoscopically and treated with local antifungal therapy for one month. Thirty-three days postoperatively the horse returned, bleeding from a lesion in the maxillary artery. The rationale for surgical intervention to prevent epistaxis associated with guttural pouch mycosis and possible etiologies for postsurgical epistaxis are discussed.

     

Equine castration: review of anatomy, approaches, techniques and complications in normal, cryptorchid and monorchid horses

Complications associated with equine castration are the most common cause of malpractice claims against equine practitioners in North America. An understanding of the embryological development and surgical anatomy is essential to differentiate abnormal from normal structures and to minimise complications. Castration of the normal horse can be performed using sedation and regional anaesthesia while the horse is standing, or under general anaesthesia when it is recumbent. Castration of cryptorchid horses is best performed under general anaesthesia at a surgical facility. Techniques for castration include open, closed and half-closed techniques. Failure of left and right testicles to descend occurs with nearly equal frequency, however, the left testicle is found in the abdomen in 75% of cryptorchid horses compared to 42% of right testicles. Bilateral cryptorchid and monorchid horses are uncommon. Surgical approaches described for the castration of cryptorchid horses include an inguinal approach with or without retrieval of the scrotal ligament, a parainguinal approach, or less commonly a suprapubic paramedian or flank approach. Laparoscopic castration of cryptorchid horses has recently been described but the technique has limited application in practice at this time. A definitive diagnosis of monorchidism can only be made after surgical exploration of the abdomen, removal of the normal testis and hormonal testing. Hormonal assays reported to be useful include analysis of basal plasma or serum testosterone or oestrone sulphate concentrations, testosterone concentrations following hCG stimulation, and faecal oestrone sulphate concentrations. Reported complications of castration include postoperative swelling, excessive haemorrhage, eventration, funiculitis, peritonitis, hydrocele, penile damage and continued stallion-like behaviour.     

Ultrasonographic and quantitative histologic assessment of sequelae to testicular biopsy in stallions.

A sample of testicular parenchymal tissue, approximately 2 x 7 x 7 mm, was aseptically removed from 1 testis in each of 9 stallions on day 0. Slight to moderate hemorrhage from the tunica albuginea was observed in 8 stallions, but bleeding from the parenchyma was detected in only 2 stallions. Stallions were castrated 27 days later. Normal development of granulation tissue was evident at the biopsy site, but hematomas were not observed. In situ measurement of the widths of the right and left testes, total scrotal width, and evaluation of testicular echogenicity during ultrasonography were variables used to monitor changes in the testicular parenchyma from 14 days before biopsy through 27 days after biopsy. The control testis was consistently larger than the biopsied testis, except for day 3. Ultrasonography revealed signs of a localized change in the parenchyma of the biopsied testis in 4 stallions, but each lesion decreased in size by day 27. Tissues removed during biopsy enabled an excellent appraisal of spermatogenesis at that time. Detailed examinations of seminiferous tubules in the testes were performed to assess for damage to testicular function. At castration, samples were taken from 6 sites in each testis. Quantitative histologic evaluations of testicular tissues revealed low numbers of spherical spermatids and pachytene spermatocytes in biopsied testes, compared with control testes. It was concluded that there was a transitory increase in degeneration of preleptotene spermatocytes and B spermatogonia at the time of biopsy. A mild inflammatory response at the biopsy site in some testes was evidenced by an increased number of leukocytes at the biopsy site and at a dorsal site.(ABSTRACT TRUNCATED AT 250 WORDS)     

Anaerobic peritonitis caused by Clostridium septicum as a complication of routine castration in a 2‐year‐old Warmblood horse

This case report describes an unusual case of anaerobic peritonitis in a 2‐year‐old horse following castration. The horse was evaluated 2 weeks following castration for signs of acute, severe abdominal pain and swelling surrounding a previous castration site. Physical examination revealed marked scrotal and ventral abdominal oedema that was cool and crepitant upon palpation. Ultrasonographic evaluation was unrewarding because gas shadowing distributed throughout the subcutis prevented imaging of the abdominal cavity. Ventral midline celiotomy revealed a copious amount of malodorous, serosangious, cloudy peritoneal fluid that was submitted for culture. Abdominal exploration revealed the gastrointestinal tract to be in its anatomically correct position. There was diffuse petechiation of the small intestine and large intestine, oedema and crepitant swelling surrounding the left inguinal ring and body wall. The abdomen was lavaged with 10 l of sterile saline prior to closure of the celiotomy and the left castration incision was opened digitally, releasing a large volume of serosanguinous fluid and gas that flowed freely from the incision site and deeper inguinal tissues. The horse was placed in the recovery box where it suffered cardiac arrest. Culture of the peritoneal fluid revealed heavy growth of Clostridium septicum. This case of anaerobic peritonitis represents an unusual complication following castration not previously reported in the horse.     

Extratesticular interstitial and Sertoli cell tumors in previously neutered dogs and cats: a report of 17 cases

Primary neoplasms derived from testicular tissue and in an extratesticular location are extremely rare. Clinical and surgical information was collected and verified from 15 different submitting practices for 12 dogs and 5 cats that spontaneously developed neoplasms of testicular origin after castration. Eleven dogs had Sertoli cell tumors in an extratesticular location. One dog and all 5 cats had an extratesticular interstitial cell tumor. Six animals (1 dog, 5 cats) had developed secondary sexual characteristics that reversed after removal of the tumor. All had a palpable mass in the scrotum or at the site of the original prescrotal incision. No animals died of neoplasia-related disease and no metastases were identified. Several possibilities, including the presence of embryological ectopic tissue or the presence of testicular tissue transplanted during castration, are considered as causal.     

Post-anaesthetic myelomalacia in a horse

This article describes a rare neurological complication of anaesthesia in a 2 year-old Clydesdale colt undergoing castration. Anaesthesia was induced with glyceryl guaiacol ether and ketamine and maintained with halothane. Following an uneventful anaesthetic of 40 minutes, the horse recovered from anaesthesia in a padded recovery stall. After approximately 70 minutes in the recovery stall, the horse attempted to stand and adopted a dog sitting position. One hundred and fifty minutes later, the horse became distressed and was sedated with xylazine. Clinical examination of the horse did not reveal any evidence of myositis or fractures. A neurological examination revealed an intact anal reflex, deep pain response in the hind legs, tail tone and voluntary movement of the hind legs was possible. The horse deteriorated neurologically over the next 24 hours and was euthanased on humane grounds. The horse was submitted for necropsy. Gross pathology was unremarkable except for a small amount of haemorrhage around the right kidney. Histopathology revealed no abnormalities in any muscle groups or peripheral nerves. Congestion and axonal swelling of the spinal cord was evident from T16 to S1. Ischaemic neurons were evident from L 1 to L 6. The most prominent lesions were at L4 and L5. A diagnosis of myelomalacia was made. This is a rare complication of anaesthesia in horses with 9 case studies appearing in the literature since 1979. This is the 1st case to be reported in South Africa. The speculated pathophysiology and risk factors for this complication are discussed.     

Testicular changes observed in boars following experimental inoculation with pseudorabies (Aujeszky''s) virus.

Four boars were inoculated intranasally with pseudorabies virus to determine if microscopic testicular changes occurred as a result of infection. Testicular biopsies and semen samples were taken at two, four and six weeks postinoculation and the boars were castrated immediately after the last sample collection. Testicular samples and semen were cultured to determine if the virus was present. Pseudorabies virus was not isolated from the semen or testicular tissue. Virus was isolated from trigeminal ganglia at necropsy and from nasal swabs taken one day after castration. Consequently, a time of high risk for shed of the virus from clinically normal carrier animals is immediately following castration. Gross changes were not observed in testicular tissues and microscopic changes in the testicles were the result of biopsy. Lesions consistent with pseudorabies virus infection were observed in the central nervous system of all inoculated boars. Temporary lowered fertility may result from the effects of elevated body temperature on spermatogenesis during acute clinical disease. However, it appears that the strain of pseudorabies virus used, lacked the ability to infect and/or replicate in the boars' reproductive tracts.     

Occlusion of the internal carotid artery by means of microcoils for preventing epistaxis caused by guttural pouch mycosis in horses.

Occlusion of the internal carotid artery by insertion of intravascular platinum microcoils for guttural pouch mycosis was experimentally evaluated in 9 healthy adult Thoroughbred horses. The internal carotid artery was ligated to its origin, and an arteriotomy was made distal to the ligature, which was then occluded by insertion of the microcoil approximately 13 cm distal to its origin. Cessation of blood flow was determined visually and by angiography at the arteriotomy site. Six horses were evaluated for complication clinically and by endoscopy after surgery. One horse was necropsied after 30 days of surgery for histological evaluation of artery thrombus formation. In the other 3 horses, the blood flow of the right internal carotid artery was monitored, before and after microcoil occlusion of the left internal carotid artery. One or 2 microcoils stopped blood flow within a few minutes. No other abnormal findings were observed clinically. Thrombus was observed in the occluded segment of 1 horse 30 days after insertion; but no abnormalities were detected. The blood flow in the right internal carotid artery increased by approximately 28-58% after occlusion of the left internal carotid artery. This microcoil vascular occlusion technique causes an effective thrombosis, and based on experimental studies and clinical application in 2 horses with epistaxis due to guttural pouch mycosis, this technique would appear to be safe and efficacious.     

Effect of NSAID administration on creatinine clearance in healthy dogs undergoing anaesthesia and surgery

Thirty healthy male dogs were randomly assigned to receive carprofen (4 mg/kg intravenously), ketoprofen (2 mg/kg intravenously) or saline (0.2 ml/kg intravenously) at induction of anaesthesia for castration surgery. A routine castration was undertaken and a buccal mucosal bleeding time was assessed at the completion of surgery. Twenty-four hours after surgery a 24-hour endogenous creatinine clearance study was undertaken. Buccal mucosal bleeding time was not significantly different between the three groups. Creatinine clearance was significantly lower (P < or = 0.01) in the two groups of dogs that received a non-steroidal anti-inflammatory drug compared with that in the dogs that received sterile saline. There was no significant difference between the carprofen and ketoprofen groups with respect to creatinine clearance.