Visceral prolapse after castration in the horse: a review of 18 cases

During a 10 year period, 18 horses were treated surgically because of visceral prolapse after castration. Surgery was successful in six cases of omental prolapse and in eight out of 12 cases of intestinal prolapse. To minimise the risk of visceral prolapse, the authors prefer half-closed castration, with proper ligation of the parietal vaginal tunic, to open castration. If adequate treatment is started promptly, prognosis in cases of visceral prolapse is favourable.     

Routine castration in 568 draught colts: incidence of evisceration and omental herniation

REASONS FOR PERFORMING STUDY: Castration is one of the most common routine surgical procedures performed in the horse, from which a number of potential complications can arise. We undertook a prospective evaluation of short-term complications associated with castration of draught colts over a 3-year period (1998-2000). OBJECTIVES: To compare castration complications in a large number of draught foals with previously published literature. METHODS: Five hundred and sixty-eight draught colts, age 4 or 5 months, were castrated in field conditions. Foals were observed for complications for 24 h post operatively. RESULTS: There was no significant difference in complication rates between open and closed surgical techniques. Inguinal/scrotal hernia rate was 4.6% (26/568) prior to surgery, and evisceration of the small intestine occurred in 4.8% (27/568). Foals observed to eviscerate underwent immediate surgical correction with an overall survival rate of 72.2% (13/18). Omental herniation was seen in 2.8% (16/568) of colts. CONCLUSIONS: This study showed no difference between the closed and open techniques of castration and the rate of omental herniation or evisceration. The evisceration rate in combination with the omental and presurgical herniation rates approached 12.2%, which is high enough to warrant further examination. POTENTIAL RELEVANCE: Future investigation should help to assess predisposing factors for evisceration. Regardless of the technique employed, herniation appears to pose a significant risk to draught foals undergoing castration.     

Results and complications of a novel technique for primary castration with an inguinal approach in horses

Reasons for performing study: Complications associated with equine castration can have medical and financial consequences. This retrospective study investigated a novel method of castration via an inguinal approach in mature stallions and compared the incidence of complications with other methods. Hypothesis: Castration via an inguinal approach has a low complication rate at the site of surgery compared with other castration techniques. Methods: Mature stallions (n = 238) were castrated under general anaesthesia in dorsal recumbency using an inguinal approach. The vaginal process was incised, the spermatic cord ligated twice and the testis removed. After suturing, the vaginal process and one or 2 layers of fascia, the subcutis and cutis were closed in a simple continuous pattern. Results: Five of 238 (2.1%) horses had post operative haemorrhage and a haematoma in the scrotal region, which required additional treatment. All horses made a full recovery. Five of 238 (2.1%) of the horses had a post operative respiratory infection, which resolved with antibiotic therapy. Sixteen of 238 (8.8%) had transient signs of colic shortly after surgery. Conclusion: This technique of castration with an inguinal approach had a low incidence of complications at the site of surgery compared with other methods. An inguinal approach and leaving the vaginal tunic in situ may cause less soft tissue trauma than a scrotal approach.     

Congenital inguinal hernias associated with a rent in the common vaginal tunic in five foals

Five foals were admitted because of colic that developed within 24 hours after birth. Physical examination revealed swelling from the inguinal region to the cranial aspect of the prepuce. Through the skin overlying the swelling, distended loops of bowel could be palpated. The hernias could be reduced with the foals restrained in dorsal recumbency. Surgical exploration showed the swelling to be an inguinal hernia with small bowel herniation through a rent in the common vaginal tunic. Concurrent rupture of the vaginal tunic should be suspected when a congenital inguinal hernia is associated with colic, swelling that extends to the prepuce, or intestine that is easily palpated within the hernial swelling. Repeated manual reduction in these cases would be of little benefit and surgical intervention would be recommended.     

Diagnosis and treatment of peritonitis caused by a larval cestode Mesocestoides spp., in a dog.

Infection of the peritoneal cavity with cestode larvae, presumptively diagnosed as tetrathyridia of the genus Mesocestoides, was found by exploratory celiotomy in a dog with clinical signs consisting of episodic anorexia, vomiting, and depression. Lymphopenia and hypoalbuminemia were associated clinicopathologic abnormalities. Dystrophic calcification and midline duodenal displacement were found on abdominal radiographs. Therapy with mebendazole was instituted after recurrence of the initial episodic clinical signs postoperatively. Daily use of mebendazole for intermittent periods of up to 3 months led to remission of gastrointestinal signs for 30 months. However, 17 months after the initial diagnosis, infection of the vaginal tunic of the testicle with similar cestode larvae necessitated castration and removal of the vaginal tunic to the inguinal ring. Mebendazole therapy was reinstituted and continued for 31/2 months postoperatively. The dog was free of clinical signs of infection during and for the 16 months since this period of treatment.     

Ruptured inguinal hernia in new-born colt foals: a review of 14 cases

Over a six year period, 14 new-born colt foals were treated surgically because of ruptured inguinal hernia. In all cases, the prolapsed intestines, which were jejunal loops, were situated subcutaneously and protruded through a rent in the parietal vaginal tunic at the level of the inguinal canal. After herniorrhaphy and unilateral castration, the prolapsed loops were replaced into the abdomen, and the superficial inguinal ring closed. Seven foals survived.     

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.     

Laparoscopic inguinal herniorrhaphy with barbed suture in a ram

A 7-month-old Hampshire ram, with no history of trauma or breeding, was referred for treatment of acute, unilateral scrotal swelling. Physical examination revealed a moderately sized, soft, left-sided, non-reducible swelling of the proximal scrotum and mild swelling of the scrotal neck. Ultrasound evaluation of the scrotum revealed morphologically normal testicles and a mild accumulation of free fluid in the left vaginal tunic. Unilateral, laparoscopic inguinal herniorrhaphy under general anesthesia was performed. The herniated omentum was reduced and barbed suture was used to imbricate the internal inguinal ring and the vaginal ring. No recurrence of herniation was reported 5 months after surgery.Key clinical message:Laparoscopic inguinal herniorrhaphy with barbed suture can be a safe and effective means of scrotal hernia resolution in a ram. When performed by a competent surgeon experienced in laparoscopy, this treatment for inguinal and scrotal herniation may minimize post-operative pain, provide a rapid return to function, and preserve normal testicular and scrotal anatomy.     

Omental herniation through the esophageal hiatus in a cat

A four-year-old male cat was presented with regurgitation. Thoracic radiography and contrast radiogram showed a large oval mass and elevated esophagus. Exploratory thoracotomy showed omental herniation into the posterior mediastium through the esophageal hiatus. Because the mass of the omental herniation was so large, celiotomy through a paracostal incision was combined in order to return the omentum to its normal position. The diameter of the esophageal hiatus was approximately 1 cm but no fibrous adhesion was observed around the hiatus. Continuous 1-0 surgical sutures on the hiatus reduced the diameter of the hiatus. The cat made a successful postoperative recovery without complications.     

Unilateral testicular mastocytoma in a Peruvian Paso stallion

A 12‐year‐old Peruvian Paso stallion was examined for scrotal swelling and unilateral testicular enlargement of 4–6 weeks duration. Physical examination and ultrasonography of the scrotum revealed an enlarged, nonpainful right testis with a well encapsulated mass at the cranial‐medial aspect containing echodense flocculent material. Unilateral castration was performed and the testis, spermatic cord and vaginal tunic were submitted for histological examination, which revealed a mastocytoma with accompanying evidence of malignancy. Short‐term follow‐up examination did not reveal any evidence of abdominal metastasis and the stallion has since successfully achieved pregnancy in a small number of mares. Although considered rare, mast cell neoplasia should be considered as a differential diagnosis when unilateral testicular enlargement is encountered.     

A Surgical Approach to Collect Testicular Fluid from the Extratesticular Rete Testis of the Pony

A surgical technique was developed to collect testicular fluid from the extratesticular rete testis of the pony stallion. A cannula was inserted through an incision in the visceral vaginal tunic following ligation of the efferent ductules. The cannula was sutured in place in the extratesticular rete testis. The other end of the cannula was exteriorized and inserted into a plastic collection receptacle fastened to the scrotum. Testicular fluid was collected for 12 to 36 hours at a rate of 1.07 ± 0.8 ml/hr. Sperm clots in the proximal end of the cannulas were responsible for the cessation of drainage.     

Castration of the Vietnamese pot-bellied boar: 8 cases

Surgical techniques for castration of the Vietnamese pot-bellied boar and outcome are described. Vietnamese pot-bellied pig (VPBP) boars (n = 8) were admitted for castration. Data retrieved from medical records (2002–2011) for these pigs included signalment, history, reason for castration, perioperative management, surgical technique, and complications. Follow-up information was obtained from owners. A scrotal approach with closed technique was used for 6 boars with normally descended testes. A scrotal approach and open technique was used in 1 inguinal cryptorchid boar. In a hemicastrated abdominal cryptorchid boar an ipsilateral parainguinal approach was used. No complications occurred. Castration of the Vietnamese pot-bellied boar is associated with minimal complications and a satisfactory cosmetic outcome. We recommend the routine closure of the external inguinal rings, a simple and fast procedure that may prevent post-castration inguinal herniation.     

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.     

Surgical treatment of acquired inguinal hernia in the horse: a review of 51 cases

During a seven year period, 51 cases of acquired inguinal herniation in 50 stallions were treated surgically. In 25 cases the herniated loop was ileal, in the other 26 it was jejunal. In cases of strangulation, the vaginal ring was enlarged by incising the peritoneum and transverse fascia. Closure of the superficial inguinal ring was advisable to prevent the hernia recurring. In all cases unilateral castration was performed. Laparotomy was carried out in 33 cases; 22 required intestinal resection and in four cases a bypass was made. Follow-up at least six months postoperatively indicated that surgery had been successful in 76 per cent of the cases treated.     

Pinhole castration: a novel minimally invasive technique for in situ spermatic cord ligation

OBJECTIVE: To describe a minimally invasive technique for castration of bull calves by in situ ligation of the spermatic cord. STUDY DESIGN: Experimental study. ANIMALS: Male calves (n=6) aged, 48-56 days. METHODS: Calves were blocked by weight and then separated into 3 groups: (1) bilateral spermatic cord ligation; (2) unilateral-1 spermatic cord ligated; and (3) control-neither spermatic cord ligated. After local anesthesia, in situ spermatic cord ligation was achieved by restraining the cord laterally within the scrotal sac and passing suture through a hypodermic needle inserted caudal to cranial at the neck of the scrotum and adjacent the medial margin of the restrained spermatic cord. The needle was removed leaving the suture in place and the spermatic cord repositioned medially, then the needle was reinserted through the original holes and the suture passed back through the needle, which was withdrawn. The suture ends were tied ligating the spermatic cord, leaving the knot subcutaneously. Calves were monitored and testes removed after 30 days for gross and histologic examination. RESULTS: Castration was accomplished without postoperative complications. Spermatic cord ligation resulted in testis atrophy, and histologically, complete ischemic necrosis. CONCLUSIONS: This novel minimally invasive technique is a simple, alternative method for castration of bull calves. CLINICAL RELEVANCE: This method of castration is simply performed, without obvious skin wounds, and no postoperative care needed. The technique should be readily adaptable to other species.     

Castration of Horses with Primary Closure and Scrotal Ablation

Fourteen horses and one pony, 1 to 16 years of age, were castrated with a technique designed to promote primary healing and ablation of the scrotum following removal of descended testicles. Twenty-six testicles (10 nondescended, 15 normal descended testicles, and 1 neoplastic descended testicle) were removed. Nondescended testicles were removed through a skin incision over the external inguinal ring. Descended testicles were removed, and the scrotum was ablated by excision of the ventral scrotum. All testicles were removed by emasculation. The common vaginal tunic was not opened prior to emasculation of the descended testicles, and transfixation liqation sutures were used in only two horses. All incisions were closed with multiple layers of synthetic absorbable sutures in the subcutaneous and subcuticular tissues. All incisions healed by primary intention, and 14 recovered without complications. As a result of incomplete scrotal ablation, one horse had temporary lameness and swelling of the scrotal area that resembled the presurgical appearance.     

Intracorporeal suture closure of the internal inguinal and vaginal rings in foals and horses

Objective— To report a technique for repair or prevention of inguinal hernia in horses using intracorporeal suture closure of the internal inguinal and vaginal rings.
Study Design— Case series.
Animals— Foals (n=6) and geldings (n=2).
Methods— After selection of a peri-umbilical telescope portal, instrument portals were made unilaterally or bilaterally, as needed. Herniated viscera was reduced, castration (foals) or spermatic cord remnant transection at the internal inguinal ring (adults) performed, and then simple interrupted intracorporeal sutures of synthetic absorbable suture material were used to close the internal inguinal and vaginal rings.
Results— There was no recurrence of inguinal hernia. Postoperative morbidity was minimal and cosmetic outcome was comparable to that achieved with conventional, open techniques.
Conclusion— Laparoscopic, primary closure of the internal inguinal ring by use of intracorporeal sutures provides a secure barrier to herniation and costs considerably less than using endoscopic staples.
Clinical Relevance— Laparoscopic suture closure of the internal inguinal and vaginal rings provides safe and effective repair of inguinal hernia in horses.     

Patent ductus arteriosus in the dog: a retrospective study of clinical presentation, diagnostics and comparison of interventional techniques in 102 dogs (2003-2011)

A left-to-right shunting patent ductus arteriosus (PDA) is a common congenital heart defect in dogs. If it is left uncorrected, life expectancy in most cases is decreased due to the development of left-sided congestive heart failure. The aim of this study was to describe the dogs diagnosed with PDA in the Utrecht University Companion Animal Clinic from 2003 to 2011. The medical records of 102 patients were retrieved, and the clinical presentation and outcome of PDA closure by surgical ligation or transarterial catheter occlusion (TCO) were reviewed. In the TCO group, the result of coiling was compared with the placement of an Amplatz Canine Duct Occluder (ACDO). A predisposition to PDA was found in the German Brak, Stabyhoun, and Schapendoes. Dogs treated with surgical ligation were significantly older and heavier than those treated with TCO; within the TCO group, dogs treated with ACDO were significantly older and heavier The initial success rate (complete disappearance of the audible murmur in a patient that survived the procedure) was not significantly different between the different treatment modalities. Major complications were more common with surgical ligation, but the incidence of minor complications was not significantly different. There was no diference in survival between dogs treated with surgical ligation and dogs treated with TCO. This study shows a previously unreported predisposition to PDA in certain breeds. Both surgical ligation and TCO are suitable techniques for PDA closure, although major complications were more common with surgical ligation. ACDO appears to be the method with the least complications and thus can be considered the safest method.     

Laparoscopic intra-abdominal ligation of the testicular artery following castration in a horse

A 364-kg (800-lb) 1-year-old mixed-breed horse was admitted for treatment of uncontrolled bleeding after castration. Multiple attempts to ligate the testicular artery through the scrotal incisions prior to referral had been unsuccessful. Because of the owner's concerns about cost, an attempt was made to control the bleeding by applying pressure to the inguinal region and administering formalin IV. However, hemorrhage continued. A decision was made to use laparoscopy to ligate the testicular artery. The horse was anesthetized and positioned in dorsal recumbency, and a routine ventral laparoscopic approach was used. The horse recovered without further complications. Laparoscopy should be considered for ligation of the testicular artery in horses with uncontrolled bleeding after castration.     

A Review of Laparoscopic Cryptorchidectomy

Laparoscopic cryptorchidectomy has provided the surgeon with an easy, efficient means of locating and castrating abdominally retained testes without the complications associated with routine open approaches. It is especially useful when the horse's castration history is unknown, or if previous attempts at cryptorchid castration have been made. With the direct visualization that laparoscopy provides, surgeons are able to visualize both vaginal rings for presence of intra abdominal and inguinal testis in addition to testicular remnants and adhesion formation from previous surgical manipulations. Furthermore, because it is minimally invasive, laparoscopy shortens patient confinement time and reduces postoperative complications such as eventration. With experience, it is a technically easy procedure and can safely be performed on anesthetized or standing sedated horses.