Drip,drip, drip

A unique complication to castration is published in the preceding Case Report in this issue, whereby a 2‐year‐old Thoroughbred racehorse gelding suffered chronic haemoperitoneum weeks after standing castration. The causes and treatment of post castration haemorrhage are reviewed along with haemoperitoneum and the use of laparoscopy. Supplementary explanations are discussed.     

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.     

Laparoscopic Cryptorchid Castration in Standing Horses

Objective — This article describes a new technique for laparoscopic cryptorchid castration in standing horses. Study Design — Prospective study. Animals or Sample Population — Eight horses aged 11 months to 3 years and weighing between 300 and 643 kg. Methods — Food was withheld for 24 to 36 hours, and then horses were sedated with detomidine HC1 (0.02 to 0.03 mg/kg) and butorphanol tartrate (0.02 mg/kg). The paralumbar fossa region was desensitized with 2% mepivacaine in an inverted “L” pattern and caudal epidural anesthesia was administered with either xylazine (0.18 mg/kg diluted to 10 to 15 mL with 0.9% sodium chloride) or a combination of 2% mepivacaine and xylazine (0.18 mg/kg). Initial laparoscopic exploration was performed from the left flank; in three horses, right flank laparoscopy was needed to complete the procedure. The spermatic cord was ligated within the abdomen with one or two sutures of 0 polydioxanone suture, and the testis or testes removed through a flank incision. Results — In five horses with no palpably descended testes, standing laparoscopy was the only procedure performed, whereas in two horses, the abdominal testis was removed laparoscopically, and the descended testis was removed under short acting anesthesia. In one horse, with nonpalpable testes, it was determined by laparoscopic observation that the testes were in the inguinal canal, and castration was performed under general anesthesia. No surgical or postoperative complications were noted. The right side of the abdomen, and especially the right vaginal ring, could be easily observed from the left side by passing the laparoscope through a small perforation in the mesocolon of the descending colon or by elevating the descending colon with an instrument or by use of an arm in the rectum. Conclusions — The standing laparoscopic approach combined with or without short-acting anesthesia to remove the descended testis is easily performed. Clinical Relevance — This approach will provide surgeons with another option to castrate cryptorchid stallions.     

Laparoscopic cryptorchidectomy in a cat

Several techniques for castration of cryptorchid cats have been described. In this case report, the use of laparoscopy for castration of a bilateral cryptorchid cat (with testes located in the abdomen) is described. Three trocars were inserted into the abdominal cavity, the testicles were easily identified adjacent to the urinary bladder. Haemostasis of the gubernaculum testis and spermatic cord was achieved with bipolar cauterisation. The testicles were easily removed in approximately 20 min. To the authors' knowledge this is the first report of the use of laparoscopy for the treatment of cryptorchidism in cats.     

Complications in laparoscopic surgery.

As laparoscopic surgery gains popularity, it becomes crucial to understand complications associated with the procedure. The potential complications of laparoscopy include those related to laparoscopy and those related to the surgical procedure. As new applications for laparoscopic surgery emerge, it is important for the surgeon to become familiar with potential complications.     

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.     

Autologous tunica vaginalis communis flap for repairing an abdominal wall hernia in a dog

An 8-year-old, intact male miniature dachshund dog, weighing 8.6 kg, was presented with a soft swelling in the caudal abdominal region, including both sides of the groin area. Laparotomy revealed a severe caudal abdominal wall hernia with atrophy of the rectus abdominal muscle. The defect was repaired using a tunica vaginalis communis flap following a standard open prescrotal castration. There were no complications or recurrence of the hernia at 11 months after surgery. This surgical technique involves autogenous reconstruction, is easy to perform, and requires minimal dissection. The tunica vaginalis communis flap has potential clinical applications for repairing caudal abdominal wall hernias in male dogs.     

Diagnosis, surgical treatment, and performance after unilateral castration in breeding bulls: 21 cases (1989-1999)

OBJECTIVE: To evaluate signalment, surgical treatment, postoperative complications, and future breeding success or semen production in a group of bulls with naturally occurring disease of the scrotum or testis. STUDY DESIGN: Retrospective study. ANIMALS: 21 bulls that underwent unilateral castration after evaluation for scrotal swelling. PROCEDURE: A computer-assisted search of medical records at 2 veterinary teaching hospitals was performed. Historical, diagnostic, surgical, and follow-up data were collected and analyzed for those bulls with scrotal swelling that underwent unilateral castration. RESULTS: Four of 5 pasture breeding bulls and 9 of 10 semen collection-center bulls successfully bred cows or produced viable semen within 6 months of surgery. Fourteen of 21 surgical procedures were performed after induction of general anesthesia. Sixty-six percent of procedures were performed as open castrations. Seventy-one percent of bulls developed postoperative complications, most of which were mild swellings. Unilateral castration returned 13 of 15 bulls with unilateral disease of the scrotum or testis to productive service by 6 months after surgery. CONCLUSION AND CLINICAL RELEVANCE: Unilateral castration is an effective treatment for unilateral disease of the,scrotum or testis in bulls, allowing return to reproductive function.     

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.     

Complications of castration and ovariectomy

This article discusses the complications of castration and ovariectomy and their treatment and prevention. These two procedures were chosen because castration is the most common surgical procedure performed by the equine practitioner and ovariectomy is associated with a high number of complications.     

Comparison of the use of a braided multifilament transfixation suture for field castration with other castration techniques

Complications with castrations occur commonly and are usually not life-threatening, with the exception of evisceration or haemorrhage, which are uncommon. Primary closure castration (closing deeper tissue layers and skin) or use of a transfixation ligature alone to prevent evisceration has been recommended. The goal of this study was to investigate the use of a closed technique with multifilament suture for transfixation of the spermatic cord alone in field castrations. The results of this study support our hypothesis that a closed castration technique with a multifilament, transfixing ligature (No. 2 polyglactin 910) did not result in additional post-operative complications when compared with a closed castration technique without ligature placement or a primary closure castration technique in a hospital setting.     

Standing laparoscopic castration in an equine male pseudohermaphrodite

This report describes the surgical anatomy and successful removal of the internal gonads in a 6-year-old male pseudohermaphrodite Friesian horse by standing laparoscopy. Gonads could not be identified by physical or ultrasonographic examination and bilateral standing flank laparoscopy revealed the presence of intra-abdominal gonads suspended from the dorsal aspect of the abdominal cavity by 10–15 cm long vascular pedicles. No evidence of female internal genitalia such as a uterus was found and bilateral gonadectomy was performed laparoscopically. Histological analysis of the excised gonads confirmed the diagnosis of male pseudohermaphroditism. Minor cosmetic surgery of the external genitalia to correct urinary misdirection was successfully performed 3 months after laparoscopic castration. Standing flank laparoscopic examination was excellent for identification and surgical removal of internal genitalia. Standing flank laparoscopy should be considered for inspection and removal of internal genitalia in intersex horses.     

General principles of laparoscopy.

Laparoscopic surgery is minimally invasive and minimally traumatic in cattle. It allows the animal to return rapidly to production. These techniques are destined to develop further, especially in the dairy and show cattle industries, where recovery periods must be as short as possible. Although it is important to remain skeptical about new procedures if they do not offer advantages over open techniques, in many cases laparoscopy is clearly superior. Laparoscopy is not an easy surgical technique. It requires a good knowledge of anatomy and abdominal topography and rigorous training. It must be performed with great care and delicacy because complications, such as perforated organs, can occur. Laparoscopy also requires the use of sophisticated and costly technology.     

Evaluation of common vaginal tunic ligation during field castration in draught colts

The objective of this study was to determine if ligation of the common vaginal tunic could prevent or reduce the incidence of omental herniation and eventration in draught colts undergoing routine field castration. It was found that common vaginal tunic ligation, while not completely preventing omental herniation and evisceration, significantly reduced the incidence of these complications and should be considered in those males deemed at increased risk of significant post castration complications.     

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.     

Comparison of post-operative inflammatory response in horses undergoing elective castration treated preoperatively with ceftiofur crystalline free acid or procaine penicillin G

Castration is among the most common surgical procedures performed in the horse (Equus Caballus) and a variety of post-operative complications can occur. This study aims to determine if a single dose of long-acting ceftiofur crystalline free acid (CCFA) used as a preoperative antimicrobial in equine field castrations offers any reduction in post-operative inflammatory markers when compared to procaine penicillin G (PPG). Sixty-five horses aged 8 months to 2 years were randomly assigned to the CCFA (n = 33) or PPG (n = 32) treatment groups. Horses were castrated under general anaesthesia using a closed castration technique with removal of the median raphe. Quantitative and qualitative inflammatory markers were measured and short-term complications were recorded post-operatively on Days 3, 8 and 14. No clinically significant difference in any post-operative inflammatory markers between the CCFA and PPG group was detected. In the CCFA group, 48% of horses experienced short-term post-operative complications compared to 31% in the PPG group. Regardless of the preoperative treatment, castration induced significant elevation in serum amyloid A (P<0.0001), preputial oedema (P<0.0001) and scrotal oedema (P<0.0001) at Day 3. These values returned to baseline levels by Day 8. Horses with grade 3 or above preputial oedema had elevated serum amyloid A values (P<0.001). The data from this study indicate CCFA used as a preoperative antibiotic for routine castration offers no advantages over PPG. The difference in complication rate between groups is likely of minimal clinical importance, as all complications were mild and self-limiting.     

Surveyed attitudes, perceptions and practices in Norway regarding the use of local anaesthesia in piglet castration

The last two years piglet castration in Norway has been performed by veterinarians and with the use of anaesthesia. In order to evaluate this new policy, veterinarians and pig producers were asked to fill out a questionnaire regarding their experiences with the new castration practices. The answers showed that the piglets were most often castrated using a combination of subcutaneous and intratesticular administration of lidocaine with adrenaline at an average age of 10 days. The effect of the anaesthesia was regarded as good by 54% of the veterinarians and 19% of the producers. Post-operative complications were rare. The overall evaluation showed that two-thirds of the veterinarians, but only one-third of the pig producers were satisfied or very satisfied with the implemented policy. However, while two-thirds of the pig producer had a negative attitude to the policy before it was implemented, only one-third were dissatisfied after two years experience.     

Equine castration: A review of techniques,complications and their management

Complications associated with castration occur commonly and, although the majority are mild and resolve easily, potentially life‐threatening complications can occur. The preoperative identification of risk factors for these complications can help the veterinarian to take the appropriate measures to reduce these risks. However, even with proper surgical technique, complications can occur. Therefore prompt recognition and initiation of appropriate therapy are essential to prevent further morbidity, death or lawsuits.     

Acute cortisol responses and wound healing in lambs after ring castration plus docking with or without application of a castration clamp to the scrotum

OBJECTIVE: To test whether the cortisol response to ring castration plus docking is reduced by additional application of a castration clamp across the full width of the scrotum distal to the ring. DESIGN: A physiological study with controls. PROCEDURE: Lambs, 3 to 6 weeks of age, were castrated using a ring or ring plus castration clamp applied for 6 or 10 s and docked using a ring. Blood samples were taken before and regularly for about 4 h after treatment and analysed for plasma cortisol concentrations. The healing of the scrotal wounds was monitored for 6 weeks after castration. RESULTS: The plasma cortisol concentrations were lower only at 60 min after treatment in lambs castrated with a clamp placed on the scrotum for 10 s after ring castration and docking than in lambs castrated and docked by ring alone. Scrotal wounds healed more quickly after ring plus clamp than after ring only castration. CONCLUSIONS: The castration clamp had at most a marginal effect on the cortisol response to ring castration and docking of 3- to 6-week-old lambs, but it did seem to improve the rate of healing.