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Equine castration complications - Coggle Diagram
Equine castration complications
Haemorrhage
Risk factors
Improper applications of emasculators
Thick cord - may require double emasculation
Prevention
Large/ older horses and donkeys: closed or semi-closed under GA + ligatures
Keep hold of the spermatic cord until you have assess haemorrhage - Allis tissue forceps
Relatively common and testicular artery most significant source
Treatment
Try clamping a vessel - mixter right angle forceps
Packing with unrolled bandage
Give it time!
GA and clamp/ ligate artery - referral if possible
Clinical signs of acute blood loss
Heart rate/ pulse
Mucous membranes/ CRT
Demeanour
Haematology - sudden drop needs transfusion
Normal for blood to drip (slowly) for several hours
Swelling and oedema
Common
Can be +/- seroma or infection
Exercise crucial
Seroma
Common with open castration
Preventions
Open castration
Big surgical incisions
Lots of movement post surgery
Closed castration
Reduce dead space
Good surgical technqiue
Rest and slow return to exercise post-surgery
Treatment
Closed castrations
Do NOT open wound if not infected
Focus on reducing risk of secondary infection
+/- Antimicrobials
Wound care
Open castrations
Re-open wound and focus on drainage
+/- antimicrobials
Pocket of serum (tinged with blood) that fills scrotum
Iatrogenic penile trauma
Emergency referral for repair or phallectomy
Root of penis mistaken for testis
Accidental emasculation of root of penis
Scrotal infection
Common with open castration
Treatment
If open...
Thoroughly open wound and lavage
Systemic antibiotics
Clean wound with antiseptic
Systemic anti-inflammatories
Swab first for C&S
If closed...
Culture if possible
Broad spectrum antibiotics
Systemic anti-inflammatories
Less common with closed castration
Lack of drainage
Presence of implant (ligature)
Septic funiculitis
Chronic non-healing inflammation with discharging sinus tract
Palpable thickening of the cord
Not usually pyrexic
Treatment
Bold surgical excision of thickened avascular and necrotic tissue
Absorbable suture can be focus of infection
Avoid ligatures in non-sterile surgery
Vicryl doesn't absorb as well in necrotic environment
Initial treatment
C&S from swab
First line antimicrobials but recurrent failure is diagnostic
Peritonitis (rare)
Clinical signs
Abdominal pain/ colic
Very dull
Weight loss
Pyrexia
Referral for intensive care
Injectable antibiotics
Anti-inflammatories
Supportive care
+/- peritoneal lavage
IVFT
Diagnosed by abdominocentesis
Evisceration
Omentum
Through inguinal hernia
Rare
Not surgical emergency
Diagnosis by appearance
Treatment
Pull it out as far as possible
Emasculate and monitor
High degree of sterility
Small intestine
Rare but VERY serious - likely fatal without intervention
Treatment
Protect bowel from further damage and further contamination and get ready for transportation
Make protective sling and urgent transport to clinic with surgery
Field anaesthesia - lavage - place back in scrotum and suture skin if possible
Through inguinal hernia