Page 606 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Reproductive system: 2.3 Equine castr ation 581

VetBooks.ir vaginal tunic attachments to the subcutaneous tis- necessary to retrieve it from the scrotum; however,
the inguinal canal must be sutured to prevent hydro-
sues. The testicle can then be retrieved through the
incision and the procedure continues in the same
way as that described for a closed castration. The coele formation.
wound is closed using a subcutaneous layer and an POSTOPERATIVE MANAGEMENT
intradermal layer.
The horse is allowed to recover from sedation or
Advantages general anaesthesia as normal and should be kept
The same as for a scrotal approach. This approach, under close monitoring for the first 6–12 hours,
however, has been shown to cause minimal compli- preferably in a clean stable. Medication with
cations, and the fast return to work (7–14 days) is NSAIDs is recommended for 2 or 3 days. If the skin
appreciated by some owners and trainers. wounds have been left open for drainage, the horse
should be walked in-hand and/or kept in a small
Disadvantages paddock for the first 7 days (preferably on his own).
The same as for the scrotal approach; however, less A small amount of swelling and minimal drainage
swelling tends to occur with this approach. are seen for a few days. If primary closure was per-
formed, exercise should be restricted for 7 days and
VARIATIONS only minimal swelling around the incision sites is
expected.
In the closed technique, the vaginal tunic may be If no postoperative complications occur, exercise
opened after the ligature has been placed to allow may resume once the skin wounds have closed or
separate emasculation of the vascular and tubular 10 days postoperatively in closed castrations.
portions of the cord (open-closed technique). In the The owner should be informed that the horse
closed parainguinal technique, the vaginal tunic might remain fertile for up to 6 weeks and to moni-
can be incised and the testis retrieved through this tor for excessive swelling, haemorrhage and general
opening, thus reducing the soft-tissue dissection signs of systemic illness.

POSTOPERATIVE COMPLICATIONS AND THEIR MANAGEMENT

HAEMORRHAGE SWELLING

After surgery, a small amount of bleeding is to be Minimal postoperative swelling is expected in the
expected and this usually originates from subcutane- first 24–48 hours after surgery and it usually peaks
ous vessels and stops within a few hours. If a stream at 4–5 days, particularly in closed castrations. Any
of blood persists for more than 15 minutes, it should excessive swelling should be investigated. In open
be considered excessive (Fig. 2.180). castrations the most common cause of swelling is
A decision as to whether to intervene should be premature wound closure or incorrect position-
made as early as possible in order to minimise blood ing of the incision causing drainage impairment
loss. The horse should be sedated, and an attempt (Fig. 2.181). The castration wound should be exam-
made to find the origin of the haemorrhage. Surgical ined, opened and palpated by sterile digital explo-
exploration under general anaesthesia may be ration. In some cases, increasing exercise will, on
required. In less severe cases, packing of the scrotum its own, reopen the wounds, thus avoiding further
with sterile swabs may stop smaller haemorrhages. If manipulation of the surgical sites.
the testicular stump is bleeding, it should be re-emas- In closed castrations, swellings may be harder to
culated and a ligature placed around it. The patient investigate. Ultrasonographic imaging of the area
should be given systemic antibiotics for at least 5 days. may help identify the cause of the problem. Bleeding,