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What is castration?
Surgical removal of the testis.
When is castration most commonly performed?
12-18 months old.
What are the indications for castration?
Remove masculine behavior, management problems, trauma, testicular neoplasia, inguinal herniation, torsion of the spermatic cord.
What are some pre-op considerations for castration?
Tetanus antitoxin, antimicrobials, fasting (10-12 hours)
What are the two methods of castration?
Closed and open.
What is the difference between closed and open castration?
Closed: amputate whole vaginal process (parietal tunic is not opened).
Open: incision through vaginal process to remove testicle (parietal tunic is opened).
What are the types of stallion castration regarding anaesthesia?
Standing, recumbent.
What is the preferred method of castration for young stallions?
Standing castration.
What is the preferred method of castration for older stallions?
Recumbent castration.
What is the procedure for standing castration?
Sedation
Local anesthesia
Scrotal incision → opening tunica vaginalis → Transection of lig. caudae epididymitis → separation of mesorchium → sandy emasculator for 2 minutes. No suture!! Secondary intention healing.
What is the mesorchium?
The fold of the peritoneum that attaches the testes to the dorsal wall of the body cavity or scrotal sac.
What are the potential complications of standing castration?
Aseptic, bleeding, evisceration of intestine or omentum
What sedation, induction and local anaesthetic drugs are used for recumbent castration?
Sedation: Xylazine/detomidine + butorphanol
Induction: ketamine + diazepam
Local anaesthesia: lidocaine- S.C, intratesticular and spermatic cord.
What are the advantages of closed castration?
More safe for bleeding, insurance cover, primary healing.
What are the types of closed castration?
Covered
Covered with ligature
Covered with Henderson
Covered with Equitwister
What is a closed castration?
Scrotal fascia stripped away until cremaster and parietal tunic are fully exposed.
Entire spermatic cord emasculated close to superficial inguinal ring. Make sure testicular arteries are crushed!
How is closed castration with ligature carried out?
Scrotal fascia stripped away until cremaster and parietal tunic are fully exposed.
One ligature around the spermatic cord and vaginal process
Entire spermatic cord emasculated close to superficial inguinal ring.
What suture material is used for castrations?
Polyfilament size 5.
How are Henderson/Equitwister castrations effective?
Torsion/twisting of entire cord.
Why are the Henderson and Equitwister methods dangerous?
Risk of bilateral evisceration.
What is a castration from the regio inguinalis?
Cutaneous incision created over the superficial inguinal ring.
Bluntly separate tissue to avoid pudendal vessels.
Testicle is manually manipulated from the scrotum into the inguinal area and exteriorised through the incision
Ligation and emasculation of spermatic cord (vascular & musculofibrous portion separately or together)
Suture of skin.
What is the open method of castration?
Recumbent castration without closure and with/without ligation – done with emasculator or twisting – Stops the bleeding.
Initial incision through the skin and tunic
Prolapse testicle through incision and break lig. cauda epididymis from the tunic
Emasculator: Sandy, Henderson,
Twisting method: Henderson method and Equitwister
How is the half-closed method carried out?
Incise parietal vaginal tunic proximal to testicle
Hook fingers into inverted vaginal tunic
Strip scrotal fascia from spermatic cord
Extend incision in the vaginal tunic
Emasculate the spermatic cord
What is the most common method of scrotal healing?
Secondary intention healing.
Describe secondary scrotal healing
Common to stretch the incision to help post-operative drainage. Ensure excess fascia is trimmed.
When is secondary healing carried out?
If lots of blood, better to leave open for drainage to avoid seroma or haematoma formation.
Describe when primary scrotal healing is carried out
If performed under sterile conditions, with adequate haemostasis.
What are the benefits of primary intention healing?
Decreases risk of post-operative complications.
What is involved in post operative treatment after castration?
Box rest 24 hours
Hand walk for 15 minutes to reduce oedema formation
ATB: Procaine penicillin for 5 days
NSAIDs: Flunixin IV immediately, phenylbutazone PO 3 days
Tetanus antitoxin serum: 20 ml IM single dose
What are the potential complications of castration?
Haemorrhages
Evisceration
Oedema
Septic funiculitis
Clostridial infection
Septic peritonitis
Penile damage
Hydrocoele
Persistent masculine behaviour
Obstipation colic.
How are haemorrhages treated and why do they occur?
Grasp and re-crush with emasculator for >30 mins. 4ml formalin + saline IV → stops bleeding.
Usually due to improper tying before removal of emasculator, the cord was too large or too hard exercise of the horse before castration.
What is evisceration after castration?
Prolapse of intestinal or omental contents (because tunica vaginalis is not removed).
What is septic funiculitis?
Infection of the cord due to contaminated emasculator or ligature.
What is the treatment for septic peritonitis?
Doxycycline for 10 days (penetrates into deeper structures).
What is the cause of persistent masculine behaviour after castration?
Improper castration resulting in retention of epididymal tissue.
How can obstipation colic be prevented?
Slowly reintroduce food.
How is cryptorchidism diagnosed endocrinologically?
Check testosterone levels before and after administration of GnRH, check levels of anti-mullerian hormones.
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