Large Animal Orchiectomy
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This document discusses castration techniques in large animals. It covers equine castration methods including standing, recumbent open, closed and semi-closed approaches. Complications like hemorrhage, evisceration, edema and infection are addressed. Food animal castration using tools like the Newberry knife, elastrator, burdizzo and power drill are described. The conclusion emphasizes understanding anatomy, surgical principles and tailoring the technique to each individual animal and situation.
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Large Animal Orchiectomy
- 1. Large Animal Orchiectomy (Castration Lecture) Dane Tatarniuk, DVM Resident, Large Animal Surgery April 5th, 2013
- 2. Terminology • castration, • orchiectomy, • emasculation, • gelding, • cutting,
- 3. Equine Castration • Overview – Age – Indication for surgery • Behavior • Neoplasia • Inguinal herniation • Testicular trauma
- 4. Anatomy • Scrotum • Testicle • Epididymis • Tunica Vaginalis – Parietal Tunic – Visceral Tunic • Inguinal Canal
- 5. Anatomy • Spermatic Cord • Cremaster Muscle
- 6. Pre-operative Considerations • Systemically healthy • Palpation – Two testicles descended? • Vaccination – Tetanus • NSAIDs – Bute, Banamine • Antibiotics – Penicillin, Ceftiofur
- 7. Supplies • General instrument pack • Sterile gloves • Scrub • Emasculators • Suture • Ropes • Towels • +/- IV catheter
- 8. Standing Castration • Advantages – Less cost & assistance – Quicker – Choice if poor anesthetic candidate • Disadvantages – Vulnerable position – Avoid on small horses, donkey’s, mules – Assess temperament prior • Sedation – Alpha-2 agonist +/- butorphanol • Local Analgesia – Essential to castrating standing – Spermatic cord or intra-testicle • Position – Tight to horse, keep head up, use reach of arms.
- 9. Recumbent Castration • Environment – Field conditions – Hospital conditions • Anesthesia • Xylazine followed by ketamine & diazepam • Recumbancy – Left lateral vs. dorsal • Rope Restraint – Tie the limbs to maintain safety
- 10. Open Castration • Incision – Through both scrotum and parietal tunic • Dissection – Ligament of tail of epididymis • Exteriorization – Testicle and spermatic cord • +/- Ligation – Hemostasis – Foreign material • Emasculation • Leaves parietal tunic behind
- 11. Emasculation • “Nut to Nut” • Held clamped for minimum of 1 minute – Anecdotal rule of ‘1 minute per age year of horse’ often used • Variable types of emasculators – Serra, White vs. Reimer
- 12. Closed Castration • Incision – Only through scrotum, not through parietal tunic • “Stripping” – Dissection of scrotal fascia • Emasculation – Parietal tunic vs. Cremaster muscle • +/- primary closure – Decrease risk of herniation and evisceration – Foreign material
- 13. Semi-Closed • Incision – Scrotum – 2cm incision into parietal tunic • Eversion of tunic – Flip parietal tunic over thumb – Provides grip to aide in retraction • Closed castration – Emasculate spermatic cord followed by parietal tunic
- 14. Scrotal Healing • Second Intention Healing – Drainage – Stretching incision – Trim excess fascial tissue • Primary Closure – Technique • Excellent hemostasis – Environment • Sterile operating conditions – Increased cost
- 15. Other • Already anesthetized • Remove wolf teeth – 505 & 605 • Interfere with bit placement in the mouth
- 16. Post-Operative Recommendations • Open Scrotal Incision – Movement • Lunging at the trot daily – Hydrotherapy • Decrease swelling • Closed – Confinement to facilitate primary intention healing • Isolation from mares – Active spermatozoa – 2 days min.
- 17. Complications “The one who does not operate, does not have complications.”
- 18. Hemorrhage • Emasculator application – Thick cords – Angle non-perpendicular – Instrument condition • Testicular Artery – Some dripping normal, from scrotal vessels – Active stream of blood is not normal • Treatment – Wait 20 – 30 min, observe – Sedate, re-grasp cord, ligate – Pack with gauze for 24 hours – Anesthetize and find bleeder • Monitor yourself – Stay on farm or refer
- 19. Evisceration • Prolapse of intestine / omental tissue through inguinal canal and scrotum • Breed – Standardbreds, Drafts • Clean and replace contents back into abdomen – May have to anestheize – Refer immediately • Sequela – Strangulation of intestine – Septic peritonitis
- 20. Edema • Common, normal result • Management – Exercise – Hydrotherapy • If non-responsive, – Re-open scrotal incision – Promote further drainage
- 21. Septic Funiculitis • Definition: Infection of spermatic cord • Open castration – More tissue left behind • Treatment – Antibiotics – Drainage – Surgery • Champignon vs. Scirrhous Cord – Streptococcus vs. Staphylococcus
- 22. Clostridial Infection • Clostridium tetani – Spastic paralysis • Clostridium botulinum – Flaccid paralysis • Malignant Edema – Tissue necrosis, cellulitis, fever, depression, toxemia, deat h • Poor prognosis
- 23. Septic Peritonitis • Anatomy – Vaginal cavity communicates with abdomen • Treatment – NSAIDs – Antibiotics – Peritoneal Lavage • Referral
- 24. Penile Damage • Inadvertent emasculation of penis • Edema formation • Paraphimosis • Know your anatomy
- 25. Hydrocele • Scrotal swelling – Excess abdominal fluid in vaginal cavity • Open castration • Cosmetic problem – Usually painless • Drainage not helpful – More abdominal fluid – Can introduce bacteria • Surgery – Remove parietal tunic
- 26. Behavior • Perpetual masculine behavior • Learned response • Older stallions • Warm owners
- 27. Cryptorchidism • Definition: Failure of one or more testicles to descend • Location – Abdominal vs. inguinal – Left vs. right • Inherited • Diagnostic techniques – Palpation, ultrasound, explorato ry, hormone assays • Surgical removal – Do not remove a descended testicle if the other testicle cannot be located.
- 28. Food Animal • Principles of castration similar to equine • Meat quality, behavior • Often performed by producer • Restraint alone vs. sedation/anesthesia • Scrotal incision – Overlying testicle – Transect distal 1/3rd • Strip, +/- ligate, emasculate, etc.
- 29. Food Animal Tools • Newberry knife – Splits scrotum in half – Good access – Good drainage
- 30. Food Animal Tools • Bloodless Castrators – Elastrator – Callicrate • Strangulation of vasculature -> atrophy -> necrosis • ~ 3 weeks • Small, young animals
- 31. Food Animal Tools • Burdizzo – Crushes spermatic cord from the outside – May have to apply multiple times – Testicles atrophy, don’t usually slough
- 32. Food Animal Tools • Henderson castrating tool – Attached to power drill – Twisting motion – Good hemostasis in older animals
- 33. Conclusion • Understand the anatomy, know your basic surgical principles, and evaluate the unique factors present (specie, purpose of animal, animal temperament, surgical environment, owner expectations, owner budget etc.) • Recognize potential complications from castration and know how to manage them appropriately. • There is no “one right way” to perform castration - the right way is to know every way and apply the appropriate technique to the individual / situation.