EQUINE VETERINARY EDUCATION / AE / AUGUST 2019
429
Results
Post-operative complications are summarised in Table 1 for all three groups.
Group 1 – closed castration with transfixation Thirty horses of the following breeds were included in this group as follows; 11 Thoroughbreds, 9 Warmbloods, 3 draught horses, 3 ponies, 2 Quarter Horses and 2 Standardbreds. They
were between 1 and 5 years of age (Mean age s.d.: 1.8 1 years) and weighed between 250 and 650 kg (Mean kg s.d.: 395.3 106.6 kg). All castrations were performed by two board certified surgeons. Eleven horses were
positioned in right lateral recumbency and 19 in left lateral. Lidocaine was injected into the testicles of 21 horses with a volume range from 5 to 20 mL based on size; the remaining horses received saline (n = 9). All horses were injected with penicillin (Procaine Penicillin G; 20000 IU/kg bwt i.m.)7 and phenylbutazone (Phenylbutazone 20% INJ; 4.4 mg/kg bwt i.v.)9. The duration of surgery ranged from 9 to 22 min, with a mean of 13.4 min. The transfixation suture was No. 2 polyglactin 910 in all horses. Most horses (n = 25) had a recovery score of 1 (excellent), while five horses had a recovery score of 2 (good). It was recommended to continue oral phenylbutazone treatment at home for 3–5 days, but owner compliance was not recorded. Four out of 30 horses had a total of nine post-operative
complications (one or more than one complication/horse; Table 1; 13.3%). In the three horses with post-operative signs of infection, two of them resolved with antibiotic treatment, and one continued to have issues necessitating surgical removal of the infected spermatic cord (septic funiculitis).
Group 2 – unsutured castration Thirty horses of the following breeds were included in this group as follows: 8 Quarter horses, 8 Thoroughbreds, 5 Warmbloods, 5 ponies and 4 Standardbreds were included. They ranged in age from under 1 year to 6 years of age
(mean age s.d.: 2.6 1.6 years) and weighed between 220 and 550 kg (mean kg s.d.: 448 116.3 kg). Right lateral positioning was used in 14 horses, and dorsal and left
lateral in eight horses each. All horses except for two had lidocaine injected into the testicles, and volume ranged from 5 to 30 mL. All horses were given phenylbutazone (4.4 mg/kg bwt i.v.) except one, which received flunixin meglumine (Banamine; 1.1 mg/kg bwt i.v.)10. Horses received either i.m. penicillin (n = 22), i.v. trimethoprim sulfa (n = 4; 24 mg/kg bwt i.v.), i.v. gentamicin (n = 2; Gentocin; 6.6 mg/kg bwt i.v.)11 or no prophylactic antibiotics (n = 2). Surgery time ranged from 7 to 21 min with a mean of 12.6 min. A recovery score of 1 (n = 18), 2 (n = 10), 3 (n = 1) and 4 (n = 1) was noted. It was recommended to continue oral phenylbutazone treatment at home for 3–5 days, but owner compliance was not recorded.
Three out of 30 horses had a total of eight post-operative
complications (one or more than one complication/horse; Table 1; 10%).
Group 3 – primary closure castration The majority of cases in this group were Standardbreds (with exception of one draught horse). They were between 1 and
6 years of age (mean s.d.: 2.3 0.9 years) and weighed between 250 and 575 kg (Mean kg s.d.: 411.3 82.8 kg). All horses were positioned in dorsal recumbency on a surgery
table. Lidocaine was injected into the testicles in 12 of the horses, with a volume ranging from 8 to 40 mL. Flunixin meglumine was administered to 21 horses, and nine received phenylbutazone. All horses received i.v. penicillin (Penicillin G Sodium; 20 000 IU/kg bwt)7, and seven horses additionally received gentamicin. Surgery time ranged from 40 to 105 min
(mean s.d.: 71 min). The transfixation suture of the spermatic cord was done with braided suture material in 18 horses and monofilament in 10 horses (see Table 2). Transfixation suture type was not recorded in two horses. For the two fascia/subcutaneous layers and the intradermal sutures, monofilament was used in 28 horses and braided suture in two (see Table 2). Recovery scores of 1 were recorded in 21 horses and of 2 in nine horses. It was recommended to continue oral phenylbutazone treatment at home for 3–5 days, but owner compliance was not recorded. Seven out of 30 horses had a total of 14 post-operative
complications (one or more than one complication/horse; Table 1; 23.3%). In Table 1, five horses are listed with post- operative infection, three resolved with medical therapy, but two needed surgical removal of the infected cord.
Group comparisons More 2-year-old Standardbred horses underwent primary closure castrations in the hospital (Group 3) than any other age group (P<0.01) or breed (P<0.01). In addition, significantly more horses were placed in dorsal recumbency (n = 38) than in left (n = 27) or right (n = 25) lateral recumbency, with all the primary closure cases being placed in dorsal recumbency (P<0.01). Primary closure castrations took longer
(71 16.9 min) than transfixed closed (13.4 2.7 min) or unsutured closed (12.6 4.3 min) castration (P<0.01). However, no significant difference was noted between groups
for lidocaine volume injected into the testicle, surgeon, medications used or recovery score from anaesthesia. The proportion of post-operative complications was 3.3%
of the overall study population, and did not differ statistically between the three groups (P = 0.44). A recovery score of ≥3 was only observed in two horses but was significantly associated with having post-operative complications (P<0.01). Regardless of the group, horses experiencing haemorrhage were 13 times more likely to develop scrotal swelling then those without (OR 13.8; 95% CI: 1.2–165.4; P = 0.053). The type
TABLE 1: Post-operative castration complications encountered for each surgery group; Group 1: Closed castration with transfixation; Group 2: Unsutured castration; Group 3; Primary closure castration
Complications Swelling Haemorrhage Omental herniation Intestinal herniation Incisional infection Septic funiculitis Group total Group 1
Group 2 Group 3
4 2 7
Total numbers 13
1 2 0 3
0 1 0 1
0 0 0 0
3 2 5
10
1 1 2 4
9 8
14 31
© 2017 EVJ Ltd
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88
