Survey of the complications occurring after castration of
stallions using the half-closed method and the inguinal
approach.
By: drs. A Bakels-Jintes
Supervisor: dr. J M Ensink
Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
Contents
SUMMARY ................................................................................................................................. 3
1. INTRODUCTION ..................................................................................................................... 4
1.2 METHODS OF CASTRATION ................................................................................................ 4
1.2.1 THE OPEN CASTRATION TECHNIQUE.............................................................................. 4
1.2.2 THE HALF- CASTRATION TECHNIQUE ............................................................................ 4
1.2.3 THE INGUINAL APPROACH. ............................................................................................. 5
1.3 COMPLICATIONS ................................................................................................................ 5
1.5 REASON FOR THIS STUDY ................................................................................................... 6
2. MATERIALS AND METHODS ................................................................................................. 7
2.1 AGE GROUPS ....................................................................................................................... 7
2.2 COMPLICATIONS ................................................................................................................ 7
3. RESULTS ................................................................................................................................ 8
4. DISCUSSION ......................................................................................................................... 15
5. CONCLUSION ...................................................................................................................... 18
6. ACKNOWLEDGMENTS ........................................................................................................ 19
REFERENCES .......................................................................................................................... 20
2
Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
Summary
This study was set to find out if there is a difference in the occurrence of
complications with the two castration methods used in the Utrecht University Equine
clinic. Another question that we wanted to answer was to find out if age was of any
influence on the occurrence of a complication.
The methods used are the half-closed method and castration using the inguinal
approach. The stallions were separated according to their age and the method of the
castration used.
The data were gathered out of the patient records of the clinic and the owners were
called to find out whether or not the horse had any complications after it came home.
To analyse the data, the statistics programme SPSS and the Chi-squared test were
used. When only the method of castration was taken into account we found no
difference in the occurrence of a complication. However a difference was found
between the two age groups and the methods used. The older stallions were more
prone to develop a complication than were the younger stallions. A difference in the
use of method was found in the younger age group. There the inguinal approach had
fewer complications than the half-closed one. This would mean that castration using
the inguinal approach causes fewer complications. That this difference was not found
in the older stallions findings might be because the older stallions might be more
prone to develop a complication regardless of method.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
1. Introduction
In the Netherlands the castration of horses is common practice (2,3). The most
common reason for castration is that the horse is not going to be used for breeding
purposes or to prevent behavioural problems (1,6). The benefits of castration a
stallion are that the horse can then be placed with mares and/or geldings, and is easier
to handle (1). Castration is a procedure, which due to the frequency at which it is
performed, can be considered a routine one (3,4,5). And because of the fact it is a
routine procedure, owners may underestimate the complications that can occur during
or after the castration.
Every castration should start with a thorough physical examination (1).
1.2 Methods of castration
There are different methods, which are used to perform a castration. Some methods
are used outdoors and others are best used in a clinic where castration is performed
under aseptic conditions. The Utrecht University Equine Clinic uses the half-closed
method of castration and the inguinal approach. Laparoscopic castration will not be
considered here. The laparoscopic castration is only used with crypthorchid stallions.
This is not a standard procedure with normal stallions. This is because the
laparoscopic castrations don’t always have reliable results concerning successful
castration in normal stallions, due to revascularisation of the testicle (1,6).
1.2.1 The open castration technique
The open castration method will be described first. This method is usually performed
in standing stallions (2), after the horse is sedated and local anaesthesia is applied to
the scrotum (1). A local anaesthetic is placed along both sides of the raphe, from the
cranial to the caudal pole of the testis, where the surgeon will make the incision (1).
Often a local anaesthetic is applied to the spermatic cord as well (1). When the horse
is adequately anesthetized the surgeon will make an incision about 1-2 cm through the
scrotal skin, the tunica dartos and the tunica vaginalis (6), beside the raphe scrotalis
and is about 7 cm long (1,4) (8-10cm,(4,8)). It has to be large enough for the testicle
to pass through. After making the incision the testicle can be pulled out of the scrotum
(1). The ligament of the tail of the epididymis is cut and the spermatic cord is
separated manually from the tunica vaginalis (4). The emasculator is placed on the
spermatic cord as proximal as possible, and held there for about a minute (1,4). After
that the spermatic cord is cut at about 2 cm distal to the emasculator. The other
testicle is removed in the same fashion. The scrotal wounds are left open to enable
fluids to flow out of the scrotum and reduce the chance of an infection. If an infection
does occur, then the infection fluids can drain out of the scrotum (1). There are
surgeons who, for better drainage, remove part of the scrotum (the part between the
two incisions) (1). To prevent cutting through large vessels, the excision should be
close to the scrotal skin (1). The open technique is the most used (1).
1.2.2 The half- castration technique
The half-closed technique is similar to the inguinal approach, which is a closed
technique. With the half closed technique the incision is made through the scrotal skin
and the tunica dartos, the tunica vaginalis is kept intact (4,6). The tunica vaginalis is
digitally separated from the scrotal fascie and the tunica containing the testicle is
removed from the scrotum (1). A 2-3 cm incision is made in the tunica vaginalis at the
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
cranial pole of the testis or the distal part of the spermatic cord (1,4). The testicle is
removed from inside the tunica. This enables a way for an examination of the testicle
and spermatic cord (4). Then the emasculator is placed as proximal as possible on the
spermatic cord, which is still covered by the tunica vaginalis. The advantage of this
technique compared to the open technique is that there is no connection between the
abdominal cavity and the outside world (1). This reduces the occurrence of the
evisceration of digestive organs through the scrotum to a minimum, though this is
only achieved if the surgeon places a ligature on the site of the crushed spermatic cord
(1).
1.2.3 The inguinal approach.
The inguinal approach differs significantly due to incisions made in the inguinal area,
about 2 cm caudal of the external inguinal ring (1). The incision is made till one has
opened the fascia scrotalis (1). By pulling gently on the tunica vaginalis (with the
spermatic cord inside) the testicle is pulled out of the scrotum (1). The tunica dartos is
stripped from the tunica vaginalis and the emasculator is placed as proximal as
possible. Before the spermatic cord is cut, a ligature is placed on the crushed part of
the spermatic cord, with transfixation to prevent slipping of the suture (2). After that
the spermatic cord is cut about 2 cm distally for the suture. Then the wound is closed
in two layers using an intradermal simple continuous suture (1). The first layer that is
closed is the subcutaneous layer using 2-0 vicryl and a simple continue suture (1). The
second layer that is closed is the skin using 2-0 vicryl and using an intradermal suture.
It is possible to perform the inguinal approach with either a closed or half-closed
technique. With a half-closed technique it is possible to inspect the content of the
tunica vaginalis (1). If the horse has an inguinal testis, the inspection makes it
possible to look if the whole testis is to be removed and not only the epididymis (1).
1.3 Complications
As with every surgical procedure complications can occur. There are quite a few
complications that can occur after a castration. Swelling, excessive bleeding, infection
and an intestinal prolapse can occur.
Some of these complications are rare while others are more common. Three rare but,
possibly, life-threatening complications are, bleeding of the spermatic cord (which
can be prevented by placing a ligature) (1,2). Prolapse of intestines, only occurs with
the open castration technique, this is the main reason this technique should not be
performed (1,2,8).
The third life-threatening complication is tetanus, which can be prevented by a good
vaccination protocol (1,2,5).
Other complications are not as life threatening as the ones above, but are of a more
common occurrence.
The most common complication is edema (1,2,3,4,5). Most of the time this is not a
very serious complication when it stands on its own, but it can hide other
complications. Other complications can be overlooked due to the swelling, for
example a hernia scrotalis. Edema is a complication, which occurs with every method
of castration used, and is to be expected if there is tissue trauma (1). Tissue trauma
occurs with every surgery, the amount of trauma differs however with the amount of
tissue manipulation (1). The more a surgeon has to manipulate tissue, especially when
stripping the spermatic cord, there will be more trauma, which results in edema (6).
This means that when comparing the half-closed and closed methods with the open
castration method, the half-closed and closed methods are expected to have more
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
swelling than the open method. This is because of the blunt separation of the tunica
dartos from the tunica vaginalis, which causes more tissue trauma.
Another complication is infection especially with castrations in the field (2), where
there is no controlled environment and where it is difficult to keep everything sterile.
A chronic infection after castration is called a funiculitis (infection of the stump of the
spermatic cord) (1). The scrotal wound doesn’t close properly and there is pus coming
out of the wounds. This can be due to scrotal infection that has reached the spermatic
cord or due to contamination during castration (1).
1.4 Reason for this study
The main reason for this study is to determine which methods are most suitable for
each patient. This way the staff can make a more adequate decision about the different
method and give owners the advice about which method is best suited for their horse.
By evaluating the castrations performed in the last three years and comparing the two
different castration techniques used, the clinic staff is able to give horse owners better
advice as to which castration method is best suited for their horse, and they are able to
give a better complication analysis.
It is vital for veterinarians that they are able to give their clients good information
about complications that can occur with veterinary treatment. A part of this is to help
a client which method is best suited for their horse and which has the lowest chance
on complications. The data for this are available in the clinic records of the Utrecht
University Equine Clinic, but has to be evaluated and compared in order to help us
answer the question, which method is best suited for which horse.
With this study we want to answer the following questions:
 Is there a difference between methods used in the clinic concerning
complications?
 Is if there is a significant difference between different age groups?
 Are there other factors that might be of influence on the occurrence of
complications, like the duration of the anaesthetic, breed and the season the
castration is performed?
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
2. Materials and Methods
The medical records of 247 horses castrated at the Utrecht University Equine Clinic,
between May the 1st 2007 and the 31st of December 2010 were collected from the
clinics database. The reason for these dates is that all castrations in this period were
performed in the same operating theatre (with laminar flow). Only horses in which
both testicles were removed using the same method of castration were included in this
study. The following data were extracted from the medical records:
- Age
- Method of castration
- Duration of the anaesthesia
- Complications during the horse’s stay in the clinic
- Duration of stay in the clinic
After extracting the data from the patient files, every owner was called for a survey
(appendix 1) concerning their horse’s health in the weeks and months following their
castration and recovery at home.
2.1 Age groups
The horses then were divided in two age groups. The first age group consists of
horses till their 36th month of age. The second age groups are horses older than 36
months.
2.2 Complications
To examine the prevalence of complications, different grades where given, and then
divided into three separate groups. The first group consists of horses without any
complications. The second group consists of horses with mild complications, which
did not require any veterinary treatment; the last and third group consists of horses
where the complications required additional veterinary treatment. The marks that
where given to these complications where as follows: if a horse had no complications
it was given a mark 0, a mild complication was given a 1 and a serious or severe
complication was given a 2. A complication was considered severe if there was need
for additional veterinary care, like antibiotics or another veterinary procedure.
After the castration the horses were housed in the clinic, the duration of their stay
varied according to whether or not they had any complications, if a horse had a
complication it would stay longer in the clinic. These horses were discharged from the
clinic when there were no signs of complications. As mentioned above, the owners of
the horses were called to evaluate the amount of complications at home. This was
done because some complications do not become evident until a few weeks or even
months have passed. It has to be noted that calling the owners after their horse is
discharged from the clinic, is not a standard procedure, but was done for this
investigation.
2.3 Data analysis
To analyse the data, the statistics programme SPSS, version 19, and the Chi-squared
test were used. Significance was accepted if P < 0.05.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
3. Results
During the database search we were able to find 247 horses who where castrated and
which qualified for this survey. All of the castrations where performed bilateral using
the same method for both testicles. Horses with an inguinal hernia or other
complicating factors for the castration were excluded.
Out of these 247 horses one was not included in the tests, as it had to be
euthanized as a result of a broken leg during recovery. As this is a complication more
related to the recovery after any anaesthesia than a complication from castration, this
horse was excluded. Furthermore we could not evaluate the events that would have
happened if the horse had not broken its leg.
Out of the 246 horses, 177 were castrated using the half closed method and 69
horses were castrated using the inguinal approach
Out of the 246 horses we were able to contact the owners of 151 horses and there
were two owners who did not wish to participate in the study.
There are a few factors that have to be taken into account when choosing a
castration method. We asked the owners, which factors were of an influence when
deciding which method to use. The answers they gave were as follows: the cost of the
castration was of an influence. The inguinal approach cost a few hundred euros more
than the half-closed method. Other factors were previous experience the owner has
had with a castration of a horse and the advice given by the University Clinic staff.
The advice on the clinic is that younger stallions are to be castrated using the halfclosed method and the older ones castrated with the inguinal approach.
Mostly the owners were content about the treatment of their horse and the way
the clinic staff kept them informed about their horse's condition after the operation
and during their stay on the clinic. The two owners who did not want to participate in
the study had a negative experience with the clinic. One was a financial issue. The
other one blamed the clinic that his horse had died because they let it eat grass.
Castration method
0-1 years
1-2 years
2-3 years
3-4 years
4-7 years
Half-closed
3
26
46
68
25
Inguinal approach
0
9
16
14
15
7-10 years
10-13 years
13-16 years
16-19 years
19-22 years
Half-closed
5
1
1
1
1
Inguinal approach
8
3
3
*1
2
* fractured leg during recovery, this horse was therefore excluded from the survey.
Table 1. Shows the choices made according to age.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
Castration Method
Half-closed
Age
0-36
months
37 months
and older
85
92
Complications
Clinic: Swelling
Complications
Clinic: Other
Complications
Home
None
47 (55,3 %)
74 (87,1 %)
43 (75,4 %)
Mild
Severe
35 (41,2 %)
3 (3,5 %)
6 (7,1 %)
5 (3,5 %)
8 (14 %)
6 (10,5 %)
None
38 (41,3 %)
83 (90,2 %)
41 (75,9 %)
Mild
43 (46,7 %)
11 (12 %)
4 (4,3 %)
5 (5,4 %)
10 (18,5 %)
3 (5,6 v%)
85 (47,5 %)
78 (44,1%)
14 (7,9 %)
157 (88,7 %)
10 (5,6 %)
10 (5,6 %)
84 (75,7 %)
18 (16,2 %)
9 (8,1 %)
85 (48 %)
157 (88,7 %)
84 (75,7 %)
92 (52 %)
20 (11,3 %)
27 (24,3 %)
None
20 (76,9 %)
26 (100 %)
10 (76,9 %)
Mild
Severe
6 (23,1%)
0 (0 %)
0 (0 %)
0 (0 %)
3 (23,1 %)
0 (0 %)
None
21 (48,8 %)
40 (93 %)
16 (61,5 %)
Mild
15 (34,9 %)
7 (16,3 %)
1 (2,3 %)
2 (4,7%)
6 (23,1%)
4 (15,4 %)
41 (59,4 %)
21 (30,4 %)
7 (10,1 %)
66 (95,7 %)
1 (1,4 %)
2 (2,9 %)
26 (66,7 %)
9 (23,1 %)
4 (10,3 %)
41 (59,4 %)
66 (95,7 %)
26 (66,7 %)
28 (40,6 %)
3 (4,3 %)
13 (33,3 %)
Severe
All
177
None
Mild
Severe
All
Inguinal approach
0-36
months
37 months
and older
177
26
43
No
compl.
Compl.
Severe
All
69
None
Mild
Severe
All
69
No
compl.
Compl.
Table 2.
Table 2 shows the horses and their complications divided between method, age and
severity of the complication. Only the horses of which we could reach the owner are
mentioned in the complications home section of the table.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
In total there were 183 complications divided over 133 horses. This means that some
of the horses had more than one complication (most often swelling in combination
with another).
Of all these complications 120 consisted of swelling (99 mild and 21 severe), 19 of
infection, 5 protrusions of the tunica dartos, 4 of mild bleeding, 2 times funiculitis
was found. One surgical complication occurred, namely the incision of the preputium.
This horse was treated with metacam and had no complications.
None of the complications where fatal, two required another surgery. Two horses
from the inguinal group required opening of the scrotum for better drainage. One of
these horses had developed a funiculitis. A total of 7 horses required reopening of the
scrotal wounds to allow for more adequate drainage of the scrotum. Depending on
other signs apart from swelling (fever for example), antibiotics (depocillin) were
given to 19 horses (either at the clinic or at home after a visit from a veterinarian).
The duration was depending of the response (reduction of swelling and receding of
the fever) of the individual horse and ranged from 2 days to 3 week. Three horses
received metacam for swelling without fever. Most however, did not require other
treatment apart from exercise; walking the horse twice daily and a longer stay in the
clinic (no horse with only swelling stayed longer than 6 days).
The complications related to bleeding, resolved themselves and did not require
veterinary treatment, apart from monitoring.
One of the two horses with funiculitis required a long treatment with antibiotics (3
weeks) and reopening of the scrotal wounds to allow drainage. This horse was an
older stallion and castrated using the inguinal approach. The other horse required
another surgery and antibiotics to treat the funiculitis. This horse was castrated using
the half closed method and was an older stallion.
The protrusion of the tunica dartos was treated with removal of the protruding part
under sedation. Although it requires veterinary treatment, a protrusion of the tunica
dartos was not considered a severe complication.
One horse died shortly after coming home from the clinic. This horse was diagnosed
in the clinic with laminitis after castration; this required a longer stay in the clinic and
further treatment. It is not sure if the laminitis can be related to the castration, so this
complication was not taken into account. Castration related complications were severe
swelling, some blood cloths in the scrotum and a fever (1 day), which receded after
antibiotic treatment.
7 horses received antibiotics and/or other medication (metacam) in relation to another
problem or surgery. Of these 7 horses 2 did not receive antibiotics, but metacam.
To answer our first question about
whether or not the method of castration
has influence over the occurrence of a
complication. The method was set out
against the appearance of any
complication either at the clinic or at
home. This did not show any significant
difference between the two methods, as
P = 0.118. The difference of the
complications between the two
castration methods is shown in figure 1.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
Then the usage of both methods in
both groups was compared and that
also showed no significant difference
as P = 0.143, between the two
groups. Figure 2. shows how the
horses where divided between the
two groups
There was a significant difference
between the two age groups when
setting the age of the horse out
against the occurrence of a
complication (figure 3). The older
horses had significantly more
complications than the ones in the
young age group, as P = 0.015.
To see if the castration method had
any effect on the complications
occurring when the age groups were
viewed separately, the complications
were set out against the age groups
and two calculations were made.
Figure 4. is showing the comparison
using the half-closed method. Figure
5. is showing the comparison using
the inguinal approach. There was no
significant difference when using the
half-closed method as P = 0,121.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
A significant difference was found,
between the age groups when using the
inguinal approach P = 0.013, with the
older stallions having more
complications.
To see if the castration method had any
effect on the appearance of these
complications in the older stallions, the
method was compared with the
complications that occurred, only
using the age group of 37 months and
older (figure 6). No significant
difference was found as P = 0.569.
The same comparison that was made
in figure 6. was done with the younger
stallions; there was a significant
difference between the two methods
(figure 7). The half closed method
gave significant more complications P
= 0.030.
12
Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
The group aged 0-36 months, showed a
significant difference with the methods
against the complications. To see if the
difference could be found at both groups
of complications the following results
where found.
The methods were set out against the
complications found in the age group.
First of the complications used was the
swelling (figure 8).
A significant difference was found
between both methods, P = 0.048 the
half-closed method having more horses
that had a
swelling. The same was done with the
other complications in figure 9, no
significant difference was found there P
= 2.
The group aged 36 months and older,
showed no significant difference with the
methods against the complications (P =
0.411).
The methods were set out against the
complications found in the age group.
First of the complications used was the
swelling (figure 8b).
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
The same was done with the other
complications in figure 9, no significant
difference was found there P = 0.825.
Other questions that came up during this research were whether or not breed, the time
of castration (the season) or the duration of the procedure (using the duration of the
anaesthesia) had any influence on the appearance of any complication.
The outcome of the chi-squared test when determining whether or not breed had an
influence on the occurrence of a complication was that no significant difference was
found (p = 25).
To determine whether the duration of the
anaesthesia had any influence, the duration
was set out against the complications
occurring at the clinic (figure 10). No
significant difference was found as P = 2.
The last factor we wanted to investigate
was whether or not the season (in other
words the time of the year) had an
influence. In order to do so, the horses
were put in 4 groups according to the
season they were castrated in. The seasons
were set out against the complications
occurring at the clinic (figure 11). No
significant difference was found as P = 3.
14
Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
Figure 12
Figure 13
Figures 12 and 13 show the total of all complications which occurred in each age
group, using the half closed method.
Figure 14
Figure 15
Figures 14 and 15 show the total of all complications, which occurred in each
group, using the inguinal approach.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
4. Discussion
The most important question this survey was meant to answer, was to find out
whether or not there is a significant difference between the two castration methods
and the occurrence of a complication.
Another question was whether or not there is a difference in the age of the stallion.
When analysing the data no significant difference was found when comparing the two
methods and the complications that have occurred. This would mean that when the
age of the stallion is not taken into account, the method of castration does not have
any influence for the development of a complication. However according to other
findings in this survey, there is a significant difference between the two age groups,
with the older stallions having significantly more complications. To find out whether
or not this difference was caused because of difference in method, a comparison was
made between the method and the occurrence of a complication in the age group 37
months or older. In this group there was no significant difference in method and
whether or not a complication occurred. However when the same was done with the
age group 36 months and younger, there was a significant difference between the two
methods. It seems that in the group aged 0 till 36 months the castration using the
inguinal approach gave less complications than the half-closed method of castration.
This raises the question as to why there is no significant difference between the two
methods and the occurrence of a complication in the group of 37 months and older. A
reason for this might be that older stallions are more prone to develop complications
after a surgical procedure and might not be related to castration or the method of
castration at all.
A survey in the USA (Moll et al, 3) under practitioners showed a total of 8.747
complications in 23.229 castrations. Out of these complications excessive swelling
was most reported (27,9 %). The percentage of edema in this survey is higher for the
half closed method (34,2%). The difference is most likely due to the stricter lines in
complications concerning swelling. Mild swelling was considered a complication,
even if it did not require further veterinary care. The percentage with the inguinal
approach is much lower in the younger stallions (5,4%) and also in the older stallions
(17%). When compared to the study of Kummer et al, who reported an incidence of
37,8% of the horses developed swelling, both of our groups had a lower incidence of
swelling as well.
The percentage of infections in the survey of Moll et al was 3,4%. It has to be noted
though that in this survey 312 out of 615 respondent, gave antibiotics as a standard
medical treatment when performing a castration. This undoubtedly has an effect on
the number of infections. The number of infections might have been higher without
the standard usage of antibiotics, especially because the castrations where performed
out in the open field and not in a sterile operating theatre.
As the survey of Moll et al showed, the horses with antibiotic treatment did have a
significant lower infection rate (2,9%) in relation to horses who did not get the
standard antibiotic treatment (4%). The number of infections in our survey was low
with 19 horses requiring antibiotic treatment.
There where a total of 7 horses who did get medical treatment (including antibiotics
in 5 horses), before or soon after their castration. But this was given in relation to
other problems (abces in the neck) or other operations. This treatment, which
sometimes consisted of antibiotic therapy, could have had an influence on the
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
development of a castration, especially the antibiotic treatment. It is impossible to
determine whether or not these horses would have developed a complication.
Other complications reported in the survey of Moll et al, where hydrocele, eventration
and peritonitis, none where reported in this survey. Most likely due to a difference in
techniques used. In the survey of Moll et al, open techniques where used as well,
which can explain the incidence of the eventration. A problem with this survey can be
that the veterinarians, who had to fill in the survey, answered the questions according
to memory instead of their records. This survey showed that it is not easy, sometimes
almost impossible, to determine whether or not a horse had swelling from the records.
As there are many people who fill in these forms and all with their own interpretation.
This is something that has to be said for both the survey of Moll et al, as well as this
one.
Another study done by Kummer et al in 2009 (6) was done to look at the
complications that arise form the inguinal approach. All these horses received
treatment with antibiotics before and after castration. This makes it harder to compare
their findings concerning fever/infection and funiculitis with our survey. This is
because, as mentioned before, none of the horses in our survey was treated with
antibiotics pre or post op as a standard medication. Seroma incidence was higher in
the older age group compared to the others in the retrospective study of Kummer et al.
The percentage of respiratory infections was 2,1 % (5 horses), these where also the
only horses with a fever for longer than two days.
As for complications concerning excessive haemorrhage, 4 horses where reported
with a hematoma and 1 with abdominal bleeding. In our survey we had 4 horses who
had some haemorrhage. One horse had a mild bleeding during surgery, which was
treated accordingly and no other signs of bleeding where found. Two horses at the
clinic had a mild haemorrhage and one at home. All three horses did not require
further treatment apart from monitoring.
Mason et al, also did a study to compare different techniques and their complications.
However as they only took in complications when additional veterinary care was
needed, a comparison is not easily made. As this survey shows, when called, the
owners reported swelling as a complication, but did not call a veterinarian. They did
find a significant difference concerning infection. The group that had the open
castration method had 20% occurrence of infection opposed to 2,1% in the group
castrated in a sterile environment.
Breed had no significant difference; this might be because there was a great variety of
horse breeds and low numbers of each breed. This made the comparison difficult and
the groups were not large enough for the equation. This way there was no certain way
to tell if that makes a difference or not.
Season showed no significant difference, this might be because all the operations
were performed in the same operating theatre with the same environmental conditions
and the horses were housed in the clinic for the first few days.
A difference between the two methods was that the inguinal approach takes more time
to perform. To look if this made a difference, the time that a horse was anesthetized,
was compared to the whether or not a horse had a complication. This did not show
any significant difference between the two methods or the age of the stallion.
A follow up on this paper, might be to try and test the findings in the field. Meaning
that if the owner is willing, the horse (according to the age group) is randomly put in a
group that is using either the half-closed method or the inguinal approach. So as the
test the data that has come up in this research. A useful tool in this would be with a
scorecard, which can be used as a tool to determine in which category a stallion is
17
Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
with, for example, swelling. Another possibility is to examine this, with new data
from the clinic files. These can be used for a new survey in the difference between the
two methods, to see if there still is a difference between the two methods. it might be
worthwhile to score the signs a stallion has after surgery.
5. Conclusion
According to the findings it would seem that overall the method of castration does not
have any effect on the appearance of any complications. However when the two
groups are split according to age, there is a difference in the younger stallions. There
it seems that the inguinal approach is the better option when the complications are
taken into account.
It would be better to castrate the stallions using the inguinal approach, at least this
advice should be given to owners. The owners should also be made aware that with
the increase in age a stallion has a higher chance of developing a complication.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
6. Acknowledgments
Allereerst wil ik mijn begeleider dr. J.M. Ensink bedanken voor alle hulp en vooral
haar engelen geduld, zonder haar zou ik door de bomen het bos niet meer hebben
gezien.
Ik had voor dit onderzoek gekozen omdat het me een erg interessant en leuk
onderwerp leek. Ook omdat ik op dat moment zelf een paard had dat gecastreerd
moest worden. Dat maakte het meer persoonlijk voor mijzelf. Plus het leek me erg
leuk om te horen wat al die eigenaren zelf voor ervaringen hadden gehad en wat nu
echt een betere methode is om te gebruiken. Er was namelijk weinig literatuur te
vinden die de verschillende methodes met elkaar vergelijkt en ook uitzet tegen de
complicaties die optreden.
Verder heb ik een hoop geleerd tijdens dit onderzoek. Bijvoorbeeld dat zelfs een
back-up van een back-up best een slim idee kan zijn, zeker met wat avontuurlijke
katten in huis.
Het bellen van eigenaren vond ik in het begin een hele spannende beleving. Echter als
je op den duur iemand aan de telefoon krijgt die keihard ‘nee laat dat’ in de telefoon
schreeuwt, om zich vervolgens te verontschuldigen want de pony was het huis in
gelopen, dan nemen de zenuwen aardig af.
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
7. References
1. Auer J.A., Stick J.A., Equine Surgery 3th edition, Hoofdstuk 65 (788-807),
Saunders
2. Railton D., Complications associated with castration in the horse In practice
3. Moll H.D., Pelzer K.D., Pleasant R.S., Modransky P.D., A survey of Equine
Castration complications Journal of Equine Veterinary Science 1995;15: 522526
4. Searle D., Dart A.J., Hodgson D.R., Equine Castration: review of anatomy,
approaches, techniques and complications in normal, cryptorchid and
monorchid horses, Australian Veterinary Journal, 1999;77: 428-434
5. J Schumacher, Complications of castration, Equine Veterinary Education,
1996:8:254-259
6. Kummer M., Gygax D., Jackson M., Betterschart-Wolfensberger R., Fürst A.,
Results and complications for primary castration with an inguinal approach
in horses., Equine Veterinary Journal, 2009:41:547-551
7. Mason B. J., Newton J. R., Payne R. J., Pilsworth R. C., Costs and
complications of equine castration: A UK practice-based study comparing
‘standing nonsutured’ and ‘recumbent sutured’ techniques., Equine
Veterinary Journal 2005:37:468-472
8. Shoemaker R., Bailey J., Janzen E., Wilson D.G., Routine castration in 568
draught colts: incidence of evisceration and omental herniation. Equine
Veterinairy Journal 2004:36:336-340
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Survey of the complications occurring after castration of stallions using the half-closed
method and the inguinal approach.
Appendix 1 Survey question
1. Were there any problems concerning the castration after the horse came
home?
2. If there were, what were those problems and what has been done to treat the
problems?
3. Which veterinarian was called upon when a complication arose?
4. How was the horse stabled?
5. Was it with other horses or alone?
6. What kind of information was given by the clinic staff concerning the
castration method
7. Have you been informed enough to make a calculated decision? And how did
you get tot hat choice?
8. What was the reason you chose this method?
21