Farrell Campbell
Pre-Clinical Advisors: Dr. Richard Hackett &
Dr. Linda Mizer
Clinical Advisor: Dr. Hayley Lang

Signalment
● 2yo Standardbred gelding
Chief complaint/History
● Earlier in day rDVM performed open castration w/ ligation
● Difficulty loading onto trailer & kicking violently
● Placed in a stall which he attempted to jump out of and subsequently got cast
● Approx three inches of bowel could be seen exiting the left incision which prompted immediate referral

Assessment
● Backwards in the trailer
● Shocky
● Abrasion above right eye
● Large amount of blood on the floor trailer
● Approx. 10 feet of S.I. exiting left scrotal incision
● Nonvital bowel
● PE not performed

● The horse was sedated with detomidine and butorphanol
● After discussing our findings with the owner euthanasia was elected

● Occurs within 3-4 h after castration but can occur up to
12 days later
● 2/3 SI evisceration
● 1/3 Omental
● Uncommon *
0.2 - 4.8%
Kilcoyne et al. 2013

Pre-op
● Breed
● Pre-existing or history of inguinal hernias
● Large vaginal rings: >2 fingers width
Post-op
● Incr. abdominal pressure / pressure gradient change
● Reduction in the size of the pampiniform plexus
● Leg position during recovery
● Excessive exercise

“The surgical procedure of castration must itself alter some biomechanical aspect of the equine abdomen and inguinal canal.” -
Shoemaker et al. 2004

Medial
Lateral http://www.ucd.ie/vetanat/images/image.html

Images: Auer & Stick 4th ed
Vaginal ring ->

Diagram courtesy of
Dr. Hackett
Parietal vaginal tunics

Field Castration Techniques: open, closed and semi-closed en.wikipedia.org/wiki/Gelding
Open Closed
Kilcoyne et al. 2013

Incise vaginal tunic here, inspect contents
Kilcoyne et al. 2013
Emasculate here

Field
● Castration with ligation
● Castration with “twist and tack”
Hospital
● Castration with primary closure

Diagrams courtesy of Dr. Hackett

● Technically challenging through scrotal incision
● May require inguinal approach
Image courtesy of
Dr. Hackett
Shoemaker et al. 2004 - NO statistical difference between the incidence of
PCE whether open or closed castration
Carmalt et al. 2008 - Vaginal tunic ligation significantly reduced postcastration evisceration

● Surgical closure of tissues
● Lower incidence of complications
● Minimal aftercare
Disadvantages
● General anesthesia
● 3x more expensive than field castration
○ CUHA routine castration $250
○ Primary closure ~ $700
Image courtesy of
Dr. Hackett

● Elliptical incision around scrotum
● Remove scrotal skin
● Strip, ligate and emasculate
● +/- twist and tack
● Close incision in 2-3 layers
● Disadvantages
○ Substantial dissection
○ Large amount of dead space
○ Large incision/closure
○ Time-consuming
Auer & Stick 4th ed

● Inguinal approach
● Vaginal tunic opened
● Tunic, SQ, skin closed
● No tunic is removed
● Advantages
○ Less dissection/tissue disruption
○ Fast
Images: Kummer et al. 2009

● Breakage of the ligature
● Rupture of the vaginal tunic
● Poor recovery from anesthesia
● Fractious patient
Pollock 2012
and requires prompt, effective first aid prior to transport to an appropriate facility.

● Immediately anesthetize
● Clean and irrigate bowel with sterile saline
● Replace prolapsed intestine into the abdomen
○ Not just into scrotum
● Ligate spermatic cord and vaginal tunic proximally
● Close superficial inguinal ring or pack it with sterile gauze
● Parenteral administration of broad spectrum Abx
● NSAIDs for analgesic & anti-endotoxic therapy
● Sedate horse for travel if systemically stable

If a large amount of intestine is present:
● Moist towel/drape made into sling
● Hand towel can be sutured to the inguinal region
Getman, 2009

● Life threatening complications are associated with castration.
● Client communication
● Do something! Don’t ship horse “as is”.

Emergency visit
$146.00
Euthanasia & body care
$358.16
Total: $504.16
Estimate:
$5000-10,000
● Colic sx
● +/- R&A
● Hospitalization

● Carmalt JL, Shoemaker RW, Wilson DG. Evaluation of common vaginal tunic ligation during field castration in draught colts. Equine Vet J 2008; 40
(6): 597-598.
● Getman LM. Post castration evisceration. Equine Vet Educ 2013; 25(11):
563-564.
● Kilcoyne I, Watson J, Kass PH, et al. Incidence, management, and outcome of complications of castration in equids: 324 cases (1998-2008). J Am Vet
Med Assoc 2013; 242(6):820-825.
● Shoemaker R, Bailer J, Janzen E, et al. Routine castration in 568 draught colts: incidence of evisceration and omental herniation. Equine Vet J 2004;
36(4): 336-340.

● Dr. Haley Lang
● Dr. Richard Hackett
● Dr. Linda Mizer
● Class of 2014 http://en.wikipedia.org/wiki/Greyhound_%28horse%
29