Dealing with Complications of Castration

Equine castration is such a commonly performed technique in equine practice that is often considered to be completely routine. However, it is a technique that is recognised to be associated with complications and these can represent minor nuisances or life- threatening catastrophes. Knowledge of potential complications can help their early recognition and appropriate treatment leading to the optimum outcome.

The prevalence of castration complications has been broadly reviewed and would appear to be around 10% (de Ban 1970; Johnson 1973; Lindley 1982; Moll et al. 1995; Mason et al. 2005; Embertson 2008). One study comparing open standing castration and closed sutured castration found different complication rates for the different techniques of 22 and 6%, respectively (Masonet al. 2005).

Haemorrhage
Some haemorrhage after castration is often inevitable but will usually cease within 20 min. This haemorrhage usually originates from scrotal vessels and is self-limiting. Continued or profuse haemorrhage usually arises from the testicular artery and is a result of an equipment or technical failure during the procedure. In many cases keeping the horse quiet (with chemical sedation if necessary) will result in cessation of the haemorrhage. In severe cases, attempts should be made to identify and occlude the testicular artery. This may be possible in the standing horse with placement of artery forceps or re-emasculation. On occasion general anaesthesia may be required to allow identification of the bleeding vessel. Standing laparoscopic intra-abdominal ligation of the testicular blood vessels has also been described. If severe haemorrhage cannot be stopped by direct occlusion of the testicular vessels then the scrotum may be packed with swabs and sutured closed (Embertson 2008). Alternatively the use of i.v. formalin solutions has been recommended (Schumacher 2006). [...]