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Surgery of the Reproductive Tract in Camels
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Part One: Surgery of the Reproductive Tract in the Male Camelid
Surgical procedures are required for the correction of some reproductive tract disorders, for convenience and in some obstetrical situations.
Castration
Castration of camels is a routine management practice throughout the world. It is used in almost all males destined for work in order to reduce their aggressive behavior especially during the rutting season, and is often essential in cases of testicular diseases.
Most of the males are castrated at 2 years of age. However, earlier castration (6 months) is possible. Several types of anesthetic regimes can be used including chloroform, etorphine with acepromazine, chloral hydrate and xylazine. In field conditions the best results for security (and lower cost) is sedation with xylazine and local anesthesia. Food and water should be withheld for 48 hours before surgery, and then castration of older subjects can be performed after the animal is hobbled in the sitting position. However, castration of young calves can be performed on the standing animal in a squeeze chute or if it is maintained against a wall by assistants.
Castration using the Burdizzo method has been used in the past but is now abandoned in favor of complete removal of the testis [1,2] so the technique used nowadays is similar to standard methods used in other species. The animal is sedated with xylazine (0.3 to 0.6 mg / kg iv) and the scrotum is injected with 2% lidocaine solution 3 to 5 cm cranial to the scrotum on either side of the median raphe (Fig. 1). Two skin incisions are made 3 to 5 cm cranial to the scrotum and 1 cm to the right and left of the median raphe (Fig. 2).
Figure 1. Castration in the dromedary: The male is restrained in lateral recumbency. Local anesthesia is obtained by testicular infiltration of lidocaine.
Figure 2. Castration in the dromedary. Incision of the scrotal skin.
The spermatic cord is isolated by blunt dissection of the tunica vaginalis and a finger is then placed under the spermatic cord to lift it out of the incision thus pulling the testicle out of the scrotum (Fig. 3). The testis is grasped and its tunica is stripped from the fat toward the external inguinal ring. A ligature is placed around the tunica near the external inguinal ring and the cord is transected with either an emasculator or a scalpel (Fig. 4a & Fig. 4b).
Figure 3. Castration in the dromedary. Exteriorization of the testicle.
Figure 4a. Castration in the dromedary: Ligature of the testicular cord.
Figure 4b. Castration in the dromedary: Emasculation.
A double crush emasculator is recommended and should be kept in place for at least one minute to insure complete crushing of the blood vessels and to avoid post-surgical hemorrhage. The cord should then be ligated with No 3 or 4 chromic catgut [3] and the scrotal incisions can then be left open to allow drainage (Fig. 5). Castration is described as open or closed according to whether or not the tunica vaginalis was incised or not. If open castration is performed, the common tunic is left in situ after ligation and transection of the testicular cord. A pre-scrotal castration technique is preferred by some authors because it is more esthetic and does not reveal the surgical scar.
Figure 5. Castration in the dromedary: Surgical wounds after castration.
Post-surgical care consists of routine administration of tetanus toxoid and tetanus antitoxin (subcutaneously) for non-vaccinated animals [4]. If the animal has been previously vaccinated against tetanus, a booster with tetanus toxoid is sufficient. However, antibiotic treatment is not usually necessary unless there is reason to believe that infection may occur (orchitis, or unclean surroundings), but some authors suggest administration of long acting tetracycline (20 mg /kg) or 5 days of aqueous penicillin procaine G (20000 IU/kg/day) as a preventive measure [4]. The animal should be placed in a clean stall after castration or better still left out in a clean dry pasture.
The most frequent complication of castration in camelidae is infection and development of schirrous cord. Hemorrhage or evisceration as seen in other species are very rare in llamas and dromedaries but if bleeding persists, the animal should be re-evaluated and all bleeders ligated individually with chromic catgut No 1.
Cryptorchid Castration
Abdominal cryptorchidism is rare in camels, more frequently the testis is present anywhere from the external inguinal ring to near the scrotum or alongside the penis. In a few cases, the gonad may be located in the subcutaneous fascia on the medial aspect of the rear limb but the retained testis may be small and difficult to palpate.
Vasectomy
Vasectomy is used for the preparation of teasers for the induction of ovulation in female camelids. However, because of its esthetic advantages some breeders may opt for this technique, rather than castration, to sterilize males that are undesirable for reproduction. An incision is made cranial to the scrotum and the spermatic cord is isolated and exteriorized. Next the tunic is incised and the ductus deferens isolated, then ligatures are placed 2 cm apart and the segment between the sutures is excised. The tunic should be sutured by simple interrupted absorbable suture (Fig. 6a & Fig. 6b) [4].
Figure 6a. Vasectomy in the dromedary.
Figure 6b. Vasectomy in the dromedary.
Surgery of the Reproductive Tract in the Female Camelid
The most common reproductive surgery procedures in the female camelidae are cesarean section (hysterotomy), ovariectomy and to a lesser extent ovario-hysterectomy.
Cesarean Section
Cesarean section is indicated in many instances where normal delivery of a live or dead fetus is impossible [5-8]. The most common reasons for delivery by cesarean section in camelids are: uterine torsion [9], fetomaternal disproportion, fetal malformation (ankylosis, schistosomas reflexus, mummification), improper dilation of the cervix, breech presentation [10], forelimbs crossed over the neck [5] or lateral deviation of the head and neck [11]. The best technique for Cesarean section in camels is the left paralumbar approach whilst the animal is restrained in the sternal position (Fig. 7).
Figure 7. Cesarean section in the camel: Preparation of the surgical site.
Cesarean section has been accomplished under many different anesthetic regimes in the dromedary female [12]. under field conditions, regional anesthesia of the surgical site by inverted L and line block (60 ml to 120 ml of 2% lidocaine solution) and good restraint of the animal is sufficient. Sedation with xylazine hydrochloride (2.2 mg/kg IM) may be required after exteriorization of the fetus and in the last stages of surgery if the animal is not depressed.
The surgical site must first be clipped, shaved and cleaned thoroughly. A 35 to 40 cm skin incision is done starting 10 cm from the angle formed by the hip and the lumbar vertebrae and continued downwards parallel to the thighs in the sitting animal (Fig. 8). The first muscular layer (external abdominal oblique muscle) is incised followed by a grid separation of the second and third abdominal muscles (internal abdominal oblique muscle and the transverse abdominal muscle; Fig. 9).
Figure 8. Cesarean section in the camel: Incision of the skin and subcutaneaous muscle layer.
Figure 9. Cesarean section in the camel: Dissection of the muscle layers in a grid.
Incision of the peritoneum is made along the surgical site with blunt dissecting scissors. The uterus is then exteriorized by grasping the uterine horn at the level of one of the fetal limbs (Fig. 10).
Figure 10. Cesarean section in the camel: Exteriorization of the uterus by holding a fetal limb and exposing the greater curvature of the uterus.
A 30 cm incision is made along the large curvature of the left uterine horn and the fetus is delivered by gentle traction (Fig. 11, Fig. 12). The uterine incision is closed (after removal of the placenta - if possible) using a row of Cushing sutures superimposed with continuous Lembert (chromic catgut No 2 or 3; Fig. 13) [5,12,13].
Figure 11. Cesarean section in the camel: Uterine incision above the fetal limb.
Figure 12. Cesarean section in the camel: Exteriorization of the fetus. The surgeon is holding the uterus in place while two aids are pulling the fetus out and one is holding the head of the fetus. Note the 4th membrane of the fetal body.
Figure 13. Cesarean section in the camel: Uterine closure using the Utrecht suture pattern.
The uterus is then cleaned with sterile saline and replaced inside the abdominal cavity. The peritoneum, muscular layers and subcutaneous tissue are closed separately with simple continuous sutures with chromic catgut No 2 [5]. Others prefer suturing the peritoneum, then the internal oblique muscles in one layer and the external oblique in another, with continuous lock sutures. The skin incision is closed using interrupted mattress sutures or interlocking suture (Fig. 14) with silk No 4 or with staples [10].
Figure 14. Cesarean section in the camel: Skin suture using an interlocking suture pattern.
Post-operative care includes administration of 30 to 40 IU of oxytocin IM to stimulate uterine contraction and expulsion of the placenta (if not already removed) or lochia. Antibiotic therapy should be continued for 5 to 10 days and the sutures can be removed two weeks after surgery. Postoperative complications include: retained placenta, metritis, endometritis, agalactia or herniation of the surgical site [12,14].
Ovariectomy
Ovariectomy is indicated in the case of ovarian or ovario-bursal diseases. We have used the flank approach for the removal of the affected ovary in cases of hydrobursitis [9,15]. The surgical site is clipped and shaved over an area 30 cm x 30 cm, extending vertically down from the processes of the lumbar vertebrae and horizontally from the last rib to the hip. A vertical skin incision is made in the middle of the paralumbar fossa starting at about 10 cm ventral to the transverse process of the lumbar vertebrae and extending ventrally for 15 to 20 cm depending on the estimated size of the affected ovarian bursa (Fig. 15).
Figure 15. Ovariectomy in a dromedary camel with ovario-bursitis. Exteriorization of the affected side via a flank laparotomy.
After opening the 3 abdominal muscular layers and peritoneum, the hand of the surgeon is introduced into the abdominal cavity and directed caudally to the pelvic region where the uterus is identified by direct palpation. The uterine horn is grasped and examined throughout its length until the ovary and the affected ovarian bursa are identified. Because of the fragile nature of the ovarian bursa and the tremendous tension exerted by the accumulation of the fluid, traction on the oviduct should be avoided. Traction should be exerted first on the uterine horn until the bursa is visible at the level of the surgical site. In cases where there is an excessive amount of fluid, an aide should support the bursa by placing a hand within the abdominal cavity underneath the bursa. The ovarian bursa is then exteriorised progressively by shifting the fluid away from the surgical opening and then progressively toward the exteriorised part until the whole bursa pops outside the abdominal cavity. The whole oviduct and the upper third of the corresponding uterine horn are readily visible at this point. The ovary and affected bursa are resected in toto after placing a transfixing suture at about the third lower part of the oviduct (Fig. 16a; Fig. 16b). The abdominal cavity is then closed in the same manner as described for caesarean section. The animals should be palpated regularly for the next 3 weeks to avoid the development of adhesions and so that ovarian activity can be monitored. In the absence of any complications, ovariectomized females can be bred 3 to 4 weeks after surgery [15].
Figure 16a. Ovariectomy in a dromedary camel with ovario-bursitis: Transfixion suture at the level of the utero-tubal junction.
Figure 16b. Ovariectomy in a dromedary camel with ovario-bursitis: Resection of the ovary and ovarian bursa in block.
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1. Mullany J. Camel castration by the Burdizzo method. Vet Record 1929; 9:589
2. Thomson JK. Castration of camels. Vet Record 1978; 102
3. Cran HR. A note on Castration of the Dromedary. In: Cockrill WR ed. The camelid: An all Purpose Animal. Scandinavian Institute of African Studies. Uppsala, Sweden, 1984; 342
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Affiliation of the authors at the time of publication
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA.
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