Equine field surgery- Urogenital surgery (Proceedings) - Veterinary Healthcare
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Equine field surgery- Urogenital surgery (Proceedings)


CVC IN KANSAS CITY PROCEEDINGS


Urogenital Surgeries

     Male
     • Cryptorchid castration
     • Circumcision
     • Penile amputation
     • Urethrotomy

Cryptorchidism

     • Left testicles - more likely abdominal
     • Right testicles - more likely inguinal
     • Previous surgical exploration
          – makes identification of surgical landmarks difficult
     • If the side of cryptorchidism is unknown, surgery can be prolonged and laparoscopic exploration of the abdomen may be a better approach

Geldings with Stallion-like Behavior

     • Serum testosterone at time zero and 30 to 120 minutes after ? 6000 IU human chorionic gonadotropin (HCG) IV
          – Geldings have serum testosterone levels of less than 40 pg/ml
          – Cryptorchids have serum concentrations of greater than 100 pg/mL
     • Baseline testosterone levels – < 40 pg/ml = gelding
                                                                 – > 100 pg/ml = testicular tissue
     • Post hCG stimulation          – 6,000 or 12,000 IU given intravenously
                                                 – 1 hour & 2 hour - 200 % INCREASE
                                                 – 24 hours & 48 hours - 400 % INCREASE
     • Estrogen Assays – Conjugated or unconjugated
     • most common tested is estrogen sulfate
                                 – Increased levels
                                 – > 3 years of age - 95-96% accurate
                                 – False negatives - < 3 years or donkeys
     • If <18 months of age or during winter
     may respond poorly to HCG
     Collect additional sample 24 hours after HCG
     retest when older or during the spring

Rectal palpation

     • may help determine location
          – Horses with abdominal testicles will have a small or indiscernible inguinal ring
          – A larger ring with evidence of the ductus deferens entering the canal indicates the horse is an incomplete abdominal cryptorchid, is an inguinal cryptorchid, or has a descended scrotal testicle
     • Perform based on temperament and size of the horse, and the anticipated surgical approach
     • Bilateral cryptorchidism occurs in up to 15% of cryptorchid horses

Cryptorchid Castration

     Equipment • Emasculators - White's modified, Serra, and Reimer
     • Sponge forceps - to evert the vaginal process
     Anatomy   • Picture of normal testicle
     • Epididymis – Head, body & tail
     • Gubernaculum
                              – proper ligament
                              – Ligament of the tail of the epididymis
                              – Scrotal ligament


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