Equine field surgery- Urogenital surgery (Proceedings)

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Equine field surgery- Urogenital surgery (Proceedings)

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Aug 01, 2010
123456Next 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 123456Next