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Equine Castration: Review of Anatomy, Approaches

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Equine Castration: Review of Anatomy, Approaches Clinical Equine castration: review of Australian anatomy, approaches, techniques VE T E R I N A R Y and complications in normal, OU R N A L J cryptorchid and monorchid horses CLINICAL SECTION D SEARLE, AJ DART, CM DART and DR HODGSON University Veterinary Centre, Department of Veterinary Clinical Sciences, The Uni- EDITOR versity of Sydney,Werombi Road, Camden, New South Wales 2570 DAVID WATSON ADVISORY COMMITTEE Complications associated with equine castration are the most common cause of malpractice claims against equine practitioners in North America. An understand- AVIAN ing of the embryological development and surgical anatomy is essential to differen- LUCIO FILIPPICH tiate abnormal from normal structures and to minimise complications. Castration of EQUINE the normal horse can be performed using sedation and regional anaesthesia while DAVID HODGSON the horse is standing, or under general anaesthesia when it is recumbent.Castra- OPHTHALMOLOGY tion of cryptorchid horses is best performed under general anaesthesia at a surgi- JEFF SMITH cal facility. Techniques for castration include open, closed and half-closed tech- PRODUCTION ANIMALS niques. Failure of left and right testicles to descend occurs with nearly equal fre- JAKOB MALMO quency, however, the left testicle is found in the abdomen in 75% of cryptorchid SMALL ANIMALS horses compared to 42% of right testicles. Bilateral cryptorchid and monorchid JILL MADDISON horses are uncommon. Surgical approaches described for the castration of cryp- SURGERY torchid horses include an inguinal approach with or without retrieval of the scrotal GEOFF ROBINS ligament, a parainguinal approach, or less commonly a suprapubic paramedian or ZOO/EXOTIC ANIMALS flank approach. Laparoscopic castration of cryptorchid horses has recently been LARRY VOGELNEST described but the technique has limited application in practice at this time. A defini- tive diagnosis of monorchidism can only be made after surgical exploration of the EDITORIAL ADMINISTRATION AND abdomen, removal of the normal testis and hormonal testing. Hormonal assays DESKTOP PUBLISHING ANNA GALLO reported to be useful include analysis of basal plasma or serum testosterone or oestrone sulphate concentrations, testosterone concentrations following hCG stim- ulation, and faecal oestrone sulphate concentrations. Reported complications of CONTRIBUTIONS INVITED castration include postoperative swelling, excessive haemorrhage, eventration, Practising veterinarians and others are invited f u n i c u l i t i s, peri t o n i t i s, hy d r o c e l e, penile damage and continued stallion-like to contribute clinical articles to the Australian behaviour. Veterinary Journal. We will consider material Aust Vet J 1999;77:428-434 in a variety of formats, including clinically Key words: Horse, equine, castration, cryptorchid, monorchid. orientated reviews, reports of case series, individual case studies, diagnostic exercises, and letters containing comments or queries. astration is one of the most ment and anatomical features of the Practitioners are also invited to contribute to common surgical pro c e d u re s male equine re p ro d u c t i ve tract, the 1,2 approaches to castration of the normal, the case notes feature, where accepted arti- Cperformed in equine practice. cles are not peer reviewed but are edited for Although the pro c e d u re is considere d cryptorchid, and monorchid horse, and publication. Contributors should consult routine, surgical complications consti- the diagnosis and management of instructions to authors and recent issues of tute the most common cause of surgical complications. the journal for guidelines as to formatting. malpractice claims against equine prac- 3 Over referencing should be avoided: authors titioners in North America. A complete Embryonic development and should preferably quote only those articles understanding of male re p ro d u c t i ve surgical anatomy of the equine they feel are most likely to be of interest and anatomy and physiology and good testis benefit to readers. surgical technique will reduce the rate The embryonic gonad differe n t i a t e s 1 of surgical complications. Pre s u r g i c a l into a testis at approximately 5 ⁄2 we e k s Send all contributions to: e valuation and surgical approach to of gestation, at which time it lies on the Editor, AVJ Clinical Section cryptorchid and monorchid horses are a ventral aspect of the mesonephric AVA House, 272 Brunswick Road, m o re complex diagnostic and surgical k i d n e y.4,5 A re t roperitoneal cord of Brunswick, Vic. 3056, challenge. This article provides practi- mesenchyme coursing across the phone: (03) 9387 2982 tioners with a re v i ew of re l e vant infor- abdominal cavity from the caudal pole fax: (03) 9388 0112 mation on the embryological deve l o p- of the testis to an extraperitoneal posi- email: [email protected]. tion at the site of the future scro t u m 5 IM Intramuscularly forms the gubernaculum. The guber- IV Intravenously naculum is divided into two parts by the mesonephric duct which ultimately 428 Aust Vet J Vol 77, No 7, July 1999 Clinical d i f f e rentiates into the epididymis.4 At p e r i t o n e u m day 45 a peritoneal outpouching at the k n own as the site of the future internal inguinal ring tunica va g i- i n vades the extraperitoneal segment of n a l i s .2 , 5 T h e the gubernaculum forming the va g i n a l tunica va g i n a l i s p ro c e s s .5 Ul t i m a t e l y, when it is consists of completely differentiated, the gubernac- visceral and pari- ulum can be divided into the thre e etal tunics. T h e different segments identified in the adult visceral tunic is horse: the proper ligament of the testis tightly adhere d lies between the caudal pole of the to the testicle, m a t u re testis and the tail of the ducts and vessels, epididymis, the ligament of the tail of and the parietal the epididymis lies between the tail of tunic is contin- the epididymis and the parietal tunic of uous with the the vaginal process, and the scrotal liga- parietal perito- ment lies between the parietal tunic of neum (Figure 1).5 the vaginal process and the scro t u m The cre m a s t e r (Figure 1).5 muscle is a At approximately 6 weeks gestation, c a u d o l a t e r a l the interstitial cells of the testis begin to extension of the m u l t i p l y. By 5 months the embryo n i c internal abdom- testicle approaches the size of that of a inal oblique m a t u re stallion and lies in contact with muscle and is the kidney and the internal inguinal continuous with r i n g .4 , 5 Be t ween 7 and 10 months of the parietal laye r gestation the testicle atrophies to of the tunica a p p roximately one tenth of its former v a g i n a l i s s i ze as the gubernaculum short e n s .4 , 5 i n s e rting at the The epididymis and the ligament of the caudal pole of the tail of the epididymis expand to dilate testicle (Fi g u re Figure 1.The testicular structures seen during castration of the the vaginal ring and inguinal canal.5 2 ) .5 The parietal mature male horse using an open castration tech n i q u e. T h e Ultimately, at 9 and 10 months of gesta- tunic is inti- testicle (t) is tightly enclosed in the tunica albuginea.The head of the epididymis (a) continues as the body (b) and the tail (c) the tion dilation of the inguinal ring, mately adhere n t latter continues as the vas deferens (d).The tail of the epididymis to the scrotal skin contraction of the gubernaculum and is attached to the caudal pole of the testis by the proper ligament t h rough the i n c rease in intra-abdominal pre s s u re of the testis (e).This continues as the ligament of the tail of the combine to force the small, flaccid s c rotal fascia and epididymis (f) between the tail of the epididymis and the parietal 5 testicle into the inguinal ring. T h e tunica dart o s tunic (pt).The visceral tunic cov e rs the visceral surface of the 2 , 5 volume of extra-abdominal gubernac- m u s c l e . T h e t e s t i cl e, e p i d i dy m i s , spermatic vessels (sv), and vas defe r e n s . ulum pre vents the testicle fro m tunica dart o s The parietal tunic and cremaster muscle (cm) have been incised descending completely into the scrotum, sends a sagittal and are partially retracted. so at birth the testicles usually lie within septum into the the inguinal rings.4,5 The mass of guber- s c rotal sac naculum is quite large at birth and may dividing it into left and right pouches.5 external examination of the reproductive 5 be mistaken for a testicle.5 During the The spermatic cord courses fro m t r a c t . Sedation may be re q u i red to first few weeks of life vaginal rings abdomen to scrotum through the palpate the scrotum and the inguinal contract to approximately 1 cm in diam- inguinal canal which is bounded by deep canals for the presence of two testicles eter and gubernacular tissues reduce in and superficial inguinal rings.
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