Costs and complications of equine castration: a UK practice-based study comparing ‘standing nonsutured’ and ‘recumbent sutured’ techniques

Abstract

Summary Reasons for performing study: Clinicians are often asked to guide owners and trainers over the relative advantages and disadvantages of equine castration performed in either the standing horse with an open unsutured scrotal wound with healing by second intention, or a recumbent horse under general anaesthesia in aseptic conditions, with sutured scrotal skin allowing primary wound closure. Objectives: To identify types and frequency of complications following the 2 differing approaches, and to compare the financial cost associated with each procedure, based on practice charges. Methods: Veterinary expenses of 217 horses castrated by a Newmarket equine veterinary practice over an 18‐month period were analysed. Of these, Group 1 (n = 121) were castrated standing and nonsutured by one of 2 ambulatory clinicians and Group 2 (n = 96) castrated in recumbency, in aseptic equine hospital conditions. Results: Group 1 had a complication prevalence of 22% with no mortalities, and Group 2 a significantly lower complication prevalence of 6% (P = 0.001) with a mortality rate of 1%. The financial cost of Group 1, without complications, was approximately one‐third of the cost of uncomplicated Group 2. However, the cost of Group 1 with complications increased to approximately two‐thirds of the cost of an uncomplicated Group 2 castration. Conclusions: Even though the complication prevalence for Group 1 castrations leaving an open scrotal wound was significantly higher than for a recumbent horse with a sutured scrotal wound in a hospital, the average cost of Group 1 was still less, even taking into account the additional follow‐up costs associated with treating such complications. Potential relevance: This report provides a benchmark for the outcome of 2 methods of castration based on a database obtained from particular circumstances within the practice involved. Further studies are required to corroborate and take into account future development in surgical and anaesthetic techniques.

Open standing castration in Thoroughbred racehorses in Hong Kong: Prevalence and severity of complications 30 days post‐castration

“…Using a higher threshold for the definition of complication (C2 and C3 only) would have meant a complication rate which is closer to other studies [8][9][10]. This is two to three times higher than has been reported in other studies utilising survey-based data collection of veterinary clinical records.…”

“…Previous studies have documented the prevalence of complications associated with castrating horses using the standing sedated method to be between 16% and 22%, compared with 6% to 10% when castration was carried out under general anaesthesia [8][9][10]. Oedema and localised sepsis (infection of the spermatic cord, henceforth called funiculitis) have been reported by veterinarians as the most common complication following castration using the open standing method, with a prevalence of 22-27% [3,9].…”

Evisceration in a horse submitted to orchiectomy: a case report

“…Dentre as principais complicações citam-se a formação de edema, hemorragia extensa, herniações, tanto do omento quanto de porções intestinais, peritonite, infecções, traumas peniano e evisceração, entre outros (Shoemaker et al, 2004). Estas complicações podem ser minimizadas se a orquiectomia for realizada em um centro cirúrgico, com todas as técnicas de assepsia e anti-sepsia obedecidas (Mason et al, 2005, Getman & White, 2009). Todavia, na rotina veterinária de eqüinos, é um procedimento realizado, em sua grande maioria, a campo.…”

Diagnosis and surgical treatment of a chronic Staphylococcus aureus infection (botryomycosis) as a long-term complication after castration – a case report

“…Complications that occur within a few hours up to a few days after castration include haemorrhage, evisceration, oedema, peritonitis, penile trauma or paralysis, and priapism (Cox 1978, Nickels 1988, Oehme 1988, Schumacher 1996, Gerhards 2003, Shoemaker et al 2004, Kilcoyne et al 2013). Long-term complications are comprised of wound infections, including infection of the spermatic cord, hydrocele and unaltered stallion-like behaviour (Cox 1978, Nickels 1988, Oehme 1988, Moll et al 1995, Schumacher 1996, May and Moll 2002, Gerhards 2003, Shoemaker et al 2004, Mason et al 2005. Septic funiculitis might be caused by an ascending extension of scrotal infection with Staphylococcus spp., Streptococcus spp.…”

“…or other commensal bacteria after castration, or by a contaminated emasculator or suture material (Bolz et al 1968, Joest 1985, Schumacher 1996, Gerhards 2003, Schumacher 2012. Open ans semiclosed castration techniques might predispose for infection of the spermatic cord (O'Connor 1938, Mason et al 2005, Kilcoyne et al 2013), but septic funiculitis can also occur after castration using closed techniques (Schumacher 2012). Septic funiculitis is characterized either by a chronic draining tract or the scrotal incision might heal while the infected spermatic cord enlarges with granulation tissue.…”