FA3 Reproduction > Lecture 20 > Flashcards

Lecture 20 Flashcards

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1
Q

What are the indications for castration in the horse?

A

-eliminate masculine behavior and managerial problems
-sterilize
-testicular neoplasia
-testicular trauma
-spermatic cord torsion
-inguinal hernia

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2
Q

What are the components of pre-operative preparation for a castration?

A

-perform physical exam; ensure 2 testicles present before proceeding
-assess environment
-assess horse temperament
-plan ahead/prep team
-consider NSAIDs, tetanus vx, and antibiotics
-prep surgical site

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3
Q

What are the possible positions for the equine patient during a castration?

A

-dorsal recumbency
-lateral recumbency
-standing

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4
Q

What are the possible positions for the veterinarian to be in when castrating a horse in dorsal recumbency?

A

*behind the horse’s back
-safest position

*behind the horse’s rear with legs in air
-easiest access
-must be aware of hind leg movement

*behind the horse’s rear with legs pulled forward
-most difficult for visualization

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5
Q

Which testicle should be removed first when the animal is in lateral recumbency and why?

A

the down testicle should be removed first; in the event of bleeding, it does not limit the visualization of the upper testicle

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6
Q

Which medications are used for injectable sedation prior to anesthesia when doing a dorsal recumbency castration?

A

-xylazine: 2-4 mL per horse
+/- butorphanol: 0.5-1 mL per horse

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7
Q

Which medications are most commonly used for injectable anesthesia when doing a dorsal recumbency castration?

A

-ketamine HCl: 10 mL/1000 lb horse
-midazolam or diazepam: 5-10 mL/1000 lb horse

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8
Q

Which other medication combos can be used for castration anesthesia?

A

-thiobarbituates following sedation with xylazine
-guaifenesin in combination with ketamine HCl or thiobarbituate

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9
Q

What is the appropriate positioning for a horse that is sedated?

A

nose to ground

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10
Q

What are the steps of the closed technique for castration?

A

-isolate teste
-no incision into parietal tunic
-emasculate/incise teste encased in parietal tunic

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11
Q

What are the steps of the open technique for castration?

A

-incise parietal tunic
-emasculate/incise teste without tunic

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12
Q

What are the steps of the semi-closed technique for castration?

A

-incise parietal tunic
-emasculate/incise teste encased in parietal tunic

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13
Q

What are the possible incision types when performing castration?

A

-2 parallel incisions 1 to 2 cm on either side of the median raphe
-1 large elliptical incision

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14
Q

What are the characteristics of local block during castration?

A

-10 mL of lidocaine injected into each teste
-can be combined with line block of the incisions
-keeps animals from waking up when cutting
-optional in a down castration
-NOT optional in a standing castration

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15
Q

What are the general steps to performing a castration?

A

-identify median raphe
-instill local block
-create incision(s)
-grasp teste and strip
-emasculate
-possible ligation
-check for bleeding
-remove excess subQ tissue
-possible removal of median raphe
-possible stretching of incisions
-incisions left open

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16
Q

What are the characteristics of emasculator use?

A

-want to use an emasculator that locks
-the nut of the emasculator faces toward the teste
-typically left on for 5 minutes per teste
-some clinicians use the 1 minute per 1 year of life rule

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17
Q

What are the charactersitics of ligation during a castration?

A

-use absorbable suture
-perform friction knots
-benefits include hemostasis, decreased risk of evisceration, less worry for surgeon
-con is the presence of foreign material
-Collar ligates in donkeys, older animals, and animals with large inguinal rings

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18
Q

What are the advantages of performing a standing castration?

A

-decreased risk of anesthesia
-anatomic position
-no waiting for recovery from anesthesia
-can perform in a small area
-less assistance needed

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19
Q

What are the disadvantages of performing a standing castration?

A

-greater risk to surgeon
-decreased access
-decreased ability to deal with complications
-difficult to stay sterile
-more technically challenging

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20
Q

Which medications are used to sedate a horse for standing castration?

A

-detomidine: 0.5-1 mL per horse
-butorphanol 0.5-1 mL per horse
-xylazine NOT recommended

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21
Q

When is primary closure of castration incisions performed?

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A

-hemostasis is critical
-sterile conditions
-wanting decreased recovery time and discomfort

22
Q

What is the Henderson tool?

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A

drill attachment that clamps onto the testicle and spins it until it detaches from the body

23
Q

What are the management steps for a horse post-op from a castration?

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A

-force exercise beginning 24 hours post-op
-hydrotherapy can help; just not in the incisions
-isolate from mares for 2 days
-mild edema expected for up to 5 days

24
Q

What are the characteristics of castration complications?

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A

-10 to 22% complication rate
-complication rates increase with age

25
What are the possible castration complications?
-hemorrhage -infection -evisceration -septic peritonitis -penile damage
26
What are the castration-associated infections that can be seen in horses?
-scirrhous cord -champignon caused by Strep.
27
How are castration-associated infections treated in horses?
-open incisions and provide antibiotics -re-operate to remove infection
28
What are the steps to handling a post-castration evisceration?
-lavage if possible -close the incisions -refer to a surgeon
29
What are the characteristics of cryptorchidism?
-non-descended teste -can be inguinal or abdominal -75% of left crypts are abdominal -42% of right crypts are abdominal -teste location determined through palpation and percutaneous ultrasound
30
What are the steps for castration of an inguinal cryptorchid via an inguinal approach?
-dorsal recumbency -incision over inguinal ring -blunt dissection to scrotal ligament -incise vaginal process and remove teste -close incision
31
What are the other possible approaches for an inguinal cryptorchid?
-parainguinal -paramedian
32
What are the possible approaches for castration of an abdominal cryptorchid?
*flank -standing sedation *ventral abdominal -dorsal recumbency -trendelenburg -gives option to move to inguinal
33
What are the characteristics of inguinal hernias in foals?
-congenital -typically reducible and resolve with medical management -rarely strangulating
34
What are the characteristics of inguinal hernias in adult stallions?
-commonly results in small intestine strangulation -considered an emergency
35
What are the medical management steps for inguinal hernia?
-reduce hernia -pack cotton into inguinal canals -secure cotton in place with elastikon
36
What are the surgical management steps for inguinal hernia?
-place animal in dorsal recumbency -inguinal approach +/- abdominal approach -can castrate at same time -suture or partially suture inguinal canal
37
What are possible reasons to perform posthetomy/phallectomy?
*paraphimosis: -reduce edema, replace in prepuce, and provide support -can progress to surgery as needed *neoplasia: -check lymph nodes -perform rectal exam *habronemiasis: -larval migration
38
What are the characteristics of segmental posthetomy?
-known as reefing -resection of a circumferential segment of the internal preputial lamina -done in standing or dorsal recumbency
39
What are the characteristics of partial phallectomy approaches?
*dorsal recumbency: -most common -incisions are closed *standing -new urethral opening -band distal end of penis -cheaper -higher risk of stricture and infection
40
What are the indications for ovariectomy?
-aggressive behavior -excitable -excessive signs of heat -pathologic ovary
41
What are the approaches for ovariectomy?
*open flank: -less favorable now that laparoscopy is common *colpotomy: -cost effective -higher risk -done with an e'craseur *flank laparoscopic: -gold standard -minimizes risk -good visualization of pedicle/ovary
42
What are the pre-op steps prior to laparoscopic ovariectomy?
-hold off food for 24 to 36 hours to de-bulk GI contents -perform rectal exam/ultrasound -possible hormone panel -basic blood work -broad spectrum antibiotics, NSAIDs, tetanus if needed
43
What are the characteristics of laparoscopic ovariectomy post-op?
-quick recovery -discharge day after surgery -NSAIDs +/- antibiotics -can return to exercise in 3 to 4 weeks -good cosmetics -90% show improvement in unwanted behavior
44
What are the characteristics of post-operative estrus?
-horses are only species that can show signs of estrus post-ovariectomy -occurs in 30% of ovariectomized mares -mild signs -may be due to lack of progesterone
45
What can cause urovagina?
-vesicovaginal reflux and urine pooling -excessive closure of caslick -vaginitis -decreased fertility or carrying foals to term
46
What are the characteristics of urethral extension procedure?
-provide epidural -incise tissue layers to create shelf extension -fistulas can occur -good prognosis
47
What are the degrees of perineal laceration due to foaling?
*first degree: -mucosa of vestibule and skin of dorsal commissure of vulva are torn *second degree: -vestibular mucosa and submucosa involved -continues into muscles of perineal body including constrictor vulvae muscle *third degree: -complete disruptions of rectovestibular shelf -tearing of rectum, perineal body, and anal sphincter -opening between rectum and vaginal vestibule
48
What are the repairs done for each degree of perineal laceration?
*first degree: typically no repair needed *second degree: caslick procedure and reconstruction of perineal body *third degree: surgical reconstruction -delayed at least 4 weeks post injury -change diet to ensure soft but not watery manure -standing sedation
49
What are the characteristics of cervical laceration?
-occurs due to foaling -causes failure to conceive, endometritis, early fetal abortion, and persistent infertility -surgery needed if 50%+ of cervix is involved -surgery only done in diestrus -minimum of 3 to 4 weeks post-partum -postpone breeding until 30-45 days post-op -60 to 70% success rate
50
What are the characteristics of uterine cysts?
-seen in older mares -can complicate pregnancy diagnosis -can interfere with conceptus mobility and placentation -can lead to decreased fertility
51
What are the characteristics of laser ablation with endoscope as a treatment for uterine cysts?
-standing sedated procedure -lavage uterus 2 to 3 days post-op -provide antibiotics -typically do not recur -73-96% successful
52
What are the characteristics of dystocia and c-section?
-must make c-section decision quickly to have a chance at a live foal -60+ minutes of dystocia typically results in dead foal -c-section has 84% mare survival rate, 35% foal survival rate
FA3 Reproduction
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