Minimally invasive, compartmentalized, modified open castration technique with primary closure in equids

A scoping review on intraoperative and postoperative surgical castration complications in domesticated equids

BACKGROUND

Castration is the most common surgical procedure in domesticated equids; surgical techniques used and perioperative management vary considerably.

OBJECTIVES

To identify and chart the current evidence on perioperative complications associated with different methods of surgical castration in domesticated equids.

STUDY DESIGN

Joanna Briggs Institute systematic scoping review.

METHOD

CAB Abstracts, Medline and Embase databases were searched using terms related to equine castration complications. Two authors independently and blindly screened publications against eligibility criteria. Data on study methods, perioperative management, surgical techniques, and perioperative complications were extracted. Surgical techniques were grouped into categories depending on technique; open, closed or half-closed, and whether the parietal tunic was open or closed at the end of surgery.

RESULTS

The search identified 1871 publications; 71 studies met the final inclusion criteria. The data reported 76 734 castrations, most of which were open or closed, with the vaginal tunic remaining open at the end of surgery. Twenty-five studies reported information regarding surgical techniques and perioperative management, allowing detailed charting and comparisons, of which analgesia and antimicrobial usage varied notably. Eighteen different complications were reported, with swelling or oedema being the most common. Evisceration was most commonly reported in draught breeds and Standardbreds, and the risk appeared low if the parietal tunic was closed at the end of surgery.

MAIN LIMITATIONS

Grey literature and studies not available in English were not included. Existing studies varied greatly in perioperative management, surgical techniques and reporting of outcomes, making evidence consolidation problematic.

CONCLUSION

A lack of consensus regarding complication definitions creates uncertainty and discrepancies between complication rates associated with different surgical techniques and perioperative management. The implementation of standardised systems for describing surgical techniques and complications is recommended for future studies. A number of studies did not follow current recommendations for perioperative analgesia and use of antimicrobials.

A systematic review of the prevalence of post-operative complications after general anaesthesia in adult horses (2000-2023)

BACKGROUND

Equine post-operative morbidity represents a significant concern for both veterinary surgeons and horse owners.

OBJECTIVES

To estimate the prevalence of post-operative complications in horses after elective/non-abdominal surgery or colic surgery.

STUDY DESIGN

Systematic review.

METHODS

A database search identified eligible studies which reported the prevalence of equine post-operative complications published as a full paper in English in a peer-reviewed journal between 2000 and 2023. Studies were evaluated using the JBI Critical Appraisal Checklist for Prevalence Studies and GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. Data for the most commonly reported complications were analysed using Chi-squared analysis of weighted means to answer 13 PICO (Population, Intervention, Comparator and Outcomes) questions.

RESULTS

Sixty-seven studies met inclusion criteria. Data for eight post-operative morbidities (colic, surgical site complications, myopathy/neuropathy, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis, respiratory complications) were sufficient to allow statistical analyses. The weighted mean of the overall proportion of post-operative complications after elective/non-abdominal surgery is 17.48% (95% confidence interval [95% CI]: 13.20-22.92), significantly increasing to 55.62% (95% CI: 45.79-65.03) after colic surgery (odds ratio [OR] 6.63; 95% CI: 5.83-7.56; p < 0.001). The most commonly reported morbidity was post-operative colic, with a weighted mean prevalence of 7.45% (95% CI: 4.83-11.76) after elective/non-abdominal surgery, significantly rising to 26.46% (95% CI: 19.11-35.97) after colic surgery (OR 4.11; 95% CI: 3.60-4.71; p < 0.001). The weighted mean prevalence of surgical site complications, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis and respiratory complications were significantly higher after colic surgery compared with elective/non-abdominal surgery. Myopathy/neuropathy was the only morbidity where prevalence was not different between groups (OR 1.86; 95% CI: 0.86-4.16; p = 0.16).

MAIN LIMITATIONS

The majority of studies were retrospective. Morbidity definitions, data collection periods, follow-up time and methods varied between studies.

CONCLUSIONS

Based on current evidence, the prevalence of post-operative colic, surgical site complications, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis and respiratory complications is significantly higher after colic surgery compared with elective/non-abdominal surgery under general anaesthesia.

Early castration in foals: Consequences on physical and behavioural development

BACKGROUND

The impact of very early castration of foals has not yet been studied despite the many positive effects observed in dogs and cats.

OBJECTIVES

The objective of the study was to compare castration at 3 days and 18 months and assess their subsequent morphological and behavioural development.

STUDY DESIGN

This was a randomised, blinded clinical study.

METHODS

Twenty-two Welsh ponies underwent either early (3-day old, EC group, n = 11) or traditional (18-month old, TC group, n = 11) castration. Animals were followed up to 3 years of age. All ponies were castrated using a primary closure technique under general anaesthesia. Weight and morphometric measurements were monitored monthly from birth until 8 months of age in both groups. Then, measurements were taken every 3 months until 2 years of age and then every 6 months until 3 years of age. Temperament tests were performed on all animals when they were 1- and 3-years old.

RESULTS

No differences were observed between the EC and TC groups in terms of physical development from birth until 40 months of age or in terms of temperament and behaviour at either 1 or 3 years of age.

MAIN LIMITATIONS

The study included only one breed (Welsh ponies) and only 22 animals that were castrated before 2 years of age, precluding comparison with castration performed at older ages.

CONCLUSIONS

We demonstrate that early castration at 3 days does not interfere with morphological or behavioural development.

Evaluation of the subcapsular technique for primary closure castration in donkeys (Equus asinus)

This study described the subcapsular technique for primary closure castration in donkeys with special regard to its efficiency and welfare impacts. The study was conducted on twelve adult male donkeys, allocated randomly into two groups; subcapsular castration (SC) and open castration (OC) groups, whether the donkeys were subjected to surgical castration either by subcapsular or open castration techniques, respectively. Testosterone, cortisol, lactate, glucose, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), and nitric oxide (NO) were measured before and after castration. Pain-associated behavioral activities were recorded post-castration. The SC was successfully performed in donkeys through a single paramedian scrotal incision. The SC was efficient as OC in reducing testosterone levels. The pain score decreased in the SC compared to the OC over time. The SC was an efficient and reliable technique for primary closure castration in donkeys with minimal postoperative complications and care and good cosmetic, physiological, and behavioral outcomes. It can be an alternative to other castration techniques in equines.