CPD Article | EQUINE
Small intestinal eventration usually occurs within 4
hours of castration, although it can occur as late as 12
days post-surgically. Signs of severe colic will follow
due to strangulation of the intestine. The eviscerated
intestine should be preserved from trauma by applying
a large cloth or towel in sling-like fashion (like a nappy).
(If only a small piece of the intestine is protruding, it can
be cleaned and placed into the scrotum, after which
the incision is sutured closed as a temporary measure
to prevent trauma to the intestine). 1,3,10 These patients
should receive broad spectrum antibiotic cover and
referred to a surgical facility immediately. 3 Survival
rates after surgical intervention ranges from 36-87% 3 ,
depending on the amount of intestine involved, the
viability of the intestine or resection thereof, and the
duration of the strangulation. 11 Standard midline colic
surgery (versus inguinal approach only) also increases
the chances of survival, as this allows for proper
evaluation and resection/anastomosis if needed. 12
Preputial and Scrotal Oedema
Scrotal and preputial swelling occurs after nearly
every castration. Making a large scrotal incision or
removing a large portion of the scrotum will increase
post-operative drainage which will decrease the
swelling, as will post-operative exercise from 24 hours
after the surgery. 1,10 A wound which seal too quickly
should be opened using a sterile instrument (e.g. large
curved artery forceps) or gloved fingers to establish
adequate drainage. Occasionally it might be necessary
to enlarge the incision to ensure continued drainage.
Strict asepsis should be adhered to which will decrease
the chance of iatrogenic infection. Exercise and the
administration of NSAIDs should also be part of the
treatment regime. 1,6,10 Although hydrotherapy with cold
water hosing on the scrotum is a well-established part
of post castration management, it has been associated
with increased swelling. 6 Continued swelling despite
adequate drainage and exercise should alert the
clinician to the presence of infection. 1
Surgical Site Infection
Surgical site infection may become apparent days to
years after castrations. It can be caused by a dirty
instrument, break in aseptic surgical technique during
the procedure or post-operative contamination.
Inadequate drainage and ligatures will also predispose
to infection. 1,3,10
The clinical signs of infection include excessive swelling,
pyrexia, hind limb lameness, pain on palpation and a
purulent discharge. Treatment consists of providing
adequate drainage, exercise, NSAIDs and antimicrobial
therapy. 1,3,10 Septic funiculitis may be caused by
extension of a scrotal infection, inadequate drainage or
dirty instruments. It is associated with open castrations
where the parietal tunic and cremaster muscle are
not removed, and with the use of a ligature. 1,3,10
Scirrhous cord is a chronic septic funiculitis often
caused by Staphylococcus sp. Although the scrotal
wound has healed, the infected stump continues to
enlarge. On palpation a hard longitudinal mass will
be present in and adhering to the scrotum. Treatment
consists of removal of the infected stump under
general anaesthetic. 1,3,10 Excessive granulation tissue
infected by Streptococcus sp., protruding from the
wound that looks like a mushroom, with a purulent
discharge is called champignon (the French word for
“mushroom”). Before the invention of the emasculator
that crushes and cuts the cord, ligatures were used to
control haemorrhage. These formed a nidus for the
streptococcal infection. Since the use of these ligatures
were discontinued, this form of septic funiculitis
has become virtually historical. 3,10 In rare cases, the
infection may also extend into the peritoneal cavity
to form an inguinal abscess. Clinical signs includes
pyrexia, weight loss and oedema. The mass will be
palpable on rectal examination. These cases are very
difficult to treat and are often euthanized. 8
• Volume 20 Issue 2 | July 2018 •
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