Castration: reducing the risk

Although castration is the most common surgical procedure in equine vet practice worldwide, complication rates remain high. Elise Rodden MRCVS explains how the veterinary profession hopes to address this issue

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CASTRATION of horses and donkeys is the most common surgical procedure in equine veterinary practice performed worldwide. However, there is currently widespread variation in how the surgery is performed, and in which medications are given pre- and post-operatively.

Castration does not come without risks and although most complications reported for this routine procedure are mild, when complications do occur, some are serious and can even be fatal.

Currently, no two research studies use the same system to categorise complications, and no two research papers have focused on the exact same surgical technique or have the same perioperative management. This highlights just how many factors may have influence on various complications that can arise.

There is a vast variation used by various vets in the different methods to geld or castrate a horse, presumably because no one protocol is perfect.

Certainly, different options are available depending on the clinician's choice and the exact circumstances. For instance, castration can be performed standing or under general anaesthesia (GA), in a hospital setting or on yards, placing sutures or not, using local anaesthetic or not, or leaving the skin incisions open or closing them.

WHAT CAN GO WRONG?

A RECENT review performed on this topic by this author found 17 different reported complications following castration procedures.

Among the less concerning complications are those that cause no distress to the horse but are a concern for the owner, such as swelling or continued undesirable behaviour, and mild complications that resolve with minimal intervention (oedema or localised infection).

More seriously, severe and life-threatening complications such as bleeding, prolapsed gut or abdominal infection/ inflammation can occur.

Despite castration being a routine surgical procedure, mortality rates are reported up to 1%.