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  Discussion on Experience with sutured/"closed" castration
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Member:
ekaufman

Posted on Monday, Mar 3, 2008 - 4:58 pm:

I helped a friend/client take a 3 year-old colt for castration at CSU this morning. Dr. Baxter at CSU is now a proponent of a procedure where they ligate the cord and suture the incision. He calls it a "closed" castration, though I think he was using lay-person terminology, since that term typically refers to something else with castration. The procedure is performed in a sterile environment, so the risk of infection/excess drainage is apparently low. Has anyone had experience with this procedure? Dr. Baxter feels that this approach virtually eliminates the risk of post-op evisceration. It seems that it would also greatly reduce fly problems, and allow for "off season" castration. It isn't a field procedure, but seemed awfully interesting if a horse will be hospitalized.
Moderator:
DrO

Posted on Tuesday, Mar 4, 2008 - 7:42 am:

Done under sterile field conditions this might be a way to go. Though I suspect complication rate might be the same, you do avoid the serious complication of evisceration through an open incision. I have had to reopen a closed castration that was done in the field to remove a sclerotic cord.

On the other hand, I have to say after hundreds and hundreds of castrations, I have never had a serious complication from a castration. All right there was that foal with the abnormal testicular architecture I had to lay back down to stop a bleeder and there was the veterinarian's horse where he did not follow instructions so we had to lay it down cut out a sclerotic cord...but two serious complications in hundreds of castrations is not bad.

I think for many this might be a issue of cost. I do a castration, including anesthetic, for around 200 dollars. What does the sterile field procedure cost?
DrO
Member:
paardex

Posted on Tuesday, Mar 4, 2008 - 8:43 am:

I will send them to you Dr O!
Closed castration especially when the horses are a little bit older is common in Holland[lots of insurances demand it] Normally we were very content with the result the horse comes back from the clinic usually in two or three days and for the owner it is easy no coldhosing handwalking etc. They arrive back 'ready for pasture' [if they do not exaggerate]. On the other hand with the 'old' field method we only once had a problem due to a 'hernia[?]' and in that case we lost the horse. Vet said if he had been in a hospital he could have been saved[all the intestines got out?]
So we have the new method more due to assurances then discontent with older methods.
Jos
PS 'Oldfashioned methods' cost around 400 to 800 euro, new method between 800 and 2500 euro just differs with the clinic.
Member:
ekaufman

Posted on Tuesday, Mar 4, 2008 - 10:11 am:

Hi Dr. O, thanks for the feedback!

In my area, it is virtually impossible to get a vet to do a field castration on an adult horse. So those who wait past about 2 years-old will need to take them in to CSU (or Littleton Large, or somewhere).

Dr. Baxter says that the difference between the "closed" and the regular castration at CSU is $200-$400, depending on time on the table. If they pass the hour limit, the anesthesia team will switch to gas, which explains the range. So that is the difference between the tradition in-hospital procedure and this new one.

CSU recommends an overnight stay post-surgery, and my friend chose to bring her horse a night early (she didn't have the heart to fast him at home), so her estimate ($900) included 2 nights and some dental work, and was well over the bare bones surgery. I suspect that with no overnight stays you could get out of there on the closed surgery for $500-$600, but that's a guess.

My own perspective was that I will likely continue to geld babies at home prior to weaning, but would choose this procedure for an older horse, since it does seem to provide a greatly reduced risk of the scariest complication (evisceration).
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