July 1, 2020

From rare complication to remarkable recovery

This is the remarkable story of Jaxon’s recovery from a rare castration complication, as told by Vet Dr Marcus Allan.

In early July 2018 Jaxon was castrated. This is a routine common procedure in veterinary practice, however in this case Jaxon had one retained testicle. This required laparoscopic (key hole surgery with camera) assistance for the testicle to be retrieved and removed.

The procedure went swimmingly and Jaxon recovered well. He was discharged home and progressed as expected without problem.

A few days later the owner noticed the horse appeared uncomfortable and was rolling as though he had colic. Something was noticed protruding from the castration wound (from normal descended teste surgical site). On closer inspection it was noticed to be a loop of intestine. The owner phoned the primary vet who then arranged for us (due to proximity to the client) to immediately attend to the horse.

Intestines protruding from wound on arrival

Intestines protruding from wound on arrival

By the time we arrived many more loops of intestine were protruding from the wound. Due to the contractile nature of the intestines they forced themselves out of the hole quickly.

Immediate action was required which involved anaesthatising the horse to facilitate treatment. Once the intestines were managed the wound was temporarily sutured and clamped closed. Doses of antibiotics and pain relief were administered. The horse was recovered from anaesthesia and once steady on his feet he was loaded into the truck and transported to an equine hospital for emergency abdominal surgery.

The surgery went well and he recovered uneventfully. The prognosis was still guarded as there was a high risk of him developing a severe infection within the abdomen. Over the following few days he didn’t show any adverse signs so was then discharged home.

Over the next few weeks regular revisits showed he progressed really well. He did develop subcutaneous fluid build up under the chest and abdomen and a subcutaneous abscess around the scrotum and this was managed by opening and flushing the abscess and then leaving it open for drainage. Luckily for him it did not track into the abdominal cavity. Large abdominal bandages were applied to support his surgical wounds.

He then progressively improved to the point where he made a complete recovery. He is now back to his normal self doing normal horse things at his loving home.

This case highlights a recovery from a rare castration complication with a guarded-poor prognosis. This was facilitated by the owner’s dedication to their horse’s welfare and care, and the effect of prompt veterinary care in the field to stabilize a true emergency situation.

In a recent UK article published on equine castration complications, eventration of any type of abdominal tissue was reported to have an incidence of 1%. Intestinal eventration is reported in the literature to have an incidence of 0.2%.

Temporary wound closure after replacement of intestines

Post emergency surgery at equine hospital.