Equine and Camelid Castration

Postoperative care for equine castration

Thinking about the processes needed for normal healing and to prevent the common complications, what postoperative care recommendations would you give to your clients?

  • Medications:
  • Exercise:
  • Nutrition:
  • Other therapies:
  • Monitoring:
  • Call if:

Common questions

How long should a horse be stall rested after castration?

We typically put them in a stall for 12-24 hours. This has no real scientific background but is most likely related to avoiding eventration and letting any bleeding subside. It would also minimize heat stress and undue activity due to pasture mates. It also allows them to be observed more closely for any potential complications from the procedure or anesthesia. 

How long are pain medications indicated? Antibiotics?

Inflammation usually lasts at least 3 days after minor surgery. It is good animal care to provide freedom from pain. Older practitioners will report that we don’t want horses to “overdo” it so they avoid NSAIDs. On the other hand, people used to “break” horses right after castration as they were more amenable (ie in pain and sedated). Neither version seems reasonable these days but old habits die hard. 

The ideal for antibiotic coverage is to have high levels at the time of surgery in case things go wrong.  If all goes well, continued antibiotics are typically not needed for castrations. Drainage is better than antibiotics at resolving any infection. Antibiotics are considered when the animal shows systemic signs (eg fever) despite adequate drainage. 

When after castration does the stallion-like behavior goes away? Fertility?

Residual testosterone effects can last 6 weeks. Fertility should diminish sooner. Some stallions retain stallion-like behavior despite gelding-like testosterone levels. Another old wives tale is that these stallions are “proud-cut” and the “squealer” was left behind. In other words, the epididymis was left behind. The testicle is what makes testosterone and “squealing” in intact stallions, not the epididymis. And it is actually hard to leave the epididymis behind unless the horse is a cryptorchid. In those horses, the epididymis is often loosely attached to the testicle and may be the thing removed. Leaving the testicle behind will definitely encourage them to retain stallion like behavior. 

When should they call you about swelling, hemorrhage, things coming out?

This is a great time to come up with your favorite food or sports ball references. “Orange” sized swelling is generally okay. Bigger often indicates that the incisions have sealed shut (via fibrin tags) and will need to be reopened by a veterinarian. Hemorrhage that is a drip is ok, not a spurt or a stream. Things coming out may be fat (okay), tunic (okay), omentum that is attached to intestines or intestines (really bad). Images may or may not help with “things coming out” and an emergency visit is advised. 

How is swelling managed?

Exercise is key to minimize swelling. Even after the horse is turned out, it is important to give them at least 20 minutes of forced exercise (hand walking) per day, following surgery. Swelling is common as the area has been traumatized and is ventral. With exercise, lymphatic flow is improved and the edema removed. NSAIDs and cold water hosing can also help. If the swelling is significant, the edges of the incision tend to seal back together, trapping in bacteria. To reopen the incision, just pull the fibrin seal apart with digital manipulation. Do NOT take a scalpel blade back in there. It isn’t needed. 

Exercises

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Key Takeaways

Drainage is key for postoperative management of the surgery site. To have adequate drainage, you need large holes and minimal swelling. To get minimal swelling horses need to exercise. Horses without pain relief will not exercise well. NSAIDs help them exercise and help with swelling. Horses should get about 3 days of NSAIDs postoperatively. One day of stall rest if often recommended but isn’t required.

If the drainage stops too soon, an infection is likely to develop. Drainage needs to happen. Generally recreating drainage just means using a gloved finger (with the horse sedated and twitched) to open the fibrin seal. Antibiotics are used only if the horse still has a fever after drainage.

Arterial bleeding, large swelling and things hanging out need veterinary attention. Large swelling is important, the others can be life threatening and need immediate attention.

It takes awhile for the horse to become infertile and to lose the mounting behavior of stallions. Keep him away from mares for about 6 weeks. Proud cut is not a thing.

RESOURCES

Equine Castration Complications Reviewed, The Horse 2013

Castration in the Horse, The Horse 2001 (but still really good)

License

Icon for the Creative Commons Attribution-NonCommercial 4.0 International License

Large Animal Surgery - Supplemental Notes by Erin Malone, DVM, PhD; Elaine Norton, DVM PhD; Erica Dobbs, DVM; and Ashley Ezzo, DVM is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.