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CASTRATION IN THE SMALL ANIMAL PATIENT
Overview
Castration in small animal patients may be performed on a routine basis for population control and behavior modification or may be performed for disease control or treatment. Intact (non-castrated) pets that reproduce in an unregulated manner may lead to companion animal overpopulation. Overpopulation is a huge problem in most municipalities across the country- recognized by crowded humane animal shelters and rescue organizations. Specific recommendations for castration associated disease control or treatment include patients suffering from cryptorchidism, testicular hypoplasia/atrophy, orchitis/epididymitis (infection), severe testicular trauma, testicular/epididymal neoplasia (cancer), testicular torsion, perineal hernia, underlying urinary tract disease (urethral calculi) and prostatic diseases.
Incidence and Prevalence
It is our recommendation that all animals should be neutered, unless they are part of an organized breeding program. Overpopulation of companion animals must be avoided to prevent overcrowding of humane animal shelters and rescue organizations.
Signs and Symptoms
Patients presenting for routine castration for population control or behavioral modification will not demonstrate any clinical signs. However, animals with disease processes involving the testicles and/or epididymis may demonstrate clinical signs relating to the underlying disease process. Patients suffering from cryptorchid testicles may demonstrate an abdominal mass on physical examination, which may cause clinical signs such as nausea, pain, anorexia, weight loss, vomiting, diarrhea, hair loss, mammary gland enlargement and sexual attraction by other male dogs. Clinical signs for testicular hypoplasia/atrophy will typically be absent unless there is an unsuppressed action of a cell type within the testicle, which may cause hair loss, mammary gland enlargement and male dog attraction. Infection of the testicle and epididymis (orchitis/epididymitis) will typically show signs of testicular pain, scrotal swelling, depression, lethargy, fever and anorexia. Testicular trauma may demonstrate signs of scrotal swelling and discoloration, pain, hemorrhage and systemic signs of shock. Tumors of the testicles and epididymis will typically demonstrate enlargement of one or both testicles, pain, hair loss, mammary gland enlargement and attraction of male dogs. Patients with testicular torsion will show clinical signs of acute pain, testicular swelling and depression. Signs associated with perineal hernias consist of swelling adjacent to the rectum, constipation, straining to defecate, and the potential for straining during urination. Signs associated with urethral calculi include straining to urinate, difficulty or inability to urinate, discolored urine, abdominal pain, lethargy, depression and lack of appetite. Prostatic diseases will typically lead to enlargement of the prostate, which may cause constipation, straining to defecate, abdominal pain, straining to urinate and discoloration of the urine.
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Testicular Tumor
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Risk Factors
Risk factors for developing testicular and/or epididymal diseases include being an intact male canine with advanced age. For urinary calculi, see the discussion for bladder stones.
When to Seek Veterinary Surgical Advice
One should seek veterinary surgical consultation when a patient demonstrates scrotal swelling coupled with any clinical signs mentioned above. In addition, consultation should be sought after if there are signs associated with lower urinary tract disease and castration must be performed to help treat the underlying disease. Find an ACVS Veterinary Surgeon
Exam, Screening Tests and Imaging
Once the patient has been diagnosed with a suspected testicular and/or epididymal disease process, a full metabolic work-up is initiated. A complete blood count, biochemical profile and urinalysis are performed to determine any evidence of concurrent illnesses or the effect of the testicular disease on bone marrow function. Abdominal and thoracic radiographs are indicated if there is suspicion of a neoplastic (cancer) process in the patient. Ultrasonography may be useful to help determine the underlying disease process and its effects on adjacent abdominal organs. All patients with suspected infection of the testicle or epididymis must undergo culture of the urine and the diseased tissue, along with performing blood tests for Brucella canis, which is an important and potentially infectious disease of dogs and humans. Patients with any testicular or epididymal disease should have the tissues submitted for histological analysis to determine the underlying disease process and to direct future therapy. Young, healthy patients presenting for routine elective castration need only a preliminary screening blood work.
Differential Diagnoses
Testicular enlargement may be due to trauma, torsion (twisting), infection, and neoplasia. A testicle may also seem enlarged when the second testicle is smaller (hypoplasia/atrophy) than the suspected enlarged testicle
Complications Caused by the Disease
Depending on the testicular disease process, a patient may experience pain, infection, fever, dermatological (skin) disease, sexual side effects (mammary gland enlargement, attraction of male dogs), metastasis from a primary tumor and bone marrow suppression.
Treatment Options
There are two classical methods for surgical castration. They consist of either an open or closed technique. The decision for either technique is based on surgeon preference. Scrotal ablation (scrotum removal) may be discussed by the attending surgeon at the time of consultation. Reasons for scrotal ablation would include the presence of a large, pendulous scrotum at the time of castration or for the treatment of the primary disease (trauma, urethral calculi removal/relief of obstruction and neoplasia).
Potential Complications Following Treatment
Castration in the small animal patient is not without complications. Complications from surgery and not the underlying disease process include scrotal bruising, hemorrhage, infection, and wound dehiscence. Most complications may be controlled by proper post-operative care for the patient after discharge from the hospital.
Aftercare
Aftercare for the patient will consist of controlled leash walks for two weeks. Cold compresses and oral analgesics, such as non-steroidal anti-inflammatory drugs may be recommended, depending on the clinical picture. Surgical sutures are removed in 10-14 days after surgery. Some patients may be irritated by the surgical wound, thus necessitating the use of an Elizabethan collar.
Prognosis
Excellent for a routine, elective castration.
Prevention
Prevention of testicular or epididymal diseases are preventable by early castration.
—Roy Barnes, DVM
Diplomate ACVS, Small Animal Surgery
Posted 8/13/2004
Updated 9/08/2008 by Dr. Barnes
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