By Jenny
Kelly, DVM
During
my surgical residency I acquired a few ‘historical’ veterinary text books from
book sales at the library. These books are from the early 1900s and it is
amazing to read through them and realize the knowledge base of veterinarians
from 100 years ago. In some aspects it seems they knew as much as we do today.
In other areas we are decades apart, as we should be.
One
area where there is a vast difference between then and now is in the area of
pain management/analgesia. There are entire books written on the topic of ‘Pain
Management and Anesthesia’. Times have changed! At most of the large veterinary
conferences there are lectures on pain management including different methods
to treat or relieve pain, newer medications, and prophylactic pain management.
An article from 2006 (Compendium: Equine Edition) entitled: “Pain: The Fourth
Vital Sign?” discussed pain in equine patients. An important aspect highlighted
in the article was: “Alleviation of pain can improve the speed and quality of
recovery after surgery or a traumatic event.”
This
current emphasis on pain management has modified some aspects of veterinary
medicine. When managing cases, veterinarians may use more than one type of pain
medication on patients whether it is a chronic case or a horse recovering from
surgery. Of course, as with all professions, veterinary medicine is no
exception, there are different opinions, as well as different options, when it
comes to managing pain in horses. Equine castrations are one area where the
profession has seen dramatic changes in the past century.
I
was recently given a gift – a drawing depicting a horse prepared for
castration: the horse is cast, blind-folded, and hobbled. This drawing is an
historical depiction – a collectable, and it highlights how far we’ve come in
the past 100 years. As the drawing I received eloquently illustrated, in the
early 1900’s, physical restraint was all that was used when castrating horses.
There was no sedation, no local anesthetic, no general anesthesia and certainly
no pain relieving medications used. In theory, our evolution from pure physical
restraint while castrating horses, to general anesthesia combined with
appropriate pain relieving medications is due to the elevation of the horse
from our working companion, to a pet and family member. Today, not all horses
are exclusively members of our family, as there are still some horses that are
considered part of a business. However, continuing to discuss the position of
the horse in our society keeps me from the true point of this article; the
topic of equine castration or “gelding”.
Today
horse owners have many options when deciding on castrating their horse. These
options include castrating the horse on the farm while standing with sedation
and local anesthesia, castrating the horse on the farm under short-acting
general intravenous anesthesia, or referral to a surgical facility for
castration under general inhalant anesthesia in a sterile surgical suite. Some
owners will choose to bring their horse to a surgical facility – older
stallions, potential cryptorchids (retained testicle), and for cases where the
owner requests a more entailed procedure termed ‘scrotal ablation’.
Cryptorchids and scrotal ablations require more extensive surgical procedures
as well as strict sterile technique. Scrotal ablation involves removing the
redundant scrotal skin and tissue during a castration and suturing the incision
closed. The suture material used to close the site is usually absorbable
therefore there are no sutures to remove and minimal post-operative care versus
castrations where the incisions are left open to heal secondarily.
Overall,
castrations performed currently are more humane than they were 100 years ago.
Medications are usually given before the surgery to decrease pain and
inflammation. The procedures are performed using sedation and local anesthesia,
short-acting injectable anesthesia, or under general inhaled anesthesia. As
discussed, there is commonly a combination of ‘pain management’ methods used by
veterinarians to prevent pain during the procedure as well as decrease the
amount of pain post-operatively. This again emphasizes the statement: “Alleviation
of pain can improve the speed and quality of recovery after surgery or a
traumatic event.” … The ultimate goal of veterinarians and owners alike. To
learn more about castration with scrotal ablation in a hospital setting, please
contact Surgi-Care Center for Horses at 813-643-7177 or email lkuebelbeck@surgi-carecenter.com with
any questions regarding this topic.
This article was originally published in Horse & Pony magazine and is reprinted with their permission.