As a follow-up to last month’s column about the condition of cryptorchidism in young stallions, this month we will look at your options for treatment. The saying goes that sometimes the cure can be worse than the disease, but I would say the opposite is the case for cryptorchidism. You may not have had the opportunity within the last month to experience the hormonal baggage that comes with this condition, but I have, so trust me. There is no stallion more deserving of a surgical remedy than a cryptorchid stallion.
The short course review on cryptorchid stallion diagnostics is either they are or they are not. It’s like being pregnant or having an annoying personality — it’s a yes or no question, and the more time you spend agonizing over the facts, the less time you will have to enjoy life. So, either you were able to make this assessment quite easily by yourself or your veterinarian had to do some testing to confirm your suspicions.
Having completed the comparatively boring medical side of the equation, we can move on to the decidedly more fun aspect of surgical solutions. To have a base of comparison, we should first establish some general guidelines and expectations for routine castrations — the run-of-the-mill kind, where within a matter of 30 minutes you have increased both the value and life expectancy of your stud colt by transforming him into a gelding.
As you read this, allow for some variance in cost and technique based on your location. As far as I am concerned, I tell folks to plan on a few hundred dollars, a few days off of riding and a half-hour of catching up on social media while their new gelding sleeps off the anesthesia. Sure, there are always exceptions. Some colts I’d just as soon wake up with a saddle on so you can use your short-term advantage in training time, but most need a few days of turnout to run around and decrease postoperative swelling, which is normal.
Cryptorchid castrations, on the other hand (or hoof, as it may be), can be markedly different. First off is the cost of the surgery. Where a routine castration done standing or under general anesthesia may cost only a few hundred dollars, a cryptorchid surgery will be closer to $1,000 or more, depending on your approach and conditions. The driving factor here is the length of general anesthesia time for the longer, more complicated surgery and the associated procedural needs based on having to enter the colt’s abdomen to retrieve the cryptorchid testicle. Sterility is a primary concern in any surgery, but it is even more so here.
Hospitalization costs must be included here, as well. Most routine castrations haul in and out the same day or are done on the farm; however, we only do cryptorchid stallions in our surgery room at the hospital. Postoperatively, we tell folks to expect two to three days in the hospital so we can monitor their attitude and appetite, pain level and swelling, and maintain constant antibiotic levels. We will take them out for a little hand-walking each day and do some grazing, as well, while they are hospitalized. The time before they can return to work is considerably longer than routine castrations due to the surgical technique.
The technique each surgeon uses is based solely on his or her comfort level with the procedures, not so much on the location of the retained testicle. The lion’s share of cryptorchid testicles are removed through a para-inguinal approach. With the colt positioned on his back, the surgeon makes a skin incision over the location where the testicle exits through the abdominal wall and inguinal ring toward the scrotum. There is a small, delicate piece of tissue called the inguinal extension of the gubernaculum that is used to trace your way back to the inguinal ring or completely into the abdomen to locate the troublemaking retained testicle. Once ALL of the testicular structures are located, then it can be double ligated and surgically removed. Having physically disturbed the inguinal ring, the surgeon will place several large tension-holding sutures to close the structure so as to prevent the potential of evisceration, which is a very real and catastrophic complication of this procedure. The other descended testicle is removed as a routine castration.
Some surgeons prefer to use a laparoscopic approach for the removal of cryptorchid testicles. This is a great option, especially in bilateral cryptorchidism, because of the direct visualization of the retained testicles and decrease in soft tissue trauma required to remove both through an inguinal approach. However, the cost and availability of this service tends to limit its use.
Either way, an abdominal surgery is performed. As such, much greater precautions must be taken to ensure a successful surgery. Due to the disruption and surgical closure of the inguinal rings, a minimum of two weeks stall rest with limited exercise is recommended. In some cases, it may be longer, depending on the variability of the horse. Regardless of original location, you will both be happier without your horse’s testicles around.