Castration Complications: The First 24 Hours After Gelding are Critical

Chubby Poco Chick should have been castrated while he was still a weanling or even a yearling, but life kept getting in the way. At age three, our Quarter Horse colt was good-natured and docile, but we aren’t breeders, and he wasn't breeding material. We knew just enough to wait for good weather--not too hot, not too cold--to schedule an appointment with our veterinarian to have him castrated. Chubby was castrated while standing up, which turned out to be fortuitous, and we took him home. The next morning we were horrified to discover something long and bloody hanging from his castration site.

A quick call to our veterinarian, Chuck Woodall, DVM, president of Aspen Ridge Equine Hospital in Monument, Colo., and we were loading Chubby into the trailer for the hourlong trip back to the equine clinic. According to Woodall, about 25% of castration patients encounter complications, and, of that number, about 1% end up with Chubby's condition: omental eventration, which is protrusion of the fatty yellow tissue that surrounds some of the abdominal organs through the incision site.

Need to Know
Castration is one of the most common surgical procedures that equine veterinarians perform day in and day out. Although the procedure is relatively simple, it does come with a high amount of complications.

Become an informed horse owner. You should know what to ask and how to provide follow-up care for your newly castrated horse. The following are some questions you should ask your veterinarian and the information you need to know to help your gelding’s recovery process go smoothly:

At what age should I castrate my horse? While both testes should be fully descended before castration, sometimes a younger horse's testes can be difficult to palpate. Ask your vet to verify if the testes have descended. A young colt whose testes have not fully descended into the scrotum is called a cryptorchid. Your veterinarian probably will want to wait until the colt’s testes come down (descend through the inguinal ring, an opening deep within the groin area for passage of the spermatic cord, which provides blood and nerve supply to the testicles) before proceeding; however, it is possible that if a testicle is retained in the inguinal canal or abdomen in a young colt, it might not descend into the scrotum. Stallions with one or two testes that have never descended can still be castrated, but the surgery is more complicated.

"We don't tend to do a lot of early castrations in horses as we do with small animals," said Gary Baxter, VMD, MS, Dipl. ACVS, professor of surgery at Colorado State University. He explains that veterinarians tend to wait until the colts are yearlings before castrating, but controversy with the timing of castration still remains. "There is some thought that if you castrate too soon they don't grow," he says. "There are some, though, that think if you castrate them early they'll grow taller."

What is the best method for my horse? There are two methods of castration: Traditional castration leaves an open incision, and the wound heals on its own, while the other procedure is similar to the castration method used in small animals (castrate and then close the incision site). The veterinarian can use either method, although there is some concern in veterinary circles that if the incision is closed after castration it will lead to an increased likelihood of complications. While that might happen in older stallions, Baxter says, it doesn't necessarily hold true for younger horses.

"It's more of a matter of expense," Baxter says. "It's less expensive to lay them down, castrate them, and then leave the incision open. Either approach is doable in most horses and works well either way."

How will castration change my horse's attitude? One of the more important aspects of castration is that it can transform an unruly and aggressive stallion into a workable and more enjoyable gelding. The changes in older horses generally take time to see, as Baxter says their learned behavior is quite ingrained by the time they are gelded and can be almost impossible to change.

"The older stallion may still retain some of his rank behavior, but it should be to a lesser degree," Baxter says. "But most yearlings will revert to being your typical gelding."

Will my horse be castrated while he stands or will he be recumbent (down) on his side or back? Baxter, as a surgery professor at a teaching university, performs most castration surgeries with the horse in a recumbent position because it's easier to teach his students with the horse situated that way. However, Woodall, who castrates both standing and recumbent horses, chose to castrate Chubby while the horse was sedated and standing. This proved to be the best choice, even though the standing castration position holds more danger to the veterinarian and the assistants. Had Chubby been recumbent, with the ometum tissue as close to the incision site as it was, when he came out of anesthesia he might have flailed around and actually created more damage. Neither approach is universally better than the other; they each have their advantages. Your veterinarian will be able to advise on which will work best for your horse. Regardless of the position of the horse, the surgical principles for the castration are the same.

Does my horse need an up-to-date tetanus shot? It's easier to vaccinate your horse to prevent tetanus than to treat the condition itself. Your veterinarian will make sure your horse has had a tetanus booster or is current on his vaccinations before castration, as the surgical site could conceivably be exposed to tetanus in the horse's surroundings.

What Can Go Wrong
The most common and least dangerous complication to a castrated horse is postoperative swelling, which can occur for several reasons: inadequate wound drainage, inadequate exercise after 24 hours, excessive surgical trauma, or infection. The follow-up care, as directed by your veterinarian, is crucial to your horse's comfort and health. Following castration, exercise, cold water hosing, and administration of non-steroidal anti-inflammatory drugs (NSAIDs) can reduce swelling at the incision site. Swelling can be a painful condition for the horse and might inhibit his ability to exercise; this can cause the wound edges to seal prematurely, compounding any problems and creating a barrier to proper drainage. Follow-up care (after the first 24 hours) usually includes removing the horse from his stall twice a day and exercising him lightly (hand-walking) for 10-20 minutes. If the horse has access to pasture and is willing to exercise himself, Baxter advises owners to turn the horse out. This allows for proper drainage of the wound site and keeps the incision from closing before the horse has had a chance to heal from the inside out.

"Healing from the inside out is essential," Baxter says. "If you take the testicle out, there is a space in there where the testicle was, and if the skin edges on the outside seal over before that area has had time to seal together, then you essentially can trap fluid and infection in the space where the testicle was. That fluid and infection can result in swelling and signs of infection in the scrotal area."

In short, the incision site must drain properly for optimal healing. While Baxter says that cold water therapy is probably good for the horse, he points out that you should avoid getting water in the open incision site, where it could cause infection and wash away blood clots.

"Other than swelling, the most common complication we see is hemorrhaging," Baxter says. Hemorrhage is a sudden and severe loss of blood, either internally or externally, and it can occur during, immediately after, or several days after surgery. Some bleeding is to be expected, but when it doesn't abate after 15 minutes, it's considered excessive and a cause for immediate action--a call to the veterinarian. Baxter explains that a true hemorrhage from the spermatic cord could be life-threatening.

A cryptorchid that retains a part or all of one testicle after castration is often referred to as "proud-cut." This can happen because a testicle was not fully descended into the scrotum at the time of castration and, thus, wasn’t removed. Proud-cut horses might be fertile, although the higher body temperature’s effect on sperm within the retained testes probably will make him infertile. The biggest problem is he will probably continue to show stallionlike behavior because the testosterone-producing cells of the testis are not affected by body temperature. Surgery would be required to remove the remaining testicle.

The most dangerous of all the castration complications is eventration (also referred to as evisceration). In this scenario, something inside the abdomen, such as the intestines or omentum tissue, pushes through the incision site. The first 24 hours post-castration is critical, says Baxter, who notes that if something is going to come out of the incision site, this would be the most likely time, although the problem also can occur after the first 24 hours. Anything hanging from the site is cause for an immediate call to your veterinarian.

"If you see anything at all from the site, confine the horse immediately," Baxter says. "Keep the horse quiet to keep any more from coming out, call your veterinarian, and watch for hemorrhage."

When Woodall saw the tissue hanging from Chubby's incision site, it was a first in his more-than-20-year career as an equine veterinarian. "In general, this happens less than 1% of the time," Woodall says. "But it is one of the complications that can happen."

We had two choices in treating Chubby's eventration of the omentum—have Woodall cut off the tissue, add packing, and close up the wound, or have him perform surgery. We chose the first and least expensive option with detailed follow-up care instructions.

Eventration of the omentum is less dangerous than eventration of the intestines, less expensive, and can be treated while the horse is standing.

Other Problems
Funiculitis This complication refers to infection of the spermatic cord and usually takes time to develop.

"This usually develops later on; weeks to months later you get swelling again, and it means that an infection has developed," Baxter says. "Sometimes you can correct this with antibiotics, but if it becomes a low-grade infection, it may require surgery to remove that section of the spermatic cord."

Hydrocele This condition occurs when there is an accumulation of fluid within the vaginal tunics (which surround the testes), and it can appear months after the castration. It is possible that the condition is a result of a vaginal tunic that was not surgically removed. The condition appears as fluid-filled enlargement of the scrotum, and treatment is usually only called for when the swelling interferes with function. Of course, your veterinarian should be alerted to the condition to discern how it affects your horse and what should be done.

Penile damage This is a rare complication that is usually due to the improper use of the scalpel blade during castration, but it also can occur as a secondary complication to excessive swelling.

Take-Home Message
Even though complications can arise from castration, it is still imperative that the majority of colts and stallions be castrated. This can prevent accidental breeding, eliminate many dangerous stallionlike behaviors, and allow you to house horses together more easily.

Baxter adds, "Another thing that we probably don’t think about or get into enough is that by castrating we can prevent genetic problems from persisting in certain breeds."

Chubby came out of his ordeal safe and sound and none the worse for wear, but in the process I learned that most veterinarians agree that when horses are gelded earlier, the testicles are smaller, and there is much less chance of hemorrhage and other complications.

About the Author

MaryAnna Clemons

MaryAnna Clemons, is the editor of the Women’s Pro Rodeo Sports News and a freelance journalist. She enjoys specializing in Western and equine writing. You can visit her Web site at

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