Where do we stand - Reggie

[dorsetladette]

We've had a truly horrible weekend. We had Reggie booked in for gelding on friday morning. Vet came with an assistant, examined Reggie and confirmed 2 large testicles in place. She said they were on the cusp of being to big to do as a standing sedation. Vet said we could either do the castration there and then or take him into the surgery and have them done there. I said 'I'm happy to do them here if you are?' so Reggie was sedated and the local anaesthetic was administered. As they were larger vet said she would crimp/crush each side twice to make sure it was properly done. After the surgery vet said to keep an eye and if you could no longer count the drips to call the office. She said it would bleed a fair bit as they were larger and that we may get a dump of fluid and then return to the dripping again. And this is exactly what happened. We got pretty heavy dripping but not a flow and every now and then about a mug full would pour out of the wound then drip again. But it didn't slow. 2hrs after vet left we still had the same rate of drips and then the gush and back to dripping pretty quickly. I videoed and sent to the vets then called and asked the vet to watch. She called straight back and td me she was leaving the syrgery and heading straight to us. By the time she arrived we had something fleshy hanging from the wound. She instantly took a photo and called a colleague. Second vet arrived within 10 mins and rushed to help. 2nd vet asked 1st various questions about the castration and then inspected the wound. They decided to packed it with swabs stitch them in cover it with larger swabs and then truss him up to put pressure on it and hold everything in. They then referred him to an equine hospital.

I feel I need to ask what happened, what went wrong as this isn't a normal side effect of gelding.

In the last few months Ive had 2 incorrectly raised invoices, charging me for things that never happened or didn't receive, 2 horrendous visits from a locom vet and now this. Ive always rated my vet practice and the partners are brilliant. Have I had a run of bad luck?

Am I wrong in thinking vet may have bitten off more than they could chew with Reggies castration?

 

[tristar]

oh dear, how old is reggie?

did they check for hernias?

 

[dorsetladette]

oh dear, how old is reggie?

did they check for hernias?

Reggie is 2 in June.

He spent 2 nights under observation in hospital so all checks done now.

 

[Orangehorse]

This was just bad luck I think. She went ahead with the castration with your agreement, but then she reacted very quickly when you said there was a problem. She may have had misgivings, but you can't stop half way through.

 

[Mrs. Jingle]

How worrying for you. Is he completely OK now? I think that it is probably just a one off bad luck thing, and you did get the option to do standing there or take him into be done so not really much you can say to them I would think. Annoying though it is, on top of their lack lustre service with you recently.

I would certainly be asking them exactly what happened and why, not to place any blame but purely for my own peace of mind that there won't be any long term problems associated with it. I think that would be a reasonable thing to ask them and they shouldn't have a problem answering in depth and exactly what any future implications might be.

Not because of this, but because it seems you have generally lost confidence in them I would be looking for another vet practice. I need to have total faith in my vet's ability and professionalism, if I haven't I would be going elsewhere. I really hope he is improving now, poor chap.

 

[Christmascinnamoncookie]

What started poking out?

 

[dorsetladette]

@Mrs. Jingle thank you. I think I need to speak to both the hospital and vets to get a better picture of what happened. Possibly wait a couple of days for me to get my head straight, a Good night's sleep etc.
Reggie is doing well now. Stressing me out throwing himself about like nothing has ever happened.

@Cinnamontoast to start with it looked fleshy, like the inside of the wound. Once 1st vet had a poke about it look more like a hernia about the size of a grapefruit. Once 2nd vet poked around we could only see bright red 'things' hanging down which had the texture of liver. 2nd vet said this was something but I can't for the life of me think what she said. 2nd vet was ace and really took over.

 

[blitznbobs]

How old was first vet?

 

[dorsetladette]

How old was first vet?

Around 30 maybe a bit younger. 2nd vet much more experienced. Ive had 1st vet do lots of thinks previously, teeth, hock injections, jabs etc. She knows Reggie quite well.

 

[blitznbobs]

Around 30 maybe a bit younger. 2nd vet much more experienced. Ive had 1st vet do lots of thinks previously, teeth, hock injections, jabs etc. She knows Reggie quite well.

she was out of her depth - might have only been her first solo. You will never prove this but she should have insisted on taking him to the hospital… but hopefully she has learnt her lesson but doesnt help Reggie tho

 

[ycbm]

I don't understand the too big to do under standing sedation comment. I have had a 4 year old castrated at home and Ludo was done at 2 after serving as a stallion all summer. His balls were pretty big! The vet kept the crushers on for ages deliberately, and in fact he took himself for a walk across the yard, towing us, with them on.

 

[Errin Paddywack]

I have never had a horse gelded standing. A friend's stallion was done standing and she lost him due to prolapse of intestines.
Mine have always been knocked out and done on the ground, usually just the vet and myself there. My 14yr old stallion was done the same way but this time I requested that two vets attend. Never had any problems.

 

[dorsetladette]

@blitznbobs that was my thinking the same in hindsight.

@ycbm not something Ive heard of either. When she first said it i thought she was talking about his height as the practise prefer to do smaller ponies under general. Then the penny dropped.

 

[Equi]

It’s surgery and things can happen, I don’t think the vet has done anything wrong per se. She did give you the option of going to hospital.

 

[honetpot]

I can remember how many I have had or seen castrated standing, I buy colts and usually leave them until they are three. My vet is a vet school, so I have had mine used as experience for students. In the old days they go a local and little else, you just did them when they were smaller because you were pinning them down.
With any surgery there is risk, including anaesthetic risk , including 'normal' complications of surgery,and it sounds as if your vets handled it well.

 

[Palindrome]

she was out of her depth - might have only been her first solo. You will never prove this but she should have insisted on taking him to the hospital… but hopefully she has learnt her lesson but doesnt help Reggie tho

Why should she have insisted? Why do you think she was out of her depth?

As an aside, my vet will only do castration at the clinic as they want the horse in as clean an environment as possible. One breeder thought it was a waste of money so she would use a different vet for castration. This other vet does them in the field and the breeder hasn't had a problem so far.

 

[ycbm]

One of the local peripatetic vet practices makes a lot of money from castrating the colts one of the hospital based practices won't do at home.
.

 

[Nari]

I can't see how any blame attaches to the vet. She explained before she started that he was on the large size and gave you the option of hospital. She did extra during the op to make sure it was done properly. She left you with normal post op instructions and then, when you weren't happy came straight back out and sought a second opinion when she found a complication. They then got him safe to refer to a hospital. Basically she did everything right including explaining to you before she started that this was on the limit of what she washappy with doing standing. No-one is to blame, it's just one of those things. Maybe as gelding is so common we tend to forget it is an op and does carry risks?

 

[tristar]

so glad Reggie is coming through this

i would never have a horse castrated standing, just to say the last colt we had cut, had 2 vets, was done lieing down, had stitches and antibiotics, was kept in for 3 three days, had hardly any blood, leaking etc, and was safely healed in 3 days, no swelling,

the one before that was done in the field, and it was healed over 24 hours, no problems

neither seemed to have huge cuts, both were 2yrs

 

[Christmascinnamoncookie]

Seems to be standard to do standing castrations with the RVC, but it’s usually colts, not adults. Hope Reggie is ok.

 

[scruffyponies]

I had two done at home on the same day. They were 7 and 5 respectively.

The only 'complication' we had is that the 7 year old seemed unsettled by it and now has a life-long hatred of that particular vet and has tried to kick him several times since. Not sure the 5 year old even noticed.
I think either your vet was inexperienced or you were very unlucky. Not sure how you would know which.

Hope Reggie is coming through it OK.

 

[Cortez]

Complications can occur with any surgical procedure, and hernias can prolapse in any age colt - the last one we had that happen to was about 10 months I think. Your vet did exactly the right thing, and your horse has recovered well so that’s great. Standing castration under sedation and open draining are standard practice.

 

[Fransurrey]

This was just bad luck I think. She went ahead with the castration with your agreement, but then she reacted very quickly when you said there was a problem. She may have had misgivings, but you can't stop half way through.

Agree with this. On this occasion it's just bad luck. They responded quickly to the complication and hopefully he's ok, now? Castrations are the bread and butter of younger vets, so I wouldn't put this down to inexperience.

 

[Gamebird]

What you have experienced are normal complications of castration. They don't happen to every horse, but they will happen to some. The castration complication rate is around 20%. That is for experienced vets. I assume your vet went through the list of possible complications, and what to do in each scenario? Complications associated with a 'straightforward' standing castration can range from mild post-op swelling to death. It is not a benign procedure! The risks of doing a horse under GA are just the same, plus the added risks of the GA itself.

It sounds as though your vet did everything in the manner they should have at the time of the operation, and that they responded quickly and properly to the events that happened. I'd be very grateful for them! It happens, even with a perfect procedure, and it will happen to everyone if they have enough horses done. It's how you deal with it that's the important thing.

(vet who has performed hundreds of standing and GA castrations)

 

[sport horse]

I have had many young horses gelded. Some sail through fine, others have minor complications and others more major issues. It is surgery! Good vets to call in extra vet and hospitalisation. as soon as needed

 

[eggs]

My yearlings have always been done under standing castration and apart from one there were no complications. I once had two colts done at the same time, one was absolutely fine but the other one had complications sounding a little like your Reggie in that he bled very heavily and also had tissue poking out of the would. I called the vet back out who was rather concerned but got the bleeding under control. A couple of weeks later he got an infection and had to have a significant amount of fluid drained. He did make a full recovery though.

Unfortunately sometimes it is just one of those things but I am glad to hear that Reggie has recovered.

 

[dorsetladette]

Reggie is doing well now.

I don't feel I need to point blame in any direction, I possibly didn't word my title very well. I was exhausted yesterday and slept for 11hrs straight after writing the OP. I just want to get to the bottom of what happened. I'm not a novice owner, I've had plenty of ponies gelded some much older than Reg, but never had this sort of issue. I've had bleeders, the odd dangly bit, swelling, slight infections and some that pretty much woke up and walked away as if nothing happened. I've never experienced anything like this before. When your vet talks about transfusions etc you do get upset/worried.

@Gamebird your 20% complication rate figure. Is that all complications? so swelling etc included?

I'm not fluffy in anyway and know that sometimes things just happen.

For my own peace of mind I'm going to call both our vets and then hospital to talk through the whole thing.

 

[Red-1]

It sounds like you need to talk it through for your own benefit, but it sounds like the vet acted properly.

I had my mare have a minor surgery for a protein lump on the saddle area. it wasn't causing any problems but she was having a short holiday so it seemed sensible to remove it. All seemed well, cut away, minor wound. Only... as she was put away, dressed and rugged, a trickle of blood escaped. I was surprised and asked the vet to just check the wound before he left, he refused as he thought it was normal, didn't want to disturb the dressing and had to pick the kids up from school.

Against my better judgement, I left her for a few hours, reassured by the vet.

8pm, I went to see to her. It became apparent that she was in trouble! I am talking lots of blood. Flooded stable. I removed the rug to see the dressing with like a housebrick inside. There was still trickling blood...

The emergency vet came out and found that, although the wound itself was clear, the stitch to hold the wound shut had apparently gone through a small artery. As he'd pulled the wound tight it had split. It was quickly dressed and in the immediate aftermath, the dressing and padded stable had held it sufficiently for me not to know the extent of the bleeding.

The attending emergency vet had to sort it out, more blood, like a massacre. She was re-stitched, including tiny ones for the artery. She was well dressed, round to keep pressure. The vet took a photo, I asked why and she indicated it was to rip the pi$$ out of the first vet.

It happens. The only thing I was slightly annoyed about was that I suspected all was not well but the first vet refused to have a look. That and the emergency call out fee when it could have been fixed at the time, with less trouble for the poor horse. But, I pay for a vet's best efforts, their time and ability. They don't have to be perfect.

The original vet came back out for a follow up and all was well. The horse made a recovery and was on holiday anyway. Stuff happens.

For yours, I would simply ask what happened and if it will affect the horse in the future. Other than that, I would move on.

 

[SEL]

I think despite best efforts by the vets sometimes things go wrong. I had a horse crash badly after some sort of reaction to a guttural pouch wash - suspect the antibiotics but we'll never know. I found the vet who did the scope quite dismissive but her colleague who did 2 x emergency callouts over 48 hours was fantastic. To this day I don't know if the vet was dismissive because she thought I was over reacting or it was just how she came across because actually she was worried she'd mucked up somehow. I think it was just bad luck.

Definitely worth a chat with the vets about Reggie for your own peace of mind. Hopefully he'll be on the mend in no time. Just going to recommend some physio once he has healed - I have recently come across a young gelding who walks as if he is wearing a wet nappy. Apparently he didn't do that pre-gelding and for some reason he didn't bounce back well although the operation was fine. He's getting some specialist fascia release work now but might have to go in to see if there is scar tissue (although I've heard Tom Beech can do a rectal exam)

I'm usually pretty robust around most medical stuff but when there is pouring blood I feel totally helpless so not surprised you're feeling totally stressed and exhausted.

 

[Gloi]

Glad young Reggie is doing better and hope he heals well from now on.