Part 22

When the factors producing congestion are extraordinarily potent, when there has been frequent copulation and heavy grain feeding, when the weather is warm and the animal has had little exercise, and when the proximity of other horses or mares excites the generative instinct without gratification, this congestion may grow to actual inflammation. Among the other causes of orchitis are blows and penetrating wounds implicating the testicles, abrasions of the scrotum by a chain or rope passing inside the thigh, contusions and frictions on the gland under rapid paces or heavy draft, compression of the blood vessels of the spermatic cord by the inguinal ring under the same circumstances, and, finally, sympathetic disturbance in cases of disease of the kidneys, bladder, or urethra. Stimulants of the generative functions, like rue, savin, tansy, cantharides, and damiana, may also be accessory causes of congestion and inflammation. Finally, certain specific diseases, like dourine, glanders, and tuberculosis, localized in the testicles, will cause inflammation.

Symptoms.—Apart from actual wounds of the parts, the symptoms of orchitis are swelling, heat, and tenderness of the testicles, straddling with the hind legs alike in standing and walking, stiffness and dragging of the hind limbs or of the limb on the affected side, arching of the loins, abdominal pain, manifested by glancing back at the flank, more or less fever, elevated body temperature, accelerated pulse and breathing, lack of appetite, and dullness. In bad cases the scanty urine may be reddish and the swelling may extend to the skin and envelopes of the testicle, which may become thickened and doughy, pitting on pressure. The swelling may be so much greater in the convoluted excretory duct along the upper border of the testicle as to suggest the presence of a second stone. Even in the more violent attacks the intense suffering abates somewhat on the second or third day. If it lasts longer, it is liable to give rise to the formation of matter (abscess). In exceptional cases the testicle is struck with gangrene, or death. Improvement may go on slowly to complete recovery, or the malady may subside into a subacute and chronic form with induration. Matter (abscess) may be recognized by the presence of a soft spot, where pressure with two fingers will detect fluctuation from one to the other. When there is liquid exudation into the scrotum, or sac, fluctuation may also be felt, but the liquid can be made out to be around the testicle and can be pressed up into the abdomen through the inguinal canal. When abscess occurs in the cord the matter may escape into the scrotal sac and cavity of the abdomen and pyemia may follow.

Treatment consists in perfect rest and quietude, the administration of a purgative (1 to 1-1/2 pounds Glauber's salt), and the local application of an astringent lotion (acetate of lead 2 drams, extract of belladonna 2 drams, and water 1 quart) upon soft rags or cotton wool, kept in contact with the part by a suspensory bandage. This bandage, of great value for support, may be made nearly triangular and tied to a girth around the loins and to the upper part of the same surcingle by two bands carried backward and upward between the thighs. In severe cases scarifications one-fourth inch deep serve to relieve vascular tension. When abscess is threatened its formation may be favored by warm fomentations or poultices, and on the occurrence of fluctuation the knife may be used to give free escape to the pus. The resulting cavity may be injected daily with a weak carbolic-acid lotion, or salol may be introduced. The same agents may be used on a gland threatened with gangrene, but its prompt removal by castration is to be preferred, antiseptics being applied freely to the resulting cavity.

SARCOCELE.

This is an enlarged and indurated condition of the gland, resulting from chronic inflammation, though it is often associated with a specific deposit, like glanders. In this condition the natural structure of the gland has given place to embryonal tissue (small, round cells, with a few fibrous bundles), and its restoration to health is very improbable. Apart from active inflammation, it may increase very slowly. The diseased testicle is enlarged, firm, nonelastic, and comparatively insensible. The skin of the scrotum is tense, and it may be edematous (pitting on pressure), as are the deeper envelopes and spermatic cord. If liquid is present in the sac, the symptoms are masked somewhat. As it increases it causes awkward, straddling, dragging movement of the hind limbs, or lameness on the affected side. The spermatic cord often increases at the same time with the testicle, and the inguinal ring being thereby stretched and enlarged, a portion of intestine may escape into the sac, complicating the disease with hernia.

The only rational and effective treatment is castration, and when the disease is specific (glanders, tuberculosis), even this may not succeed.

HYDROCELE, OR DROPSY OF THE SCROTUM.

This may be merely an accompaniment of dropsy of the abdomen, the cavity of which is continuous with that of the scrotum in horses. It may be the result, however, of local disease in the testicle, spermatic cord, or walls of the sac.

Symptoms.—The symptoms are enlargement of the scrotum, and fluctuation under the fingers, the testicle being recognized as floating in water. By pressure the liquid is forced, in a slow stream and with a perceptible thrill, into the abdomen. Sometimes the cord or the scrotum is thickened and pits on pressure.

Treatment may be the same as for ascites, yet when the effusion has resulted from inflammation of the testicle or cord, astringent applications (chalk and vinegar) may be applied to these. Then, if the liquid is not reabsorbed under diuretics and tonics, it may be drawn off through the nozzle of a hypodermic syringe which has been first passed through carbolic acid. In geldings it is best to dissect out the sacs.

VARICOCELE.

This is an enlargement of the venous network of the spermatic cord, and gives rise to general thickening of the cord from the testicle up to the ring. The same astringent dressings may be tried as in hydrocele, and, this failing, castration may be resorted to.

ABNORMAL NUMBER OF TESTICLES.

Sometimes one or both testicles are wanting; in most such cases, however, they are merely partially developed, and retained in the inguinal canal or abdomen (cryptorchid). In rare cases there may be a third testicle, the animal becoming to this extent a double monster. Teeth, hair, and other indications of a second fetus have likewise been found in the testicle or scrotum.

DEGENERATION OF THE TESTICLES.

The testicles may become the seat of fibrous, calcareous, fatty, cartilaginous, or cystic degeneration, for all which the appropriate treatment is castration. They also become the seat of cancer, glanders, or tuberculosis, and castration is requisite, though with less hope of arresting the disease. Finally, they may become infested with cystic tapeworms or the agamic stage of a strongyle (Strongylus edentatus).

WARTS ON THE PENIS.

These are best removed by twisting them off, using the thumb and forefinger. They may also be cut off with scissors and the roots cauterized with nitrate of silver.

DEGENERATION OF PENIS (PAPILLOMA, OR EPITHELIOMA).

The penis of the horse is subject to great cauliflower-like growths on its free end, which extend back into the substance of the organ, obstruct the passage of urine, and cause very fetid discharges. The only resort is to cut them off, together with whatever portion of the penis has become diseased and indurated. The operation, which should be performed by a veterinary surgeon, consists in cutting through the organ from its upper to its lower aspect, twisting or tying the two dorsal arteries, and leaving the urethra longer by half an inch to 1 inch than the adjacent structures.

EXTRAVASATION OF BLOOD IN THE PENIS.

As the result of kicks, blows, or of forcible striking of the penis on the thighs of the mare which it has failed to enter, the penis may become the seat of effusion of blood from one or more ruptured blood vessels. This gives rise to a more or less extensive swelling on one or more sides, followed by some heat and inflammation, and on recovery a serious curving of the organ. The treatment in the early stages may be the application of lotions, of alum, or other astringents, to limit the effusion and favor absorption. The penis should be suspended in a sling.

PARALYSIS OF THE PENIS.

This results from blows and other injuries, and also in some cases from too frequent and exhausting service. The penis hangs from the sheath, flaccid, pendulous, and often cold. The passage of urine occurs with lessened force, and especially without the final jets. In cases of local injury the inflammation should first be subdued by astringent and emollient lotions, and in all cases the system should be invigorated by nourishing diet, while 30-grain doses of nux vomica are given twice a day. Finally, a weak current of electricity sent through the penis from just beneath the anus to the free portion of the penis, continued for 10 or 15 minutes and repeated daily, may prove successful.

SELF-ABUSE, OR MASTURBATION.

Some stallions acquire this vicious habit, stimulating the sexual instinct to the discharge of semen by rubbing the penis against the belly or between the fore limbs. The only remedy is a mechanical one, the fixing of a net under the penis in such fashion as to prevent the extension of the penis or so prick the organ as to compel the animal to desist through pain.

DOURINE.

This disease is discussed in the chapter on "Infectious Diseases."

CASTRATION.

CASTRATION OF STALLIONS.

This is usually done at 1 year old, but may be accomplished at a few weeks old at the expense of an imperfect development of the fore parts. The simplicity and safety of the operation are greatest in the young. The delay till 2, 3, or 4 years old will secure a better development and carriage of the fore parts. The essential part of castration is the safe removal or destruction of the testicle and the arrest or prevention of bleeding from the spermatic artery round in the anterior part of the cord. Into the many methods of accomplishing this limited space forbids us to enter here, so that only the method most commonly adopted, castration by clamps, will be noticed. The animal having been thrown on his left side, and the right hind foot drawn up on the shoulder, the exposed scrotum, penis, and sheath are washed with soap and water, any concretion of sebum being carefully removed from the bilocular cavity in the end of the penis. The left spermatic cord, just above the testicle, is now seized in the left hand, so as to render the skin tense over the stone, and the right hand, armed with the knife, makes an incision from before backward, about three-fourths of an inch from and parallel to the median line between the thighs, deep enough to expose the testicle and long enough to allow that organ to start out through the skin. At the moment of making this incision the left hand must grasp the cord very firmly, otherwise the sudden retraction of the testicle by the cremaster muscle may draw it out of the hand and upward through the canal and even into the abdomen. In a few seconds, when the struggle and retraction have ceased, the knife is inserted through the cord, between its anterior and posterior portions, and the latter, the one which the muscle retracts, is cut completely through. The testicle will now hang limp, and there is no longer any tendency to retraction. It should be pulled down until it will no longer hang loose below the wound and the clamps applied around the still attached portion of the cord, close up to the skin. The clamps, which may be made of any tough wood, are grooved along the center of the surfaces opposed to each other, thereby fulfilling two important indications—(a) enabling the clamps to hold more securely and (b) providing for the application of an antiseptic to the cord. For this purpose a dram of sulphate of copper may be mixed with an ounce of vaseline and pressed into the groove in the face of each clamp. In applying the clamp over the cord it should be drawn so close with pincers as to press out all blood from the compressed cord and destroy its vitality, and the cord applied upon the compressing clamps should be so hard-twined that it will not stretch later and slacken the hold. When the clamp has been fixed the testicle is cut off one-half to 1 inch below it, and the clamp may be left thus for 24 hours; then, by cutting the cord around one end of the clamp, the latter may be opened and the stump liberated without any danger of bleeding. Should the stump hang out of the wound it should be pushed inside with the finger and left there. The wound should begin to discharge white matter on the second day in hot weather or the third in cold, and from that time a good recovery may be expected.

The young horse suffers less from castration than the old, and very rarely perishes. Good health in the subject is all important. Castration should never be attempted during the prevalence of strangles, influenza, catarrhal fever, contagious pleurisy, bronchitis, pneumonia, purpura hemorrhagica, or other specific disease, nor on subjects that have been kept in close, ill-ventilated, filthy buildings, where the system is liable to have been charged with putrid bacteria or other products. Warm weather is to be preferred to cold, but the fly time should be avoided or the flies kept at a distance by the application of a watery solution of tar, carbolic acid, or camphor to the wound.

CASTRATION OF CRYPTORCHIDS (RIDGLINGS).

This is the removal of a testicle or testicles that have failed to descend into the scrotum, but have been detained in the inguinal canal or inside the abdomen. The manipulation requires an accurate anatomical knowledge of the parts, and special skill, experience, and manual dexterity, and can not be made clear to the unprofessional mind in a short description. It consists, however, in the discovery and removal of the missing gland by exploring through the natural channel (the inguinal canal), or, in case it is absent, through the inguinal ring or through an artificial opening made in front and above that channel between the abdominal muscles and the strong fascia on the inner side of the thigh (Poupart's ligament). Whatever method is used, the skin, hands, and instruments should be rendered aseptic with a solution of mercuric chlorid 1 part, water 2,000 parts (a carbolic-acid lotion for the instruments), and the spermatic cord is best torn through by the ecraseur. In many such cases, too, it is desirable to sew up the external wound and keep the animal still, to favor healing of the wound by adhesion.

CONDITIONS FOLLOWING CASTRATION.

Pain after castration.—Some horses are pained and very restless for several hours after castration, and this may extend to cramps of the bowels and violent colic. This is best kept in check by carefully rubbing the patient dry when he rises from the operation, and then leading him in hand for some time. If the pain still persists a dose of laudanum (1 ounce for an adult) may be given.

Bleeding after castration.—Bleeding from the wound in the scrotum and from the little artery in the posterior portion of the spermatic cord always occurs, and in warm weather may appear to be quite free. It scarcely ever lasts, however, more than 15 minutes, and is easily checked by dashing cold water against the part.

Bleeding from the spermatic artery in the anterior part of the cord may be dangerous when due precaution has not been taken to prevent it. In such case the stump of the cord should be sought for and the artery twisted with artery forceps or tied with a silk thread. If the stump can not be found, pledgets of tow wet with tincture of muriate of iron may be stuffed into the canal to favor the formation of clot and the closure of the artery.

Strangulated spermatic cord.—If in castration the cord is left too long, so as to hang out of the wound, the skin wound in contracting grasps and strangles it, preventing the free return of blood and causing a steadily advancing swelling. In addition the cord becomes adherent to the lips of the wound in the skin, whence it derives an increased supply of blood, and is thereby stimulated to more rapid swelling. The subject walks stiffly, with a straddling gait, loses appetite, and has a rapid pulse and high fever. Examination of the wound discloses the partial closure of the skin wound and the protrusion, from its lips, of the end of the cord, red, tense, and varying in size from a hazelnut upward. If there is no material swell and little protrusion, the wound may be enlarged with the knife and the end of the cord broken loose from any connection with the skin and pushed up inside. If the swelling is larger, the mass constitutes a tumor and must be removed. (See below.)

Swelling of the sheath, penis, and abdomen.—This occurs in certain unhealthy states of the system, in unhealthful seasons, as the result of operating without cleansing the sheath and penis, or of keeping the subject in a filthy, impure building, as the result of infecting the wound by hands or instruments bearing septic bacteria, or as the result of premature closure of the wound, and imprisonment of matter.

Pure air and cleanliness of groin and wound are to be obtained. Antiseptics, like the mercuric-chlorid lotion (1 part to 2,000) are to be applied to the parts; the wound, if closed, is to be opened anew, any accumulated matter or blood washed out, and the antiseptic liquid freely applied. The most tense or dependent parts of the swelling in sheath or penis, or beneath the belly, should be pricked at intervals of 3 or 4 inches to a depth of half an inch, and antiseptics freely applied to the surface. Fomentations with warm water may also be used to favor oozing from the incisions and to encourage the formation of white matter in the original wounds, which must not be allowed to close again at once. A free, creamlike discharge implies a healthy action in the sore, and is the precursor of recovery.

Phymosis and paraphymosis.—In cases of swelling, as above, the penis may be imprisoned within the sheath (phymosis) or protruded and swollen so that it can not be retracted into it (paraphymosis). In these cases the treatment indicated above, and especially the scarifications, will prove a useful preliminary resort. The use of astringent lotions is always desirable, and in case of the protruded penis the application of an elastic or simple linen bandage, so as to press the blood and accumulated fluid out, will enable the operator to return it.

Tumors on the spermatic cord.—These are due to rough handling or dragging upon the cord in castration, to strangulation of unduly long cords in the external wound, to adhesion of the end of the cord to the skin, to inflammation of the cord succeeding exposure to cold or wet, or to the presence of infection (Staphylococcus botriomyces). These tumors give rise to a stiff, straddling gait, and may be felt as hard masses in the groin connected above with the cord. They may continue to grow slowly for many years until they reach a weight of 15 or 20 pounds, and contract adhesions to all surrounding parts. If disconnected from the skin and inguinal canal they may be removed in the same manner as the testicle, while if larger and firmly adherent to the skin and surrounding parts generally, they must be carefully dissected from the parts, the arteries being tied as they are reached and the cord finally torn through with an ecraseur. When the cord has become swollen and indurated up into the abdomen such removal is impossible, though a partial destruction of the mass may still be attempted by passing white-hot, pointed irons upward toward the inguinal ring in the center of the thickened and indurated cord.

CASTRATION BY THE COVERED OPERATION.

This is only required in case of hernia or protrusion of bowels or omentum into the sac of the scrotum, and consists in the return of the hernia and the application of the caustic clamps over the cord and inner walls of the inguinal canal, so that the walls of the latter become adherent above the clamps, the canal is obliterated, and further protrusion is hindered. For the full description of this and of the operation for hernia for geldings, see remarks on hernia.