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The Kinder Cut – Castration of horses

This is the time of year when people start to look at their cute little foals, and suddenly realise they're starting to grow up fast... As a result, it’s also when we start to get phone calls from people to talk about gelding them. If you are considering getting a colt gelded ("cut"), my advice would be to contact your vet, who will be able to advise you on the best approach in your particlar circumstances. However, I'm going to try and go through some of the commoner questions below, so you've got some basic information on the decisions to be made, the procedure, and what you'll need to consider. The first question, of course, is whether or not to get him cut. It’s an important decision, so these are my thoughts... The majority of male horses are castrated, and for very good reason - very few people have the facilities, the time, or the inclination to manage an entire stallion. The old adage had it absolutely right - "You can tell a gelding, you can ask a mare, but you discuss the matter with a stallion". Although there are some superbly well mannered stallions out there, it takes years of expert training - and in my experience they're almost always more "bolshie" than a gelding, and much less forgiving of any mistakes. They are also much more easily distracted (e.g. by a passing mare), and prone to fighting. Does this mean you can't train them well and keep them happily and healthily? No, of course not - but it’s a lot harder. The majority of stallions can't be kept in groups because of the husbandry regimes on most yards, so have to live on their own. That's not good for their mental health, or their owners and riders! If someone has the knowledge and facilities to bring up a stallion, I don't have a problem with that, and I wish them luck, but I've seen too many bored, frustrated and borderline dangerous stallions who haven't been brought up correctly, and remain a liability. Geldings, however, can be kept in groups, can mix with other horses, and are less likely to lose the plot or throw a temper tantrum. They also don't present you with unexpected foals in your competing mares... If you decide not to have him done, you need to be sure that you're doing it for the right reasons. The majority of horses are not necessarily good breeding material - you need to take an objective look at him and decide if breeding from him is actually going to benefit the breed. If you're avoiding doing it just because you don't like the thought of the procedure, you'll need to think long and hard about whether thats in his best interest - or yours. If you are getting your colt cut, the next decision is when to do it. There are two major concerns - the time of year, and the maturity of the colt. In terms of time of year, it’s best to do it when the weather is cold enough to prevent flies from infecting surgical wounds. Ideally, then, this would be in late autumn or early spring, but gelding him in winter is perfectly acceptable if the facilities are suitable. Regarding the colt's maturity, there is an upper and a lower limit. The lower limit is the most rigid - except in an emergency (e.g. a strangulating hernia), I would never geld a colt until both testes had descended into the scrotum - because it’s really important to make sure you've got both! This usually happens between 6 and 12 months old, but it is a bit variable. In addition, the colt has to be strong and mature enough to survive the surgery, although with modern anaesthetics this isn't as much of an issue as it used to be. The upper limit is much more flexible. Stallions into their twenties are castrated fairly commonly, but once they've passed through puberty, a lot of the stallionish behaviour is learnt, and won't be reversed by castration, including some forms of aggression, and mounting behaviour. Sometimes, people like to wait until a colt is 3 or 4 years old before gelding, but I think that often even that is too late - although it does allow the colt to develop more muscle, he'll also be developing stallion traits. In addition, the younger the colt, the smaller the testicles, and the smaller the testicles, the lower the risk of bleeding during the op. During puberty, the testicles increase dramatically in size, and as a result, their blood supply increases accordingly; the bigger spermatic artery in a post-pubescent colt is much harder to control bleeding from. As a general rule (and it’s a VERY rough rule of thumb!) I'd normally look to geld between a year and eighteen months old. That said, there are a lot of exceptions - I once had to sort out the castration of a four month old colt because he'd started mounting his mother... There are also a number of opinions about weaning - before, after or at the same time? In this case, I think it depends entirely on the colt in question, and it’s an area (one of many) where I'll usually defer to the owner's judgement. Before you go any further, its a good idea to get the colt thoroughly checked out - both testicles need to be present and easily palpable; if one is "shy" and difficult to find, I usually recommend checking again in a month or so. If it’s still inaccessible, the colt may be a cryptorchid (i.e. a rig, with one undescended testis). These colts should ALWAYS be castrated, and have to be done under general anaesthetic, if possible in a clinic. This is because the retained testicle, being kept at an abnormally high temperature inside the body, is more likely to become cancerous. Also, the defect may be genetic - and if so, he'll risk passing it on to his offspring. Once you've decided when, there's another important decision you and your vet will have to make, and that's the details of the procedure. Basically, there are two factors to decide - firstly, do you want him done "at home or away"? Secondly (a related point), do you do him under standing sedation or down under a general anaesthetic? Regarding the location, it depends on your practice's policy and facilities. Many practices now offer castration at the clinic, but the majority of people still choose to have the op done at home. The advantage of having it done at a clinic is that the procedure can be cleaner, and all the equipment and apparatus is there; in addition, many practices charge a callout fee for coming to the yard. However, that's offset by the fact that you'll have to transport the colt to the clinic; in addition, I think it’s usually less stressful for the procedure to be done at home, assuming the appropriate facilities are available. Exactly what facilities you need depend on the technique that's going to be used. There's a lot of debate as to this decision, and some frankly ridiculous comments from some badly-informed people out there. I'm going to talk through the options and the pros and cons. The two main options that you'll need to think about for the procedure itself are whether to have the op done under standing sedation or general anaesthetic. In some cases, the decision is easy - miniature horses and small shetlands should almost never be done standing, because they're too small for the surgeon to get good access and control the site, for example. Draft breeds are at a higher risk of eventration (see below, when abdominal contents escape through the castration wound), and so need a different surgical technique, which may be easier under a general; and fully adult stallions bleed more so may need better surgical access - again, a general anaesthetic makes this easier. However, most colts can be done either way, so you and the vet need to decide which you prefer. Under standing sedation, the colt is given intravenous sedatives (see my blog on sedatives) so he becomes very dopey. He will continue standing up, but his head will drop, and he is likely to adopt a wide-based stance (which makes surgical access easier!). However, its important to remember that he is still to some extent aware of what's going on, so local anaesthetic is injected into the testicles (perhaps 20ml into each one, plus some under the skin of the scrotum) or into the spermatic cord (although I find that that's easier said than done, with most colts pulling the testicles up tight to the body wall so the cord is difficult to access from outside) to numb the area. The castration is then performed with the vet working from standing beside the horse. This approach avoids the risk of a general anaesthetic, and means the horse will recover from the sedative faster. However, the degree of sedation achieved is variable, and some colts appear to be more aware of the procedure than one would like, no matter how much sedative you pour into them. There's also a MUCH higher risk of the vet or their assistants being injured - unsurprisingly, some colts object violently if they realise what you're doing... In addition, the surgical access is poorer (the vet is having to work upside down, and largely by feel) so if there is a complication, it is harder to control it. Under a general anaesthetic approach, the colt is sedated and then given an injection of a general anaesthetic. He'll become very sleepy, and then lie down. Once he's out, an assistant lifts up the top leg, giving the surgeon access. The disadvantage is that most vets will only do a GA on a horse if there's another vet along to monitor the anaesthetic, which may affect the cost. In addition, a GA is a risk in its own right - one study suggested that the average mortality rate from GA in a horse is 1% (although this includes colics and emergency operations - the risk for a young, healthy colt is much lower). On the other hand, the risk of injury to the vet or assistants is much lower, and the risk of surgical complications is also much reduced, as the surgeon can see exactly what they're doing. Is either one definitively better than the other? No. However, it is a decision to take WITH your vet, as they may have a preference that will affect their efficiency. For what its worth, I've done geldings both ways, and personally I prefer to do them under general, because its safer for me and everyone else around - and if there was to be a complication, I've got a better chance of finding and fixing it at the time. The procedure itself is pretty much the same whichever way up the horse is. Along with sedation, I give an injection of an anti-inflammatory and painkiller, and antibiotic cover (no procedure done on a yard or in a field can ever be truly sterile, so I'd prefer to make sure there are antibiotics on board when we start). In the past, vets didn't routinely give painkillers as well as the sedation (which contains a painkilling component), but personally I don't think its fair not to. There has historically been quite a mystique about the procedure itself - probably because people are a bit shy to discuss it. As a result, there is sometimes serious confusion - remember, gelding is NOT the same as a vasectomy, and it can't be reversed... Not even (as apparently happened to a colleague of mine) if the client stops you as you're about to drive off and, holding up a neatly severed pair of testicles, asks the vet to reattach them because she's changed her mind... So, here's a quick run through the procedure: The area of the groin is scrubbed with a skin disinfectant, and a final check is made that both testes are accessible. Whichever one is held closer to the body is the one I'll start with, just in case it is retracted later. I'll then scrub up so my hands are sterile. Some vets wear gloves, others don't - I don't think it really matters as long as they've scrubbed thoroughly. Gloves add an additional sterile barrier; but on the other hand they can reduce your feel and grip, so it depends on what the vet is happiest with. Once the scrotal area is scrubbed, the vet will use a scalpel blade to cut through the skin of the scrotum. There are a couple of different options from here on, but the principle is the same; to cut down through the tissue to the vaginal tunic (the membranes that surround the testis itself) and then gently pull the testicle down and out. In an "open" castration, the tunic will be opened, in a "closed" technique, it gets left intact and the testicle pulled down still inside. Once there's enough slack in the spermatic cord (containing the blood vessels, nerves etc that supply the testicle), the emasculators are applied across the cord, with or without the tunic, depending on the technique. These are a clever bit of kit that crush the cord, preventing it from bleeding, while at the same time cutting off the testicle itself. (Quick aside here - I was doing a gelding once and, as is customary, I showed the removed testicle to the owner to show it had been done; he was a teenage lad and he fainted dead away. Interesting ethical problem there - do I try and help the unconscious boy, or do I just keep working on the anaesthatised horse who'll soon wake up? Fortunately, he recovered on his own before I had to scrub out, but he was pretty green around the gills for the rest of the morning...) In an older stallion, most vets will put a suture through the cord to ligate the artery, but this increases the risk of infection, so we don't always put one in if doing an Open procedure. After removing the emasculators, the vet will check closely for bleeding from the stump. If there isn't any, they'll repeat the procedure on the other side. If the surgery is taking place in the field, the vet will usually leave the incision open for drainage; closing it seriously increases the risk of post op swelling and infection. As a note, there is always a bit of bleeding after the operation. The rule of thumb is, if you can count the drops, its fine! There's also invariably some swelling of the sheath, but again, it isn't usually anything to worry about. If in any doubt though, you should contact your vet. Your vet will give you instructions for post op care, but the most important thing is to keep the new gelding moving, to reduce the swelling and encourage drainage. The complications to be aware of are bleeding, eventration, and infection. bleeding is pretty obvious - some oozing from around the incision is normal, but there shouldn't be any significant haemorrhage from the stump of the spermatic cord. If there is, or if there's a lot of blood - call your vet! Uncontrolled bleeding is an emergency that may require a repeat surgery to control it. eventration, is when abdominal contents prolapse through the inguinal canal, and it’s more common in draft breeds. This is the main reason we'd do a Closed castration, as it ties off the tunic; but it does increase the risk of infection. Eventration usually involves some fatty tissue (the omentum) and although it needs urgent surgical repair, it isn't usually life threatening. Very occasionally, however, it progresses to evisceration, where loops of intestine come through. This is very serious, but (touch wood) it’s also very rare. infection is uncommon, and usually responds to antibiotics. In a few unlucky cases, though, a schirrous cord forms, where abscesses form in the canal. These take months of management, and in the end, treatment is usually surgical removal of the infected tissue. These complications are very rare, and even if they occur, they're usually fixable, so don't get scared of the possibility! I only mention them so you've got an idea of what to look out for. The last thing to bear in mind is that the gelding may still show sexual interest for some weeks after castration (at least, if he was before), and may even be fertile for a time: although he can't make more sperm without testicular tissue, there will still be some "in storage" in the spermatic ducts. I always advise that a newly gelded colt or stallion should be isolated from mares for at least 6 weeks, after which any remaining sperm will have died or been flushed out, and his testosterone levels will have declined to the point where he won't have any hormonal urges. The bottom line is this: although it doesn't seem a nice thing to do, for most colts in most situations, gelding leaves them happier and more content than they would otherwise be as entire stallions.
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Owners Choice – The VetHelpDirect Best UK Vets 2013

The winner of the VetHelpDirect.com Best UK Vets 2013, based on independent vet reviews  is....... Barton Lodge Vets, Hemel Hempstead. Screen Shot 2013-01-28 at 23.36.14 Seventy two of Barton Lodge's grateful clients logged on to leave a review giving them an amazing average star rating of 5! 'First Class, Patient and Understanding', '5 Star service' and 'The best in town by far' were just some of the accolades received from their clients. Congratulations Barton Lodge Vets! In second place Goddard Veterinary Group - Gidea Park in London and in third place were  St Georges Veterinary Group - Wolverhampton The VetHelpDirect Owners Choice awards are based on reviews left by owners over the course of the year 29/1/12 - 28/1/13. The number of reviews and average star rating was used to determine the winner. At VetHelpDirect.com we are determined to provide a fair reflection of the vet practices in our directory, all reviews are subject to rigorous tests of authenticity, all are checked for duplicate ip addresses, email addresses and some reviewers are asked to provide evidence that they are recent clients of the practice. The VetHelpDirect team will be visiting the winning practice shortly to award them their very well deserved prize... watch this space!
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Ask our Online Vet – My cat has white spots on her bottom, is licking her bum alot and pooing outside her box

Question from Shellie Masters My cat seems to have white spots on her bottom and is licking her bum alot more than usual, also she is pooing outside of her box, any ideas? She is about 11 years old. Thanks Answer from Shanika our Online Vet Hi Shellie, Thanks for your question regarding your cat licking her bottom more, white spots that you have noticed on her bottom and the change to her toileting habits. All the points that you have mentioned can be individual issues or linked as will hopefully become clear as I go into answering your question. What are the white spots on my cat’s bottom? The exact location of the spots will help us to work out what the spots are, the bottom itself is made up of skin which has one large opening through which the poo is passed and then two smaller openings( at 10 o’clock and 2 o’clock positions) which are where the anal sacs open via their ducts ( tube). Anal sacs are lined by glands which produce a rather smelly substance that is normally passed in small amounts every time your pet does a poo, this anal sac liquid forms part of the scent that shows cats who has been around the territory. Anal sacs can get blocked or infected, this can sometimes appear as white spots on the bottom and also lead to increased licking due to the resulting irritation. Your vet can empty the anal sacs by applying gentle pressure which may relieve the problem, if there is infection antibiotic treatment may be needed. Tape worm segments are another possibility for the presence of white spots around a cats bottom, tape worms are a parasite that live inside the gut and release small segments as part of their means of spreading. These small segments of tape worm when dry can appear like a small grain of white rice, when fresh they look more like a small piece of flattened pasta ( can be seen to move when looked at closely). Tape worms and other parasites can be treated using appropriate medication form your vet. Parasitic infections can cause irritation around the bottom which can lead to increased cleaning/licking. A less obvious cause for such licking is flea allergic dermatitis (FAD). FAD can often be seen as increased grooming and areas of hair loss along the back and inside of the hind legs. Polyps and or growths on or around the bottom can appear as white spots and may also lead to increased licking of the affected area. What other reasons may be causing my cat to lick its bottom and poo outside of its litter box? Changes to the poo itself either softer or harder than usual can cause irritation and increased licking along with toileting outside of the litter box. Loose or soft faeces may be related to diet changes, stress and or internal disease of organs and or the gut itself. Another possible cause of toileting disturbances including passing poo outside of the litter box is stress. So what could be causing your cat to feel stressed? Changes to the home environment can cause an increase in stress levels to your cat, such changes include moving home, new member to the family ( human and or furry), diet changes, cat litter type change, moving the litter box or changing it altogether and pain such as arthritis. Cats are creatures of habit and changes to their routine/home can be very difficult for them to deal with and sadly this may often show up as toileting problems. It is really important to watch closely what exactly your cat is doing and discuss this in detail with your vet who will try to come up with a plan to help your cat. Simply returning things to how they were is not always enough sometimes medications and or pheromone treatments may be of use. Pain should be taken into consideration when a cat has toileting problems. Cats are masters at hiding their pain until it becomes quite severe. Arthritis can make it difficult for cats to get in and out of their litter box or get into a position in which they can go to the toilet which may result in poo being passed outside of the box. So as you can see your question has raised many very interesting points as regards your cat’s behavioural and physical changes. I hope that my answer has gone some way to help you and your cat and that with the assistance of a visit to your vet your cat is soon feeling much better. Shanika Winters MRCVS
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Does your vets deserve to win our Best UK Vets 2013 award?

If so you can help...

What is the Best UK Vets 2013 award?

It's a new award judged by us - VetHelpDirect.com - to find the best veterinary practice in the UK based entirely on reviews made by their clients (you!). We like to think of it as a pet-owner's-choice-award and, as pet owners are the most important thing to vets, this award has created a lot of interest already! We are holding the award presentation shortly after we announce the winning practice (on the 28th January) and every client that has left a review will be invited to celebrate!

How can I help them win?

The winning vet practice can be any of the practices listed in our directory. If you're not sure if your is, just follow this link and pop in your postcode: www.vethelpdirect.com/practices If your vet comes up in the search results then follow these steps: 1. Click on your vet's listing. 2. You'll see a box on the right, just underneath their map, called 'Overall Rating', click on the link that says 'Review this vet - click here'. 3. Tell your vet what you think about them and give them a star rating out of five. 4. Submit your review…and that's it! The award will be given to the practice (or branch) with the highest number based on this formula: Number of Reviews x Average Star Rating.

When will the winner be announced?

You don't have long! We are only counting reviews left before Monday 28th January and announcing the winner the same day. The presentation will take place soon after the 28th.

What if they don't win?

There is a lot of competition for this award but, if your vets doesn't win it, there is a great commiseration prize - all the lovely reviews from their clients!

Online Reviews

Our online review service is intended to give a fair reflection of veterinary practices across the UK. Therefore if you wish to leave a negative review, they can be left in the same way as above. All reviews are read by a member of the VetHelpDirect.com team, your star rating will always be published online although defamatory comments may not.
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Ask a vet online – “What can cause staining around mouth and on dogs paws?….”

Question from Ann Hutton What can cause staining around mouth and on dogs paws? No change in diet and its come on in just a few weeks? Cavalier male aged 9. Answer from Shanika Online Vet Hi Ann, Thanks for your interesting question about the recent staining you have noticed around your dog’s mouth and paws. The staining you are referring to is most likely caused by a substance called Porphyrin. Porphyrin is a naturally occurring substance in the tears and saliva and tends to show up as a pink/brown colour where your pet has licked, dribbled or produced lots of tears. The discolouration from the Porphyrin is most obvious on light coloured fur. The staining of the fur itself is of no actual harm to your pet however it is important to get to the bottom of why it is happening and I would definitely advise that you discuss this further with your vet. There are many possible causes for the staining you have noticed which include:  dental disease, other conditions of the mouth, allergies and stress. Dental disease is a very common finding in both dogs and cats of around 3 years of age and over, a build-up of plaque and bacteria can lead to inflammation of the gums (gingivitis) and loosening of the teeth ( periodontal disease) which can result in dribbling ( excessive salivation). Treatment for dental disease may include a course of antibiotics to treat any infection present, the use of pain relief plus or minus dental surgery to clean and remove any loose/infected teeth. Your pet will receive follow up checks and advice regarding a dental health care plan to reduce the need for further dental treatment in a hurry. Dental health care includes special diets to reduce plaque build- up, use of tooth brushing where appropriate and or dental chews to keep your pets mouth as clean and healthy as possible. Other mouth related conditions that may lead to saliva staining include: inflamed and or infected fold in the gum flaps which are common in breed such as the Cavalier King Charles Spaniel. This is thought to be related to the fact that the nose of the dog is shortened, and the soft tissues including the skin are not, which can lead to folds of skin which collect saliva and food particles. The skin folds can become very painful and infected this can usually be treated with antibiotics, pain relief and or regular cleansing of the affected areas. In very extreme cases surgery may be needed. Polyps, growth or cysts in the mouth can also cause irritation that may lead to excess saliva production and therefore staining. These can best be treated once identified and the exact type of growth determined. Stress and or allergies can cause dogs to dribble and or chew their paws; this is another common cause of Porphyrin staining around the mouth and feet. So as you can see there are many possible causes for the staining of the fur around your dog’s mouth and on his paws, a visit to your vet would be the best way to find out what the cause is and how best it can be treated. I Hope that my answer has been helpful for you and that your dog responds well to the treatment plan that is best for him. Shanika Winters MRCVS
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