A prospective multicentre survey of complications associated with equine castration to facilitate clinical audit.
Authors: Hodgson C, Pinchbeck G
Journal: Equine veterinary journal
Summary
# Equine Castration Complications: Establishing Benchmarks for Clinical Practice Castration remains one of the most commonly performed equine surgical procedures, yet little objective data existed on complication rates or risk factors until Hodgson and Pinchbeck's 2019 prospective audit, which tracked 495 castrations across 18 general practices to characterise post-operative complications and identify associated variables. The research team collected intraoperative data on the day of surgery and obtained 30-day follow-up on 392 cases, using multilevel logistic regression to analyse factors associated with bleeding within 24 hours, stiffness and swelling, and discharge or infection. Intraoperative complications occurred in 14.5% of procedures (predominantly bleeding and excessive movement), whilst post-operative complications affected 11.2% of horses with follow-up data, with swelling, infection and gait stiffness being most prevalent; importantly, serious complications and mortality proved exceptionally rare. Current practice shows considerable variation—two-thirds of procedures were performed outdoors, 79% under recumbency, and nearly all horses received perioperative NSAIDs and antimicrobials—suggesting reasonable standardisation of prophylactic measures across practices. For equine professionals, these findings establish benchmark complication rates against which individual practices can audit their own outcomes, whilst the rarity of serious adverse events should provide reassurance that routine castration, when performed with standard protocols, remains a safe procedure with low clinical risk.
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Practical Takeaways
- •Your practice's castration complication rates should be benchmarked against 11.2% post-operative and 14.5% intraoperative rates reported in this multicentre audit to identify whether outcomes warrant investigation
- •Current best practice includes preoperative NSAIDs and antimicrobials in nearly all cases, with recumbent positioning being standard; these protocols appear effective at minimizing serious complications
- •Establish a systematic audit process to track minor and major complications to 30 days post-surgery, as this study demonstrates that regular outcome monitoring enables meaningful quality assessment
Key Findings
- •Intraoperative complications occurred in 14.5% of 495 castrations, with bleeding and excessive movement being most common
- •Post-operative complications were reported in 11.2% of 392 horses with 30-day follow-up, with swelling, infection, and stiffness of gait most frequent
- •98% of horses received preoperative NSAIDs and 97% received antimicrobials, with 79% performed recumbent and 21% under standing sedation
- •Serious complications and mortality associated with castration were rare