What 'knot' to do whilst castrating donkeys. A retrospective comparison of ligation method on spermatic cord haemorrhage in 261 donkeys castrated by vet students in rural Malawi using transfixing and modified millers' ligatures.
Authors: Yeomans A, Hampson R, Razemba T
Journal: Journal of equine veterinary science
Summary
# Editorial Summary Donkeys present distinct surgical challenges during castration compared with horses, particularly their proportionally larger testicular vasculature and increased haemorrhagic risk, making reliable spermatic cord ligation essential to prevent post-operative complications. Yeomans, Hampson and Razemba conducted a retrospective analysis of 261 castrations performed by veterinary students in rural Malawi between February 2020 and August 2024, comparing transfixing ligature placement (used until February 2024) against the modified millers' knot technique (introduced subsequently). Haemorrhage during the procedure occurred significantly more frequently with transfixing ligation (6 cases; 3.8%, 95% CI: 0.7–7%) than with the modified millers' knot (0 cases; 0%, 95% CI: 0–0%), with neither animal age nor weight influencing outcomes. The modified millers' knot represents the first evidence-based technical recommendation for donkey castration, offering superior haemostatic control and practical ease of application—particularly valuable for practitioners in resource-limited settings where post-operative monitoring may be challenging. Farriers and veterinarians should consider adopting this technique as their preferred method for spermatic cord ligation in donkey castrations, particularly given its reliability in preventing potentially life-threatening haemorrhagic complications.
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Practical Takeaways
- •Switch to modified millers' knot technique for donkey castration—it eliminates post-operative spermatic cord haemorrhage seen with transfixing ligation in this large cohort
- •The technique is described as easy to apply and reliable, making it practical for field conditions in rural settings where immediate surgical support may be limited
- •This finding is specific to donkeys; extrapolation to equines should be cautious despite anatomical similarities, as this is the first direct comparison in donkeys
Key Findings
- •Spermatic cord haemorrhage occurred in 6 donkeys (3.8%, 95% CI: 0.7-7%) using transfixing ligature technique
- •Modified millers' knot resulted in 0 haemorrhagic complications (0%, 95% CI: 0-0%) across 261 procedures
- •Age and weight were not significantly associated with haemorrhage risk between treatment groups
- •Modified millers' knot provides superior hemostasis compared to transfixing ligature for donkey castration