Post operation castation complications

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Kernal Popcorn

Post   » Sun Oct 01, 2017 9:17 am


First of all, thank you.
I have just joined after several nights of searching for post operative information. I've just read and put into practice some of the suggestions found in the files section.
My boy pig Patch had surgery two weeks ago along side his companion pig Night Sky, also male. Night Sky's procedure went well. He seems to have recovered very well. Patch however had complications. The surgeon could only find one testical but found what she believes is a uterine structure. She took photos, posted to various vetenarian forums as apparently it is very rare then popped the tissue and organs back in and stitched him up. (Her words were shoved it back in) He looked very swollen from the start and was slower then Night Sky but was wee-ing, pooing and eating. He did loose weight and seemed to be in pain despite twice daily 0.4ml Metacam @1.5mg/mL. On Thursday last week I took him back in to the vets and it was decided they'd operate again. My poor darling had herniated into his scrotal area. It was a different surgeon and she went in through original incision in scrotum but were unsuccessful so then had to go in through abdomen. "Something" had become stuck to his intestines - adhesions. Has anyone heard of this? It was all verbal but I've asked for a report which I don't have yet. They also found his other testical and removed that. This has all cost a lot of money, I am upset about the complications and the second surgery costing so much although it was necessary I wish the first was better handled. Seems the novelty of the uterus structure prolonged his surgery and created the hernias. When I picked him up he was so cold and lifeless, but had a heartbeat. He must of just come out of surgery. I have been giving him lots of kanga cuddles which he likes, critical care and his metacam and cleaning his wounds with salt water. I'll look into Manuka honey as suggested. I wasn't given instructions or notes after the second surgery so I am pleased to find this forum. I am worried about him, he is quite lethargic and is wiggling backwards often. He is still looking bruised and swollen. It's a public holiday here and everything is closed but I will take him back tomorrow although running out of money now. He also did a very long poo after second operation which makes me wonder if the bowel was pulled out along with the uterine structure to be examined or if it was obstructed in some way. Any advice for my little boy is appreciated. Very worried.

bpatters
And got the T-shirt

Post   » Sun Oct 01, 2017 11:20 am


What an ordeal, both for him and for you!

You're doing the right thing by feeding him critical care. A pig that is eating nothing else needs 100+ cc. of Critical Care or a pellet slurry for every kilogram it weighs, every day, split in 6-8 feedings around the clock. Adjust up or down according to the weight of the pig, and down if the pig is eating anything on its own. Eating is CRUCIAL -- guinea pigs continually secrete stomach acid, and if food isn't moving through regularly, they'll develop bloat and/or stomach ulcers, either of which is a medical emergency.

Also syringe him fluids when you're feeding him. Keeping him hydrated is also very important. Pigs generally love the electrolyte solution sold for children -- Pedialyte here, Dioralyte in some other countries. I don't know what it is where you are, but if you can get the unflavored kind and a large syringe, he may slurp it right down. Do keep the bottle refrigerated, though -- that stuff molds in a hurry.

I wouldn't worry too much about the long poop as long as you're continuing to get food in him. Any anesthesia slows the gut down and can cause abnormal poops. It would be far more worrisome if he weren't pooping at all.

Other than than, just make sure he doesn't get chilled, or over-exert himself. If you can wall off one section of their cage to make it smaller but still leave him close to his buddy, that would restrict his movement but keep him from being harassed.

Good luck with him, and do keep us posted on how he's doing.

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Lynx
Celebrate!!!

Post   » Sun Oct 01, 2017 12:47 pm


It certainly sounds like he has been through an awful lot. I think your analysis of some of the issues affecting his health is correct. I wish they had taken care of the other testicle (found it) and it may have been better to have removed the other supposed reproductive parts too. There is an inguinal ring that must be sutured during a neuter. Try to keep him warm. I trust you have read www.guinealynx.info/postop.html I highly recommend everything Talishan has to say and following the links to more of her post surgery advice and pain management in the Records forum, links on the link I posted.

Clint The Cuy

Post   » Sun Oct 01, 2017 1:43 pm


Definitely agree with all the supportive care advice. Is he on an antibiotic? I did not see one in my read through. Have they done any blood work? I would want to know what his WBC count is. Adhesions are pretty common after abdominal surgery and, unfortunately, are pretty unavoidable. Peritonitis, or inflammation, can also be caused by infection which in turn can cause adhesions too.

Did the initial vet palpate 2 testicles prior to surgery? Or did she go into surgery with the possibility of him being a cryptorchid?

adorolecavie

Post   » Mon Oct 02, 2017 10:13 am


I just wanted to offer some advice on a technique that I used once with a pet rat who had an incision site become severely infected (because she kept messing with it) - my vet recommended hydrotherapy, which basically just uses flowing warm water to stimulate tissue regrowth and help heal wounds. If you have a sprayer nozzle on your kitchen sink that works best, otherwise just the regular faucet - luke warm water and turn the pressure to steady but not beating, again you want the flowing water to stimulate and massage the cells in the area without causing any damage or pain, and allow the running water to go over the incision site for 5-10 minutes, a couple of times a day. It can't hurt as long as you are not stressing your piggier out or hurting him, and after the results I saw I'd recommend it for anyone looking for "last resorts," as my rat girl went from a gaping infected wound the size of a golf ball to totally healed in a week. Of course dry him off very well to make sure he doesn't get cold or the chills afterwards, and if he shows any sign of discomfort or stress then stop.

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Lynx
Celebrate!!!

Post   » Mon Oct 02, 2017 12:47 pm


That is an interesting technique. It would be wonderful if this could be done with warm, sterile saline but it might take a lot.

Kernal Popcorn

Post   » Mon Oct 02, 2017 8:08 pm


Thank you everyone for the suggestions and information and also moral support. I was so upset after what he went through. No he had not been given any antibiotics and I had to ask for critical care and metacam after the second surgery. I didn't see a vet before or after either surgery and the information provided by the vet nurse was sketchy, (after the second surgery his care was discussed without him present as I had trouble paying and they wouldn't let me see him until I'd settled the bill in full despite been regulars at the clinic) They went in initially looking for two testicals, however not having spoken to the vet I am again unsure but presume this is the case with two incisions. The original plan after the first op was to take him for an ultrasound however it was a different vet who did the second surgery and able to find the other testical. He certainly has had a huge irdeal. The good news is he is more animated and even a little playful at times although tires easily and eating some vegetables on his own now but typically after having a bit of critical care and metacam. However he had developed an infection now. Thank goodness the public holidays here are over. Not particularly wanting to go back to the same vet but will to get the antibiotics. We are in Australia. We have hyrdrolyte here and I have two children so had some in the cupboard. A good tip, thank you! He has been wee-ing on me (which he usually prefers to do in his litter box) but at least I know he's hydrated. Poo's are looking better too. So glad I found this forum. Well versed pig fanciers

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Lynx
Celebrate!!!

Post   » Mon Oct 02, 2017 9:48 pm


I am sorry he has developed an infection. I imagine you will see the vet for antibiotics. Flushing the incision (if that is infected) with warm sterile saline will help too.

Clint The Cuy

Post   » Tue Oct 03, 2017 12:58 am


Aftercare would be heavily dependant on the type of incisions you are caring for. We use hydrotherapy in horses following a straight forward scrotal castration in a young animal. We also leave the incisions open for drainage and then force them to move around after day 1 to keep the incisions open so they continue to drain and prevent infection.

If there are complications, such as you have encountered, then that changes things. The castration would be a closed castration (I'm assuming) with suture if they started to "explore" and search deeper for the second testicle during surgery. And if they used suture, that is also a potential nidus for infection. However, he also shouldn't have herniated if he had been sutured.

This is why I don't understand, if they had not palpated 2 testicles, then the surgery should have been via the abdomen from the get go and not the scrotum. And they should have discussed it with you so that you knew the risks. Judging by your interaction with the vet, I doesn't sound like you've been able to get any real information out of them. How frustrating. Good for you for bringing up the metacam and critical care to your vet.

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Lynx
Celebrate!!!

Post   » Tue Oct 03, 2017 7:35 am


In the distant past, we have noted some types of suture material are more prone to causing infection.

Clint The Cuy

Post   » Tue Oct 03, 2017 9:34 am


That is certainly true. In a straight forward case we have only used the crush method or Henderson method (basically twisting the testicle off) to ligate the structures. Guinea pigs are far too tiny for that unfortunately, which is too bad because it works. However in a more extensive case, suture can't really be avoided or you risk herniation /evisceration. And the suture carries an inherent risk of infection. Also an adult castration definitely needs the inguinal ring closed as Lynx mentioned or risk herniation because the ring is too large by full maturity.

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