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A Seaside Surgery

When a rescued colt requires delicate surgery in Mexico, the best location is outside in the ocean air.

Sammy's castration was performed on the Mexican coastline, literally.

Cantamar, Mexico, is an idyllic beach community that sits on the edge of the Pacific Ocean, about 35 miles south of Tijuana. The jewel of a town attracts serious surfers, divers and beach lovers. It’s not the type of place where free-roaming horses are typically found wandering the streets. But that’s exactly what happened last spring, when a wayward colt was spotted by a local resident on the outskirts of town.

The young gray was weak and severely dehydrated, with what appeared to be days-old cuts from barbed wire along either side of his neck. His weakened condition made him docile, but it also was clear that he was naturally agreeable and had had some handling because he was easily led from the road to the safety of a makeshift corral.

The colt appeared to be about 18 months old. He had no brand or halter, and there was no easy way to determine who owned him. There were no ranches in the area that had horses, nor were they any recreational equestrian facilities. Word spread quickly through the small community, but no one stepped forward to claim the colt or even to say that they recognized him. Faced with a sick horse but few resources to care for him, the colt’s temporary guardian headed into town, looking for one person he knew would help---Debby Munoz.

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Munoz and her husband, Dave, are Californians who own a second home in Cantamar, and the couple had a reputation for being kind to humans and animals alike. Fortunately, the Munozes were in town when word reached them that a horse needed their help.

“We are relatively new to horses,” says Debby Munoz. “I had only been riding about one year at the time, but we knew enough to know we could help this little guy out.” Munoz’s plan was the get the colt some basic veterinary care until his owner could be found.

Care for a foundling
A group of volunteers led the horse to the Munoz property and placed him in a makeshift corral. He was in good flesh, but the colt clearly wasn’t well. “He was very lethargic and weak,” Munoz says, “and he had a bunch of oozy, scabby wounds along the sides of his neck that looked like they could be infected.”

Munoz contacted Miguel Cuadras, DVM, the local large-animal veterinarian, who arrived that afternoon. Although he knew the local equine population well, Cuadras did not recognize the gray colt. The veterinarian administered several bags of intravenous fluid to rehydrate the youngster. The colt perked up immediately but remained friendly and easy to handle. Cuadras cleaned and debrided the cuts, which weren’t as deep or as infected as they had appeared. The colt would make a full recovery.

Munoz’s next order of business was to search for the colt’s owner, but after several days the local authorities and the community grapevine produced no leads. “It seemed like he had come out of nowhere,” she says. “He was a man of mystery.”

Meanwhile, caring for him was presenting some logistical challenges. “He was sharing a corral with other horses---as an intact colt,” says Munoz. “That was starting to get dangerous.” After a consultation with Cuadras, Munoz decided it was time to find a new, permanent home for the horse, whom she’d started to call “Sammy.” Castrating him would be an important first step in that process.

Cuadras arrived the next day prepared to perform a simple recumbent field castration, a common event in any country. For this procedure, a colt is given a tetanus shot, then laid out on a clean area of ground under general anesthesia. After a few simple incisions, the testes are pulled from his scrotum and each spermatic cord---the tube that contains the blood vessels and nerves that serve the testicle---is crushed and severed with a tool called an emasculator. The entire procedure takes less than 20 minutes.

But as Cuadras began his preliminary physical exam of Sammy, it became apparent that this wouldn’t be a routine castration. The first issue was that the colt looked a bit depressed and uncomfortable, and he had a very slight fever. Unsure of what that meant, if anything, Cuadras continued the exam. After sedating and palpating the colt, Cuadras realized that only Sammy’s right testicle was present in his scrotum---his left testicle remained undescended somewhere in his abdomen. Sammy was a cryptorchid.

“[Cryptorchidism] is the most common nonlethal congenital defect in the horse,” Cuadras says. “Basically, it is the failure of one or both testes to descend into the scrotum.” As a male fetus gestates, the testes develop high up in the abdomen, next to the bladder. In the weeks before birth they begin to descend through the abdomen. At the abdominal wall above the groin, each testicle passes through a structure called an inguinal canal to reach the scrotum. Normally, a colt’s testicles drop fully into his scrotum by the time he is 2 weeks old, but occasionally one or both may not make it all the way down, for a variety of potential reasons.

An undescended testicle will not produce sperm, but it does excrete testosterone, the hormone that stimulates stallion-like behavior. Castrating a horse by operating on only one descended testicle will render him infertile, but it will not curb aggression and libido. To fully geld a cryptorchid, the surgeon must locate and remove the undescended testis from the horse’s abdominal cavity or inguinal ring.

Cuadras performed a rectal exam to see if he could locate Sammy’s left testicle. He found it in the lower abdomen, very close to the internal inguinal ring, the entrance to the inguinal canal. While the colt was still sedated, Cuadras also took a closer took at the descended right testicle and found that it, too, presented a problem. “It didn’t look normal---it looked like some of the intestine had protruded into the right side of the scrotum through the inguinal ring, which is called an inguinal hernia,” he says. When a section of intestine is trapped and pinched off, the tissues can die, leading to a potentially fatal systemic infection. Suddenly, the colt’s slight fever, discomfort and depressed behavior took on a much more ominous significance.

Cuadras laid all of this out for Munoz. “I said, ‘This is not a regular procedure for castration. This is a cryptorchid horse so we need to do an inguinal cryptorchid surgery, and we also need to check for an inguinal hernia on the other side.’” Both of these procedures had the potential to become complicated, and typically a horse would be referred for surgery in a hospital. However, the necessary facilities were not available in rural Mexico, and shipping Sammy to the nearest large-animal clinic wasn’t a good option, either. If he did have a hernia, the delay could be fatal. “I told her we needed to do the surgery right away,” says Cuadras, “and that we could do it right there, outdoors, near their property.” Munoz agreed.

Cuadras didn’t want to perform such a risky surgery alone, so he contacted Alonso Nunez, DVM, a colleague at the Universidad Autónoma de Baja California in Mexicali, Mexico. The following day Nunez arrived to assist, accompanied by two veterinary students.

A day at the beach
With no sterile surgical suite available, the veterinary team scouted the next best location. They needed to steer clear of dusty, sandy ground that could stir up easily and contaminate the wound. They selected a grassy patch of ground just 150 feet from the ocean.

As the students prepped Sammy, Nunez and Cuadras “scrubbed in” and outfitted themselves in sterile surgery robes and gloves. “Some people might wonder why we use robes when we aren’t in the surgery room,” Cuadras says. “Well, we try to do as much as possible to avoid complications.”

Sammy was given an injection to induce anesthesia and carefully guided to the ground. The team then rolled him onto his back and propped him in position with bales of hay covered in sterile surgical drapes. By the time the surgical area was scrubbed, a small crowd of onlookers had gathered.

Cuadras focused first on the most medically urgent issue: The possible hernia. He made a small incision on the right side of Sammy’s scrotum and carefully manipulated the descended testicle, looking for signs of the suspected inguinal hernia. This investigation revealed some welcome news---Sammy appeared anatomically normal on that side, with no indication of an intestinal protrusion into the space. Cuadras pulled the testicle through the incision and completed the simple castration.

Then he turned his attention to the undescended testicle. “I made an incision between the left leg and the abdomen to directly expose the inguinal ring on the side where the testicle was missing from the scrotum,” says Cuadras. “Since you don’t have the testicle, you need to find the inguinal ring in order to find the atrophied testicle. You can work from there to pull the whole testicle out for you to castrate.”

Although Cuadras had identified the general location of the undescended testis during his rectal palpation, he didn’t know exactly where it was. The best-case scenario was that it would be contained within the inguinal canal; if not, the surgeons would have to penetrate all the way into Sammy’s abdominal cavity to reach it.

Finding an undescended testis can be tricky. “Sometimes, it’s not easy to locate the testicle because they atrophy,” says Cuadras. This was the case with Sammy. “Imagine a testicle about 1.5 centimeters in diameter---it wasn’t easy to find,” he adds. “We needed to really search visually until we found it.” But the good news was that the testicle was indeed in the inguinal canal.

Cuadras pulled the testicle out through the original incision and used the emasculator to complete the castration. He then closed the inguinal ring with sutures to prevent intestine from prolapsing through.

In less than 45 minutes, Sammy had gone from a cryptorchid colt with a potentially deadly hernia to a gelding with all his intestines confirmed to be in the correct place. The young horse recovered from the anesthesia without incident, and everyone---especially Munoz---breathed a sigh of relief. “It’s so stressful watching something like that,” she says. “I could have sworn it took hours.”

Cuadras gave Sammy some injectable antibiotics to stave off infection along with Banamine to control pain. He left Munoz with detailed instructions for continuing the medications as well as monitoring the surgical area for signs of swelling, infection or hernias.

“We got him back to this makeshift corral and a little recovery area,” says Munoz. “He just continued to get better and stronger. We had to return home because we have a company here in California, but our friends and neighbors kept a close vigil on him. When we went down the next weekend, he was already better and nearly recovered.”

Once Sammy was healthy and healed, Munoz sent him to a well-regarded champion cattle roper, rancher and local trainer, Enrique Lopenera. The plan was to give him a solid foundation to make him more attractive to potential adopters. However, after a few weeks Lopenera called Munoz and suggested she reconsider. “He told me that I had a wonderfully sweet, kind and talented horse and that I’d be crazy not to keep him,” she says. “So I did.”

With the help of Lopenera, Munoz imported Sammy to the United States to live at Oakzanita Ranch near her California home with a mature Appaloosa named Elvis. “Sammy and I trail ride together, and it’s just wonderful,” says Munoz. “He’s a long way from where he started, but he’s
got a great life. People come up to me all the time and tell me he’s an Andalusian. I have to laugh because to me he’s just Sammy.”

Posted in Health, Horse Care, Illnesses & Injuries, Rescue & Welfare | | Leave a comment

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