Introduction

Scrotal haematoma is a notable postoperative complication following canine castration, characterised by the accumulation of blood within the scrotal sac. While often self-limiting, its occurrence can lead to discomfort, delayed recovery, and, in severe cases, necessitate surgical intervention. Understanding its pathophysiology, risk factors, and management is crucial for veterinary professionals to mitigate its impact.

Pathophysiology and Etiology

The primary cause of scrotal haematoma is postoperative bleeding from the testicular arteries or veins, often due to insecure ligatures during the castration procedure. Factors contributing to ligature failure include:

• Loose or improperly placed ligatures.

• Inadequate stripping of adipose tissue from the spermatic cord, leading to slippage.

• Placement of ligatures too close to the testicle, incorporating excessive tissue.

Bleeding can also result from subcutaneous tissues, though this is less common. In some instances, bleeding may accumulate in the abdominal cavity, leading to hypovolemia and shock if unrecognised. 

Clinical Presentation

Affected dogs typically present with:

• Swelling and bruising of the scrotum.

• Pain or discomfort, leading to licking or biting at the site.

• In severe cases, systemic signs such as lethargy or signs of hypovolemia.

Management Strategies

Conservative Management:

For mild to moderate cases:

• Apply ice packs during the first 24 hours postoperatively, followed by warm compresses.

• Administer non-steroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation.

• Use an Elizabethan collar to prevent self-trauma.

• Restrict physical activity to minimise further bleeding.

• Monitor for signs of infection; antibiotics may be prescribed if indicated.

Surgical Intervention:

In cases where conservative management fails or the haematoma is extensive:

• Perform scrotal ablation to remove the affected tissue.

• Ensure thorough haemostasis during the procedure to prevent recurrence.

Preventive Measures

To minimise the risk of scrotal haematoma:

• Ensure proper exposure of the spermatic cord by breaking down the gubernaculum testis and applying adequate traction.

• Thoroughly strip adipose tissue from the spermatic cord using a moistened surgical sponge.

• Employ a triple-clamp technique with appropriate ligatures (e.g., Monocryl or PDS) placed correctly to secure the cord.

• Inspect the vascular stump for bleeding before closure.

• Consider using an intradermal closure technique, which has been associated with fewer postoperative complications. 

Conclusion

Scrotal haematoma is a preventable complication of canine castration. By adhering to meticulous surgical techniques and postoperative care protocols, veterinary practitioners can significantly reduce its incidence and ensure optimal patient outcomes.drstephenbirchard.blogspot.com

References

• Birchard, S. (2014). Scrotal Hematoma in Dogs After Castration. Retrieved from Dr. Stephen Birchard's Blog.

• Woodruff, K., Bushby, P. A., Rigdon-Brestle, K., Wills, R., & Huston, C. (2015). Scrotal Castration versus Prescrotal Castration in Dogs. DVM360. Retrieved from DVM360 Article.

• PetMD Editors. (2024). Dog Neuter Recovery: How To Care For Your Pup After Surgery. Retrieved from PetMD.

• Golezardy, H. (2019). A Scrotal Hematoma in a Dog. LinkedIn. Retrieved from LinkedIn Article.DVM 360PetMDLinkedIn