DOG CASTRATE
Just whip 'em off
Dog castrates are one of the most basic procedures for the veterinary surgeons to perform, but just because they're simple doesn't mean that we as nurses can't make them better. The use of local blocks and adequate analgesia can make the surgery and the recovery much nicer for all involved.
BASICS
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IV cannula
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ET tube
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Clippers
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Skin scrub (I use Hibiscrub at a 50:50 dilution with warm water, then a medium ChloraPrep for final prep)
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Small surgical kit
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Analgesia (NSAID +/- paracetamol)
EVEN BETTER WITH
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Local line block
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Local intratesticular block
The procedure and nursing considerations
Ensure the patient is on a heat pad with blankets and is pre-oxygenated prior to intubation.
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Clip away fur over the scrotum and just infront of the scrotum up to the base of the penis using size 40 blade clippers and clean the surgical site with your scrub of choice.
I recommend performing a local line block along the incision area as well as an intratesticular block at this stage using a 1-2mg/kg dose of bupivicaine. Any bupivicaine left in the syringe can be kept for a splash block at the point of closing the surgical site.
Then give another quick scrub and prep the area using a final cleaning stage e.g. ChloraPrep.
The surgeon can then perform the castration.
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The surgeon may do either an open or a closed castrate - it shouldn't make much difference from a nursing perspective. If a local block has been used and is working well, then you should hopefully have a smooth procedure. If an intratesticular block hasn't been used or hasn't fully worked, some patients (especially older ones) can have a pain response when the cremaster muscle is clamped. Watch out for changes in heart rate, respiration rate, or blood pressure at this point. Paracetamol can be given as a rescue analgesia (at a dose of 10-20mg/kg slow IV) or, if very severe pain response is seen, a one off dose of ketamine can be used (0.5mg/kg IM or slow IV).
Remember to lubricate the eyes during surgery and on recovery to reduce risks of corneal ulcers forming and keep the patient wrapped up warm. It is a quick surgery but they can still lose heat fast so don't forget to monitor the temperature.
Disclaimer:
The information on this website is for reference and education, and any medications and doses should be prescribed by your veterinary surgeon before giving. All patients should be assessed individually and treated as such.