Scirrhous Cord in Horses: What We Learned from 32 Cases
Castration is one of the most commonly performed surgical procedures in equine practice. Although generally considered routine, complications can occur, including haemorrhage, infection, oedema and eventration [1,2]. One less commonly encountered complication is scirrhous cord, a chronic infection involving the remaining spermatic cord following castration.
Despite its clinical importance, relatively little has been published about how horses with scirrhous cord present and respond to treatment. In our retrospective study, we reviewed the clinical features and short-term outcomes of 32 horses with scirrhous cord treated at two UK equine hospitals over a 10-year period [3].
One of the most striking findings was the considerable variation in the interval between castration and presentation. The median interval was 29.5 days, but cases ranged from 20 to 2,500 days following castration [3]. This demonstrates that scirrhous cord is not necessarily an immediate postoperative complication and may become clinically apparent several years later. A history of castration can therefore remain relevant when investigating compatible clinical signs, even when the procedure was performed some time previously.
Clinical presentation was also variable. Signs included scrotal swelling, persistent or discharging surgical sites, hindlimb lameness and pyrexia [3]. This variability is clinically important because not every affected horse will necessarily present with an obvious infected castration wound. Scirrhous cord should therefore be considered as a differential diagnosis (albeit uncommon) when horses with a history of castration present with compatible local or systemic signs.
Bacterial culture demonstrated that a variety of organisms could be isolated from affected tissues [3]. This supports the importance of obtaining appropriate samples for culture and antimicrobial sensitivity testing where possible, particularly given the increasing emphasis on responsible antimicrobial use veterinary and human healthcare settings.
All 32 horses in our study underwent surgical excision of the affected spermatic cord, and all survived to hospital discharge [3]. Surgical management of spermatic cord stump infections has also been previously reported [4] and these findings suggest that surgical excision can provide a good outcome in affected horses.
There are, however, important limitations to our study. Its retrospective nature and relatively small case population should be considered when interpreting the findings. Furthermore, long-term follow-up was not available for all cases. Our results therefore demonstrate a favourable short-term survival to discharge, rather than confirming long-term resolution in every horse [3].
Overall, our study highlights the variable nature of scirrhous cord and the importance of considering it even when considerable time has elapsed since castration. Although uncommon, recognising the condition and appropriately managing the infected spermatic cord tissue can result in a favourable short-term outcome.
References
Mason BJ, Newton JR, Payne RJ, Pilsworth RC. Costs and complications of equine castration: a UK practice-based study comparing standing nonsutured and recumbent sutured techniques. Equine Vet J. 2005;37:468–472.
Kilcoyne I, Watson JL, Kass PH, Spier SJ. Incidence, management, and outcome of complications of castration in equids: 324 cases (1998–2008). J Am Vet Med Assoc. 2013;242:820–825.
Claffey EF, Brust K, Hackett RP, Fubini S. Surgical management of postcastration spermatic cord stump infection in horses: a retrospective study of 23 cases. Vet Surg. 2018;47:1016–1020.