Paraphimosis of 7 years’ duration in a Percheron stallion

A 15-year-old Percheron stallion was presented to Auburn University Veterinary Teaching Hospital for evaluation of paraphimosis of 7 years’ duration. Available history indicated that the paraphimosis was subsequent to a kick injury that occurred 7 years prior. Vital parameters were within normal limits. The penis and prepuce were markedly fibrotic and swollen, extending to the level of the distal tarsus, and evidence of chronic penile exteriorization was present. Due to apparent lack of penile sensation and the chronicity of the lesion, phallectomy and castration were recommended. Distal phallectomy via the Williams’ technique was performed under general anesthesia, concurrently with closed castration. No excessive intraoperative hemorrhage was noted. Within 30 min postoperatively, the patient experienced mild hemorrhage from the stoma. Around 12 h post-surgery, the gelding exhibited dull mentation, pale mucous membranes, tachycardia, and tachypnea. The gelding was administered infusions of aminocaproic acid, 0.05% formalin, and a whole blood transfusion. By the following afternoon, packed cell volume had increased from 18 to 22% and total solids increased from 5.0 to 6.8 g/dL; vital parameters were within normal limits. The gelding was discharged 5 days postoperatively with normal vital parameters. Medications included phenylbutazone, trimethoprim sulfamethoxazole, and Red Cell®. Follow up telephone consultation with the owner several months postoperatively indicated the gelding had made a full recovery. This case describes resolution of a severely protracted paraphimosis and successful management of common, albeit concerning, postoperative complications.