Testicular Disorders in Equids: A Case Series

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

The study presents an extensive survey spanning 26 years of activity, providing a highly interesting account of cases involving the reproductive system of stallions and donkeys. It is rich in information and clinical detail and fulfills its aim of assisting veterinarians in future clinical practice. I also suggest that the histopathology images be better marked to correspond with the legend (findings)—for example, by using arrows, asterisks, etc.

Comments for author File: Comments.pdf

Author Response

Response to Reviewer 1

We sincerely appreciate the reviewer's positive evaluation of our work and are grateful for the encouraging comments regarding the clinical relevance and potential value of this case series for veterinary practitioners.

The study presents an extensive survey spanning 26 years of activity, providing a highly

interesting account of cases involving the reproductive system of stallions and donkeys. It is

rich in information and clinical detail and fulfills its aim of assisting veterinarians in future

clinical practice.

Line 2 – Title – The manuscript presents only one case involving a donkey, although it

broadens the descriptions, as stated in the objective of the study. Therefore, the use of more general terms encompassing both species, such as “male equids,” is recommended. We thank the reviewer for this helpful suggestion. The title has been revised to replace "stallions and donkeys" with "equids", which more accurately reflects the study population while encompassing both species.

Lines 15–17 – It is recommended that this sentence be rewritten, as it is ambiguous and

unclear. Please adjust it to refer to both species. Does the same consideration apply to

donkeys? We appreciate this comment. To eliminate ambiguity and improve clarity, the sentence in question has been removed from the manuscript. This revision avoids unnecessary generalization between species while improving the readability of the Abstract.

Line 18 – Equids testicular disorders. Thank you for identifying this inconsistency. The terminology has been corrected to "equids" to maintain consistency throughout the manuscript.

Lines 23–24 – It would be relevant to mention the use of cytogenetics. We agree with the reviewer that cytogenetic evaluation represents an important diagnostic tool, particularly for disorders of sexual development. Accordingly, we have revised the Abstract to include cytogenetic analysis among the diagnostic methods used in this study.

Line 232 – Please revise the section heading. The section heading has been revised from "[previous heading]" to "Case Selection", providing a clearer and more appropriate description of the content presented.

Line 422 – This requires correction. Thank you for identifying this error. The text has been corrected in the revised manuscript.

Line 609 – Please confirm the caption and the photograph. We appreciate this observation. The figures were thoroughly reviewed, several related images were combined into composite figures to improve presentation, and all figure legends were rewritten to provide clearer and more complete descriptions. These revisions improve the correspondence between the images and their associated captions.

Lines 1137–1160 – This paragraph is excessively long. We agree with the reviewer. This paragraph has been substantially shortened by removing repetitive information and improving the organization of the discussion, resulting in a more concise and focused presentation.

Line 1162 – Figure 60 – Please confirm the image and its description. The figure and its corresponding legend were carefully reviewed. As part of the overall revision of the figures, related images were combined where appropriate and the figure legends were rewritten to ensure that the images accurately correspond to their descriptions and are easier to interpret independently of the main text.

Lines 1459–1506 – This paragraph is excessively long. We appreciate this suggestion and agree that this section could be improved. The paragraph has been rewritten and substantially condensed to improve readability while preserving the key clinical information and discussion points.

 

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

This is an interesting and impressive collection of cases from male horses with testicular diseases. There are also many beautiful images. In the present form, however, these cases are unfortunately poorly presented. The manuscript requires complete reorganization, otherwise it remains unreadable and – what is even more important – largely useless. The authors should ask themselves why they would be interested in reading such a publication. Most likely because they want to find reference cases for a particular case they are seeing.

The following changes are suggested:

The introduction is far too extensive; on the other hand, it presents mainly textbook knowledge. It does therefore not prepare the floor for the cases. It should present a short introduction to the problem. You may point the reader to useful textbook chapters or reviews. In this introduction, the incidence of testicular diseases in stallions is important. It would also be interesting to present information about at what phases of the animal’s life such problems are usually discovered/diagnosed (e.g. after birth, at selection for becoming a sire, because of health problems) and what the main reasons for presentation are. Please delete most of the information on pathogenesis from the introduction.

Instead of presenting the animals case by case, the authors should group cases in a meaningful way (what they tried to do in part of the manuscript). Appropriate criteria for grouping could include a common reason for clinical presentation (e.g., abnormal appearance of the external genitalia), or a common diagnosis (e.g., malformations of the penis). This should be done in a systematic way, i.e. do not change the criteria for grouping in the manuscript. The subheading/group “Strongylus vulgaris” is for example not acceptable but “Parasitic orchitis” could be fine.

Cases belonging to the same group could then be presented together with similarities and dissimilarities compared in a table. This would allow for easier comprehension. At present, the text for individual cases is far too extensive.

It is very difficult to match images to the corresponding cases. This needs to be improved. Please consider that all figures and tables should “stand alone”, i.e. their legends should provide complete descriptions on what is being presented so that the reader does not have to refer to the manuscript text. Where appropriate, the legend must include information on individual animals like age and breed.

Not all images are worth presenting in the manuscript. Please select those that illustrate the case or specific findings of the case. In the images, specific findings need to be indicated (use e.g. arrows) and described. E.g. in Figure 29, many will not be able to decide what findings are pathological. This requires an explanation. In other images, attempts to indicate pathological changes have been made but are not clear or visible (e.g. Figure 30 – where is the arrow?).

The discussion needs to be organized according to the groups you are forming and presenting. Again, it is far too long and needs to be focused.

Conclusions should present a take home-message.

Author Response

Response to Reviewer2

We sincerely thank the reviewer for the thoughtful and constructive comments. We appreciate the time invested in reviewing our manuscript. We have carefully considered each suggestion and substantially revised the manuscript accordingly. All changes are highlighted in green in the revised version and are detailed below.

This is an interesting and impressive collection of cases from male horses with testicular diseases. There are also many beautiful images. In the present form, however, these cases are unfortunately poorly presented. The manuscript requires complete reorganization, otherwise it remains unreadable and – what is even more important – largely useless. The authors should ask themselves why they would be interested in reading such a publication. Most likely because they want to find reference cases for a particular case they are seeing.

The following changes are suggested:

The introduction is far too extensive; on the other hand, it presents mainly textbook knowledge. It does therefore not prepare the floor for the cases. It should present a short introduction to the problem. You may point the reader to useful textbook chapters or reviews. In this introduction, the incidence of testicular diseases in stallions is important. It would also be interesting to present information about at what phases of the animal’s life such problems are usually discovered/diagnosed (e.g. after birth, at selection for becoming a sire, because of health problems) and what the main reasons for presentation are. Please delete most of the information on pathogenesis from the introduction. We appreciate this suggestion and agree that the original introduction contained excessive textbook information. The Introduction has been substantially shortened and reorganized to better frame the objectives of the case series. We removed detailed descriptions of pathogenesis and instead focused on the incidence of testicular disorders in equids, the typical stages of life at which these conditions are diagnosed, the most common clinical presentations, and the rationale for compiling this case series. These revisions are found in Lines 62–149

Instead of presenting the animals case by case, the authors should group cases in a meaningful way (what they tried to do in part of the manuscript). Appropriate criteria for grouping could include a common reason for clinical presentation (e.g., abnormal appearance of the external genitalia), or a common diagnosis (e.g., malformations of the penis). This should be done in a systematic way, i.e. do not change the criteria for grouping in the manuscript. The subheading/group “Strongylus vulgaris” is for example not acceptable but “Parasitic orchitis” could be fine. We agree that organizing the cases by diagnosis provides a more logical and clinically useful structure. The manuscript has therefore been completely reorganized, with cases grouped according to disease category rather than presented individually. The major diagnostic categories now include Disorders of Sexual Development, Spermatic Cord Torsion, Hydrocele and Periorchitis, Parasitic Orchitis, and Neoplasia. This organization improves readability and allows readers to more easily compare similar conditions. The revised sections are located in Lines 196–208, 229–234, 445–460, and 838–847.

Cases belonging to the same group could then be presented together with similarities and dissimilarities compared in a table. This would allow for easier comprehension. At present, the text for individual cases is far too extensive. Following the reviewer's recommendation, we created summary tables for each disease category to facilitate comparison among cases. These tables summarize signalment, clinical presentation, diagnostic findings, treatment, histopathology, and outcome, allowing readers to rapidly identify similarities and differences without searching through the text. The manuscript now includes Tables 1–5 corresponding to Disorders of Sexual Development, Spermatic Cord Torsion, Hydrocele and Periorchitis, Parasitic Orchitis, and Neoplasia.

It is very difficult to match images to the corresponding cases. This needs to be improved. Please consider that all figures and tables should “stand alone”, i.e. their legends should provide complete descriptions on what is being presented so that the reader does not have to refer to the manuscript text. Where appropriate, the legend must include information on individual animals like age and breed. We appreciate this important suggestion. The figures have been extensively revised to improve clarity and usability. Related images were combined into composite figures, figure legends were expanded so that each figure is self-explanatory, and relevant information such as age, breed, diagnosis, and case number has been added where appropriate. Case numbers were also included in the figure legends to facilitate cross-referencing with the text.

Not all images are worth presenting in the manuscript. Please select those that illustrate the case or specific findings of the case. In the images, specific findings need to be indicated (use e.g. arrows) and described. E.g. in Figure 29, many will not be able to decide what findings are pathological. This requires an explanation. In other images, attempts to indicate pathological changes have been made but are not clear or visible (e.g. Figure 30 – where is the arrow?). We carefully reviewed all figures and removed redundant images that did not substantially contribute to the manuscript. We also added arrows and other annotations to highlight the relevant pathological findings, including the figures identified by the reviewer. Figure legends were revised accordingly to clearly describe each highlighted lesion.

The discussion needs to be organized according to the groups you are forming and presenting. Again, it is far too long and needs to be focused. We agree that the Discussion should follow the organization of the Results. The Discussion has therefore been completely reorganized according to each diagnostic category. We also shortened this section by removing repetitive information and focusing on the clinical significance, differential diagnoses, management, and comparison with the published literature for each disease group. These revisions are found in Lines 1083–1213.

Conclusions should present a take home-message. The Conclusions have been completely rewritten to emphasize the principal clinical messages of the case series, including the importance of recognizing the clinical presentation of uncommon testicular disorders, the value of combining imaging and histopathology for diagnosis, and the relevance of these cases for clinical decision-making. These revisions are presented in Lines 1215–1222.

 

Author Response File: Author Response.pdf

Round 2

Reviewer 2 Report

Comments and Suggestions for Authors

The manuscript has been considerably improved and should become acceptable for publication after some minor changes have been performed:

The legend of tables is always placed above the table whereas figure legends are placed below the figure.  Please move the table legends above the tables.

Subchapters should not begin with a table. I suggest to move the tables further down the subchapter.

Author Response

Thank you for your careful review and helpful suggestions. We have revised the manuscript accordingly. All table legends have been moved above their respective tables, and the tables have been repositioned so that no subchapter begins with a table, as recommended.