I kept overlooking this post because I wasn't sure who "Shadow" was...I'm glad I finally peeked!
That's wonderful that there may be other options for Shadow, I'm so happy! The vet at the local hospital wanted to lay my gelding out for the desmotomy and was going to charge me a correspondingly large amount of money to do it but after talking to all the people on here who have had it done I looked around until I found another vet who would do it standing up and for a price I could afford. It's a five to ten minute procedure, very quick and easy, and the horse was able to jump in a trailer and ride two hours home as soon as the sedative wore off. I watched him carefully on a video camera the whole way home and he was fine. He was under general anesthesia for the splitting procedure back in October and it really knocked him for a loop- the local with sedative seemed much easier on him judging by his recovery. (I suspect like people some take it better than others. Kody may not have dealt with it well.)
I've only been present at one gelding but since my vet couldn't get a catheter in to lay the horse down he ended up doing that standing up too. Poor horse! Kody is heartily sick and tired of vets at this point.
It turned out, by the way, that my surgeon is the only one I've spoken with who felt the need to do the desmotomy lying down. She admitted it was because she wasn't comfortable trying to get down that low to the ground and would rather have him up on a table where she could see well and not because the procedure itself required it. I live in a pricey area and managed to get it done for $269, others here have quoted $140. (It costs $500 to have a horse put to sleep in my county!
Gelding is $250.) I was quoted $300-500 by other vets so there's some price ranges to work with. As for how it's done, make sure the vet sterilizes the area very well then he simply makes a short incision and cuts the medial patellar ligament with a small scalpel, being careful to point the blade away from the joint. The vet who did mine actually put his finger in there under the ligament to make sure it was completely separated from any other parts before he cut it. They do both legs, clean up the blood a bit then take a stitch or two in each side and you're done!
If doing both operations at once I think I'd probably do the gelding first so that if he's standing he can support himself during the pushing and pulling of that procedure and if he's laying down the vet can lift the legs however he needs to in order to reach the testicles without pulling on fresh incisions. That's just me though! The only negative I can think of is that they're supposed to be exercised after gelding and exercise restricted for at least a couple of days after the desmotomy. Plus if he gets swollen from the gelding or has any bleeding, would that affect your ability to keep the other wounds clean? Hmm. Maybe it might be better to do the desmotomy first and make sure it helps him before going to the expense of gelding him. It means two different farm calls, two charges for anesthesia and two sets of antibiotics but it might be worth it to wait a little.
It's up to you!
If you'd like to speak to the vet who did my procedure his name is Dr. Affeldt in Centralia, WA and his office number is 360-736-3361. He hasn't done very many of these, in fact Kody was his first mini, but his mentor/ partner had done a lot of them and at least he won't make you feel like you're being an awful owner for even contemplating it like so many others will.
Good luck! Sending positive thoughts to you and Shadow.
Leia