Incidence of the Most Common Surgical Affections Among Sheep and Goats Admitted to a Referral Hospital in the State of Kuwait

| Sheep and goats are a generational legacy in the State of Kuwait. So, this study was designed to record surgical affections in sheep and goats admitted to a referral hospital in Kuwait. From the obtained data, a total number of 658 small ruminants (385 sheep and 273 goats, representing 58.51% and 41.49% respectively) suffered from different surgical affections were admitted to the hospital from May/2017 to May/2020. The incidence of these affections varied in both species and different ages. The highest incidence was recorded in sheep aged 3 to 4 years old (27%) and in goats aged less than one-year-old (35.5%). Female affected animals (61.6%) were more recorded in both species than male ones (38.4%). Sixty surgical affections were recorded among sheep and goats (14 congenital and 46 acquired affections representing 17.9% and 82.1% respectively). Numerous surgical affections were recorded among sheep and goats in the state of Kuwait with the highest incidence of urogenital system affections in both species followed by udder and teat, digestive, integumentary, musculoskeletal, abdominal wall, eye, ear, and respiratory systems affections in sheep, while it followed by musculoskeletal, integumentary, udder and teat, digestive, eye, abdominal wall, ear, and respiratory systems affections in goats. Congenital anomalies are more prevalent in goats than sheep. Metabolic, nutritional, and infectious surgical conditions were more common in sheep, however traumatic affections more in goats. While sheep and goats share many surgical affections due to their anatomical and physiological similarities, there is a distinct nature of each species that makes some disorders more dominant in one species than the other.


data collections
The present study was carried out on 658 small ruminants (385 sheep and 273 goats) who suffered from different surgical affections were admitted to a referral hospital belonging to a public authority for agriculture affairs and fish resources Kuwait from May/2017 to May/2020.

establisHment oF tHe surgical aFFections and classiFication according to tHe aFFected system case History and clinical examination
The owner complaints and the full case history were taken from the animal's owner according to previously designed sheet. The data regarding age, sex, species, breed, time of onset of the disease, previous interventions, and general health conditions were recorded (Pugh et al., 2020). Clinical signs including any changes in the animal behavior, appetite, nature of excretion and secretions, locomotion disorders, swellings, and expressions of pain and other alignments were recorded. General and local visual examinations of each case were performed for the detection of any structural and/or functional disorders of the affected region. Physical palpation of the affected parts and/or lesions was done to detect their nature, consistency, and tenderness (Abdel-Hady et al., 2015). The exploratory puncture was done whenever indicated to reveal the physical characters of the existence of fluids or contents in the examined lesions. General physical examination including pulse and respiratory rates, body temperature, and lymph nodes was performed to determine the health status of the animal. Digital photographs were obtained for each case. A complete description of the lesion was recorded to state the final diagnosis or directed to confirm the primary diagnosis using diagnostic tools (Matthews, 2016).

diagnostic tools
The diagnostic imaging was selected according to the affections which needed to be confirmed. The diagnostic imaging tools used were radiography (Abu-Seida, 2014;Hashemiasl et al., 2016), ultrasonography (Gonzalez-Bulnes et al., 2010;Hakim et al., 2018), and endoscopy (Ali et al., 2019) which performed at the diagnostic imaging unit belonging to a public authority for agriculture affairs and fish resources in the State of Kuwait. Total blood picture and blood chemistry were conducted in cases when required to confirm the primary diagnosis (Pugh and Baird, 2012). Cytological examination of fluid obtained from exploratory puncture was done (Pugh et al., 2020). Microbiological examinations were performed in cases with septic conditions to confirm the diagnosis and state the pre and post-operative antibiotic of choice for treatment of infection. Diagnostic pathological examination was done when it is possible to confirm the primary diagnosis of some surgical conditions (Benavides et al., 2015).
The surgical affections of admitted sheep and goats were categorized according to the affected system (Linklater and Smith, 1993;Matthews, 2016).
In the same direction, the goat is universally called "Poor

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Advances in Animal and Veterinary Sciences 2020 | Volume 8 | Special Issue 2 | Page 54 man's cow" (Iqbal et al., 2008). On the other hand, some societies consider sheep and goats a national heritage that reminds them of their ancient origins and civilizations of their country. This is clearly shown in the State of Kuwait, where the Arab Heritage Festival is held, and Kuwaitis celebrate their heritage and hold beauty competitions for many breeds of sheep and goats which indicate the importance of these animals as a generational legacy in the State of Kuwait (Farghali et al., 2020). According to the authors' knowledge, there is no available literature that has studied the surgical affections among sheep and goats in the state of Kuwait.
The current study was conducted to illustrate and record the common surgical disorders among the sheep and goats aiming to set a map of such affections in the State of Kuwait under its environmental and managemental circumstances to be useful for global recording and studying of such conditions. To ensure the accuracy of the recorded incidence, the authors keened to do the study in a period of three-years in a referral hospital belonging to the public authority for agriculture affairs and fish resources, Kuwait.
From the obtained data, sheep (58.51%) were more frequently admitted with surgical affections than goats (41.49%). It may be contributed to the higher population of sheep (731.845) than goats (182.039) in the state of Kuwait (Central Statistical Bureau, Kuwait, 2016). Furthermore, these findings are agreed with many articles which stated that cattle and sheep had the tendancy to be affected more frequently than goats (Radostits et al., 2007).
Regarding the age of the affected animals, the incidence of the diseases varied with the ages. This is in agreement with the findings reported for surgical conditions affecting sheep and goats in several studies (Samad, 2000;Abdel-Hady et al., 2015). In the present study, the highest incidence was recorded in sheep aged 3 to 4 years old (27%) and in goats aged less than one-year-old (35.5%). It may have resulted from the frequent admission of congenitally affected cases in goats (20.5%) than in sheep (16.1%).
From the obtained data, female affected animals (61.6%) were more recorded in both species than male ones (38.4%).
The findings parallel to that the highest affected system was urogenital (18.5%) (with the more prevalent female (67.3%) than male (32.7%) genital affections) followed by udder and teat affections (14.3%).
The urogenital system was the highest affected one in both species (sheep, 20.5%, and goats, 15.8%) because dystocia was the highest surgical indication of the admitted animals with nearly the same incidence in sheep (48.1%) and goats (48.8%). This similarity is in agreement with previous studies mentioned that generally, sheep and goats, as small ruminants, are very similar in several directions regarding reproduction performance even if there are little variations. The gestation period as will as number and delaviry procedure of offsprings seem to be parallel in both species as the initial phase of labor extending from 6 to 12 hrs., and the next phase from half to one hour with an incidence of dystocia may reach up to 50 % in these animals with more frequent incidence in ewes and does parteurate single and male offspring (Purohit, 2006;Ismail, 2017). The unforeseen low incidence of urine retention among sheep and goats in the present study in Kuwait was conflicting with several studies all over the world countries which stated that urine retention, resulted mainly from urolithiasis, is a common metabolic disease in all small ruminants (Pugh et al., 2020).
On the other hand, these results parallel to those recorded in humans which mentioned that the incidence rate of a new stone former in Kuwait was significantly lower than that reported in Europe and the USA (El-Reshaid et al., 1997). This low incidence may be returned to the low rate of male sheep and goats' castration and depending mainly on grazing feeding pattern in Kuwait which lowering urolithiasis formation. Another reason that may lead to the lacking of an accurate incidence rate is that the study was conducted in a referral hospital and that urine retention cases need interventions as soon as possible that may be carried out in small ruminant farms or in the nearest clinic.
In the present study, the affections of udder and teats ranked as the second affected system in sheep (15.6%) while in goats (12.5%) they were the fourth affected system. The findings which in the same direction of previous studies (Abdel-Hady et al., 2015). On the contrary, other research recorded that goats are more susceptible to udder and teat affections than sheep (Farghali, 2001). The most recorded cases belonging to udder and teat affections were chronic septic mastitis in both species. That is parallel to findings recorded in several articles which mensioned this affection as the most common udder affection in small ruminants which commonly caused by Staphylococcus spp. Other pathogens such as Streptococcus spp., Enterobacteriaceae, Pseudomonas aeruginosa, Mannheimia haemolytica, Corynebacteria, and fungi may contribute to the occurrence of the disease. Also, severe cases of mastitis related to incorrect preventative strategies have been attributed to the pathogens of Aspergillus fumigatus, Serratia marcescens, P. aeruginosa, or Burkholderia cepacian (Gonzalo et al., 2004;Abdel-Hady et al., 2015).
Regarding digestive system affections, it was the third affected system among sheep (14.5%), while in goats (11.7%), it was the fifth affected system. The superiority of sheep may be contributed to the higher incidence of ruminal foreign bodies in sheep (50%) than in goats (40.6%). The results which in agreement with previous researches which stated that among domestic ruminants,

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Advances in Animal and Veterinary Sciences 2020 | Volume 8 | Special Issue 2 | Page 55 cattle are more susceptible to the development of ruminal impaction due to foreign materials followed by buffalo, sheep, and goat. (Priyanka and Dey, 2018). Goat is less predisposed to the ingestion of foreign bodies due to their well-de veloped sensitive prehensile organs and browsing and selective feeding behavior (Fromsa and Mohammed, 2011).
Another cause of increased incidence of digestive affections among sheep rather than goats was the higher repeating of rectal prolapse cases in sheep (30.4%) than in goats (12.5%). The findings that previously mentioned by other researches as rectal prolapse is more common in sheep than in goats (Pugh et al., 2020).
The musculoskeletal system was placed as the fifth affected system in sheep (10.1%), while in goats (15.4%), it was the second affected one. In the current study, fracture cases put the goats (64.3%) in front of sheep (51.3%) as more musculoskeletal affected species. Fracture is the most common musculoskeletal surgical disorder in goats. These animals are frequently susceptible to fractures due to their abundant gathering in urban territories which predisposes them to trauma, canine bites leading to several musculoskeletal affections (Doijode, 2018).
Regarding abdominal wall affections, it was the 6 th affected group in sheep (10.6%) and the 7 th in goats (10.3%). In the present work, these affections could be divided into hernias (97.1%) and abdominal wall perforating wounds (2.9%). The recorded types of hernia were umbilical, ventral abdominal hernia, perineal hernia, and inguinal hernia (udder hernia) in addition to scrotal hernia (estimated with genital affections). These results parallel to previous studies stated that the types of hernia frequently recorded in ruminants are umbilical, abdominal, inguinal, scrotal, and diaphragmatic hernia (Abdel-Hady et al., 2015).
Sense organs (eye and ear) were more commonly affected in goats (11.0% and 7.3%) than in sheep (8.3% and 4.2%). These findings may be contributed to that most of the eye injuries are caused by foreign objects like thorns, bushes, stings, and another pointed object. Sharp traumas are caused by grass tips, bamboos, etc. Goats have more prominent eyes than sheep and do encounter such injuries while browsing or grazing (Khan et al., 2014) as well as the long pendulous goats' ear.
The respiratory system seemed to be less commonly surgically affected among sheep and goats and the recorded affections were narrow nostrils (in sheep only) and nasal adenocarcinoma (3 sheep and 5 goats). Enzootic nasal adenocarcinoma in sheep and goats may be an economically critical contagious tumor of the nasal mucosal glands with a prevalence that may reach 10% in some localities (Ali et al., 2019). On the other hand, the narrow nostril of sheep is rare but Kuwait has sheep of Awassi breed which has a characteristic long head and frequently recorded narrow nostrils complain (Ali et al., 2020b).
Regarding the recorded congenital affections, fourteen affections were recorded and goats (20.5%) seemed to be more commonly affected with anomalies than sheep (16.1%). The findings in agreement with previous research (Pugh et al., 2020).
When the authors classified the cases according to causes, we found that the most common causes were belonging to metabolic and nutritional causes (41.6% in sheep and 28.6% in goats) followed by infectious causes in sheep (20.3%) and traumatic ones in goats (23.8%). The results clarified that sheep had a higher tendency to be affected by metabolic, nutritional, and infectious diseases than goats (Radostits et al., 2007). On the other hand, goats had a higher tendency to be affected with traumatic affections than sheep due to their svelte conformations, and the goat's natural curiosity and independence, make them tend to get into more trouble than sheep (Pugh et al., 2020).

CONCLUSION AND RECOMMENDATION
Numerous surgical affections were recorded among sheep and goats in the state of Kuwait with the highest