A systematic review on urolithiasis in small ruminants according to nutrition-dependent prevalence and outcome after surgery

Marlene Sickinger; Anita Windhorst

doi:10.14202/vetworld.2022.809-817

A systematic review on urolithiasis in small ruminants according to nutrition-dependent prevalence and outcome after surgery

Vet World. 2022 Mar;15(3):809-817. doi: 10.14202/vetworld.2022.809-817. Epub 2022 Mar 31.

Authors

Marlene Sickinger¹, Anita Windhorst²

Affiliations

¹ Department of Ruminants (Internal Medicine and Surgery), Faculty of Veterinary Medicine, University of Giessen, Giessen, Germany.
² Department of Medical Informatics, Faculty of Medicine, University of Giessen, Giessen, Germany.

Abstract

Background and aim: Obstructive urolithiasis is a common disease in small ruminants with fatal outcomes if left untreated. Many methods have been established; however, long-term success rates remain unsatisfactory. Four bibliographic databases (PubMed, HeBis, Medline (OvidSP), and Web of Science) were searched to evaluate the prevalence of urolithiasis in small ruminants and long-term outcomes after surgery using a systematic review. The study aimed to give evidence-based data concerning prevalence and success rates after surgery.

Materials and methods: The analysis included 24 (total 239) peer-reviewed journal articles dealing with the prevalence of urolithiasis and 16 (total 39) concerning long-term outcomes after surgery. Literature was included if it referred to species, language, availability, and relevant statements to the specific questions, including the presence of control groups. Heterogeneity tests included Χ ², I², and τ², respectively. A 95% confidence interval was determined, and effects were estimated using the fixed effect model. Due to a feeding-associated bias, prevalence analysis was conducted for a sorghum-based and a corn-based feeding resulting in a weighted prevalence of 62% and 17%, respectively. Analysis of long-term outcomes after surgical interventions revealed long-term success rates of 15-77% after ultrasonographic tube cystotomy and marsupialization of the urinary bladder, respectively.

Results: The prevalence of urolithiasis is strongly associated with feeding and may be calculated as 17% in corn-based rations and 62% in sorghum-based rations. Surgical interventions result in guarded to moderate long-term success rates of 15-66%. Urethral stoma and marsupialization of the bladder provide acceptable long-term success rates with 71-77% but are rather salvage techniques than accepted surgical methods, especially when used in companion animals.

Conclusion: The development of urolithiasis is mainly influenced by nutrition. Effective prophylaxis of this disease should, therefore, always include advisory service for the owners. Existing surgical techniques should be critically re-evaluated concerning their long-term success rates.

Keywords: castration; long-term outcome; prevalence; small ruminants; systematic review; urolithiasis.