# Comparative clinical and epidemiological characteristics, risk factors, and outcomes of uterine torsion in camels, buffaloes, and cattle: a multicenter study

## TL;DR

This study compares uterine torsion in camels, buffaloes, and cattle, revealing species-specific differences in risk factors, timing, torsion characteristics, and outcomes.

## Contribution

The study provides the first systematic comparison of uterine torsion across camelids, buffaloes, and cattle, identifying species-specific patterns and risk factors.

## Key findings

- Closed housing is a universal risk factor for uterine torsion across all three species.
- Severe torsion and delayed intervention (>48 hours) are the strongest risk factors for fetal and maternal mortality.
- Camels, buffaloes, and cattle differ in torsion timing, direction, anatomical location, and severity.

## Abstract

Uterine torsion is a leading cause of dystocia in large domestic animals. However, there is no systematic comparison of its clinical presentation, epidemiological data, risk factors, or outcomes in camelids, buffalo, and cattle.

Between 2008 and 2023, data were collected from closed and open housing systems in multiple regions (Qassim region, Saudi Arabia and Minia Governorate, Egypt). A total of 3,557 camels (Camelus dromedarius), 7,157 buffaloes (Bubalus bubalis), and 5,251 cattle (Bos indicus) were examined. Detailed clinical records from 80, 262, and 129 diagnosed torsion cases were examined for parity, torsion characteristics, intervention methods, and survival outcomes. Logistic regression models were used to determine risk factors for fetal and maternal mortality.

Closed housing led to significantly higher rates of uterine torsion in all species (p < 0.001), with multiparous females being more likely to experience it. Gestational timing, torsion direction, anatomical location, and severity all differed significantly between species. Torsion occurred primarily during parturition in camels and cattle, but was evenly distributed between late gestation and parturition in buffaloes. Despite left-horn pregnancies, camels exhibited almost exclusively right-sided torsion, whereas buffaloes and cattle exhibited torsion in the direction of the gravid horn. Camels (96.3%) and buffaloes (98.6%) had more post-cervical torsion, whereas cattle had a higher rate of pre-cervical torsion (35.7%). Camels had the highest percentage of severe torsion (85.0%), buffaloes had severe (45.8%) and moderate (48.9%) torsions, and cattle had moderate (67.4%) to mild (24.8%) torsions. Severe torsion and delayed intervention (>48 h) were the strongest risk factors for fetal and maternal mortality across all species.

This study reveals significant species-specific differences in the clinical presentation and epidemiology of uterine torsion. The identified patterns in timing, direction, location, and severity provide critical evidence for developing tailored diagnostic and management strategies in camels, buffaloes, and cattle.

A graphical summary of the study. This illustration synthesizes key findings from a comparative study (2008–2023) of uterine torsion in 3557 camels, 7,157 buffaloes, and 5,251 cattle. It contrasts species-specific patterns in: (1) Risk and timing: the universal risk of closed housing and differences in onset (parturition vs. late gestation); (2) Torsion characteristics: direction relative to the gravid horn, anatomical location (pre- vs. post-cervical), and dominant severity; and (3) Outcomes: identifying severe torsion and delayed intervention (>48 h) as the strongest universal risk factors for mortality. The data underscore the need for tailored clinical management across species.Chart comparing uterine torsion characteristics in camels (n equals eighty), buffaloes (n equals two hundred ninety-two), and cattle (n equals one hundred twenty-nine). Common risk is closed housing. Species-specific findings include timing, gravid and torsion direction, cervical location, and severity. Universal mortality risk involves severe torsion and delays over forty-eight hours. Conclusion emphasizes need for tailored diagnostic and management strategies.

A graphical summary of the study. This illustration synthesizes key findings from a comparative study (2008–2023) of uterine torsion in 3557 camels, 7,157 buffaloes, and 5,251 cattle. It contrasts species-specific patterns in: (1) Risk and timing: the universal risk of closed housing and differences in onset (parturition vs. late gestation); (2) Torsion characteristics: direction relative to the gravid horn, anatomical location (pre- vs. post-cervical), and dominant severity; and (3) Outcomes: identifying severe torsion and delayed intervention (>48 h) as the strongest universal risk factors for mortality. The data underscore the need for tailored clinical management across species.