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Managing prolapses in cows

published: March 6th 2020
by: Dr. Elizabeth Crabtree
source: Oklahoma State University College of Veterinary Medicine

With spring calving season approaching, many ranchers will have to deal with the dreaded uterine and vaginal prolapse. Both prolapses are closely associated with calving, but each has very distinct causes and occurs at different times. It is important to recognize what type of prolapse you are dealing with to institute the appropriate treatment in a timely manner. This article covers the predisposing factors of each type of prolapse, the differences in treatment for each prolapse, and the implications each has for subsequent calvings.
    Both the vagina and uterus are part of the female reproductive tract. To understand prolapses, it is important to understand how the cow’s reproductive tract is arranged. In the cow, the vagina and the uterus are separated by the cervix. The cervix serves to close the uterus off to the “outside” during pregnancy. During labor the cervix dilates to allow the calf to pass out of the uterus, through the vagina, and out into the world. So, while both are a part of the reproductive tract, they are separate anatomical structures that serve very different purposes.
    As the name implies, a vaginal prolapse is the prolapsing of the vagina itself. This condition most often occurs in late gestation, days to weeks before the expected calving date. During this process the cervix remains intact protecting the pregnancy. There are many predisposing factors to the development of a vaginal prolapse, the most important being the increase in abdominal pressure due to the growing fetus. Many other factors such as high body condition score, age, and breed/genetics will also predispose cattle to vaginal prolapses. An important factor to remember is that if a cow has a vaginal prolapse once, she is highly likely to prolapse again. This makes it an important management issue, and culling is recommended.
    A vaginal prolapse is generally smaller in size with a smooth to slightly wrinkled look. Treatment for a vaginal prolapse is rather straight forward—replace the vagina into normal position with the assistance of an epidural anesthesia. A Buhner’s stitch is placed to keep the prolapse from reoccurring. This stitch will need to be removed once calving starts because it will impede the progress of labor and endanger the cow and calf.
    Uterine prolapse is much different. As the name implies, it is a prolapsing of the uterus. Uterine prolapses occur after calving when the uterus inverts itself through the cervix and the vagina out of the cow. A uterine prolapse will be larger in size than a vaginal prolapse, usually reaching all the way to the ground.
    Often another distinguishing factor is the presence of placentomes or the connection between the calf and the cow. These structures are oblong in shape, dark purple in color and raised. There are a handful of predisposing factors for uterine prolapses: a prior vaginal prolapse, low calcium levels, and dystocia or difficult delivery. In beef cattle, a prolonged delivery is the most common cause. For this reason, the best prevention of a uterine prolapse is early intervention when a heifer or cow is having difficulty calving. Uterine prolapses are an emergency and need to be addressed by a veterinarian as soon as possible. With the uterus out, tension is placed on the large uterine vessels. This tension on the vessels puts the cow at risk of rupturing, which can cause the animal to go into hypovolemic shock and bleed out internally. With this in mind, transporting is not ideal as this can cause more trauma and tension to the uterus and its associated vessels.
    Treatment of a uterine prolapse is less straight forward than a vaginal prolapse. Replacing the uterus into its proper position is more difficult than a vaginal prolapse. An increase in time spent outside of the body also increases the difficultly of replacing the uterus and decreases the prognosis. If a uterine prolapse is severe enough, the option of amputation is sometimes best. This option gives the cow time to raise her calf, but she would need to be culled due to her lack of a reproductive tract. The severity of uterine prolapses often indicates further supportive care and potential hospitalization are needed to give the cow her best shot at survival. Unlike a vaginal prolapse, uterine prolapses are not hereditary in nature. This means that a cow does not necessarily need to be culled based on a uterine prolapse alone.
    While this article makes prolapses seem cut and dry, that is not always the case. Prolapses are a vicious cycle of pressure and straining that causes a worsening of the prolapse that causes more straining and so on. It is possible for both the vagina and uterus to prolapse. Remember, if your animal has a prolapse, it is important to have the animal examined by a veterinarian in a timely manner.
    Here are some important highlights to keep in mind.
    Vaginal prolapse:
    •Smaller in size
    •Smooth to slightly wrinkled contour
    •Most likely occurs before calving
    •Genetic, recommend culling
    •Make an appointment with your veterinarian
    Uterine prolapse:
    •Larger in size
    •Most likely occurs after giving birth
    •No genetic component
    •Medical emergency
    •Transport not recommended

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