C900
Vaginal, Uterine, and Rectal Prolapses


Introduction/Clinical Signs: Occasionally, in a flock/herd of any size, a ewe or doe may experience a vaginal or uterine prolapse. Vaginal and mild uterine eversions occur just prior to the lambing/kidding season in some ewes and does. Complete uterine prolapses occur after lambing/kidding. Vaginal prolapses appear as a pink to red mass protruding from the vagina. These prolapses may appear when the ewe or doe is laying down, but disappear when she stands. Uterine prolapses are larger in size, but often have a more bright red appearance. To the inexperienced eye, mild prolapses from the vagina may appear as an aborted fetus. Because of this, care should be taken to correctly identify the problem before attempts are made to remove something that should actually be pushed back in. If a head, feet or legs cannot be felt inside the structure, it is probably a prolapse. Rectal prolapses can occur in any animal and appear as a bright red, sausage-shaped mass protruding from the rectum.

This is a typical rectal prolapse.

 

Causative Agents: In many cases, it is not known exactly why the animal has prolapsed. No matter the cause, the prolapse occurs because the animal strains as a result of irritation (coughing) or because proper muscle tone is lacking. These situations sometimes happen when the mother is pregnant and not inclined to move about any more than necessary. She may not even wish to get up to urinate. A very full bladder creates pressure within the abdomen. This pressure, added to the enlarged uterus and the large amount of food eaten, causes her to strain when she does urinate. The condition may also be caused by straining to reach up to a hay feeder over the backs of other animals. Lack of exercise to maintain proper muscle tone can also be associated with the condition. For animals that have a prolapsed uterus after giving birth, the cause is usually associated with low calcium levels (hypocalcemia), difficult births (dystocia), or lack of exercise. Rectal prolapse is a serious defect most commonly associated with the meat-type animals. It is believed that this weakness is due to an inherited defect. This condition is sometimes corrected by surgery, but affected animals often continue to prolapse. There is also some evidence that associates prolapses with docking the tails of sheep too short. In all prolapse cases, it is recommended that the animal be culled from the breeding flock/herd.

Treatment: The discovery of this condition in an animal is a matter for concern and prompt action, but not panic. The first step is to clean off the projecting structure with clean water and a very mild antiseptic solution (dilute chlorhexidine or betadine). With gloved hands and arms, along with plenty of lubricant (J-lube, etc.), gently force the prolapse back into the animal. If possible, the animal should be placed facing downhill and have their hindquarters elevated so that gravity helps keep the prolapse in place. For large uterine prolapses after the mother has given birth, 1-2 mLs of oxytocin can be given to help shrink the uterus. Cold water (even with ice) can also be used to help shrink the prolapse.

After the prolapse is put back in the animal, some type of device or surgical approach should be used to keep it in place. In many vaginal prolapse cases, a plastic paddle-shaped device or a simplified wire prolapse loop may be used. The prolapse loop or paddle should be placed in a bucket of a mild disinfectant and then inserted in the vagina. The device is placed horizontally in the vagina, and the curved end of the loop or paddle fits against the anterior (forward) end of the vagina or against the cervix. The loop or paddle can remain in place during and after the birthing process. The loop or paddle is held in place by one of two methods:

  1. On the animals with full fleece, use two wisps of wool and tie the loop in place with the wool itself.
  2. On goats and shorn sheep, a suture is placed in the skin to tie the loop or paddle in place, or a piece of umbilical tape is glued to the body and used to tie the loop or paddle in place.

This is a picture of a plastic prolapse loop that is often used in vaginal prolapses.

 

In some cases, a home-made harness (truss) can be constructed. It consists of a piece of harness leather about 4" X 6" in size. Near one end is a round opening that fits over the tail or tail stump, holding the truss in position. Below this hole is an oblong opening for the feces to pass through. Across the middle of this lower opening is a strip of leather bowed out slightly and riveted to the main piece at both sides. To each corner of the leather truss is riveted a length of 1-inch web belting 26-28 inches long. Two of these are carried forward over the back and two carried forward between the hind legs and under the stomach.

All four are buckled to loops on a strip of belting 50-52 inches long, which is passed around the body of the ewe/doe like a horse’s surcingle or cinch, just back of the forelegs. The loops on the strip of belting can be slid around for proper positioning. When the animal strains, the prolapse is held in place by this home-made harness. It is a good idea to remove the harness when lambing/kidding is imminent. There are also many commercially manufactured harnesses and prolapse loops on the market. These items can be purchased from most veterinary and/or sheep supply catalogs or businesses.

 

This is a commercial prolapse harness used to correct a vaginal prolapse.

Minor rectal prolapses can occasionally be treated by frequent application of a human hemorrhoid cream and placement of the prolapse back into the anus. If this does not seem to work, more aggressive treatments such as purse-string stitches (sutures), injections of counter-irritants, and prolapse rings should be used. All of these are more complicated procedures that require local anesthesia (epidural) and professional training to perform correctly.

Uterine prolapses are kept in place by placing a purse-string or mattress-type suture around the opening of the vulva. This also requires special training and should be performed by a veterinarian. These animals require an epidural to help reduce straining when replacing the uterus and to help alleviate the pain associated with the surgical procedure. If a uterine prolapse is older than 36 hours or the tissue is extremely damaged, the uterus may need to be amputated as a salvage procedure.

No matter what procedure has been performed, all animals should be monitored for signs of infection (discharge from the vagina, fever, off feed, etc.). Many animals should be treated with antibiotics for several days to prevent or treat bacterial infections.