Cattle Uterine Prolapse

Uterine prolapse in the cow
Andrew White BVMS CertBR DBR GPCert(FAP) MRCVS

32 NEW LANE, PENWORTHAM, PRESTON. PR1 9JJ
The call from a farmer to replace a prolapsed uterus This article illustrates how the replacement can be
into a newly calved cow (Fig. 1) is one of those achieved quickly and safely (for the patient and
occasional tasks which the veterinary surgeon in personnel alike), with little demand for farm
practice is asked to carry out. Often the veterinary manpower. This practice adopted this technique as
surgeon on duty who is asked to attend the case will our standard at least 30 years ago and have found it
not have seen many cases themselves nor will they to be very successful. In adopting this technique,
have been actually shown how this task should be basically advocated in the literature more than 20
carried out. This 8 vet practice has only been called years ago now (Johnson, Lyons and Plenderlieth
to replace 31 prolapses in the past 12 months. It is 1986) our principal concerns were, and still remain,
therefore understandable that the task ahead is faced the welfare of the cow, the welfare of the veterinary
with some trepidation. It is usually at an unsociable surgeon and the best use of equipment and available
hour and the farmer is often not very familiar with personnel on farm.
the procedure. Coupled with that is the fact that in
this modern world there is usually an acute lack of The replacement of a fully prolapsed uterus in a cow
manpower available on farm. The replacement of a places considerable stress on the animal. The
prolapsed uterus is one of those scenarios where a inevitable straining which occurs during replacement
text book article or college lecture notes can make can be controlled to some extent by the use of
the task seem very straightforward but the reality is epidural anaesthesia, but the very removal of this
completely different! push by the cow also removes the relaxation phase
which can be utilised to advantage during the
replacement procedure. Unless the uterus is very
recently prolapsed, it becomes swollen and hardened
as well as friable, making replacement more difficult.
The fluid can be drawn out of the uterus by the use
of sugar, acting by osmosis, but this all adds to the time
required for replacement and to the stress of the cow.
As our cows get bigger, and some vets get smaller (!)
so the sheer physical effort required to present the
prolapsed mass back to the vulval lips of the cow
increases. Often there are not sufficient farm staff
available to help to support the uterus whilst
replacement is attempted. The effects of gravity and
the size of the cow combined to encourage us to
look at alternative methods of replacement. To this
end it has been suggested that the cows be cast, if not
Fig. 1: Newly calved cow with prolapsed uterus. already recumbent, and the rear end either raised on
UK Vet - Vol 12 No 1 January 2007 CATTLE l CLINICAL 1

a bale of straw (Formston 1986) or that the cow be (Fig. 3) and tightened proximal to the joint.The two
placed in sternal recumbency and the rear legs belts, linked by a short rope, are attached to a fore
extended backwards. Both of these require a end lift of a tractor and raised until the vulva of the
considerable labour force to achieve. cow is about one metre from the ground (Fig. 4).
TECHNIQUE (The safety of working underneath the raised fore-

The method which we have adopted consists of end loader must be considered. This will obviously
raising the rear end of the cow to a height of about depend on an assessment of the mechanical
one metre using a fore end loading tractor. The soundness of that machine. If there is any doubt
uterus can then be cleaned, and replaced quite whatsoever that the lift will not stay raised, then the
simply by gently holding it up to the vulval lips and arms of the lift must be supported by wooden props.)
allowing gravity to do most of the work of drawing
it back into the cow.All the vet has to do is to ensure In this position, it is a simple matter to wash off the
that there is no rotation of the uterus, thus uterus, usually by immersion into a bucket of
preventing its replacement. lukewarm water (Fig. 5).The prolapsed uterus is then
simply raised above the vulva (Fig. 6) and, with only
Most cows with a prolapsed uterus are recumbent
when approached and it is important to keep her
down during the preparation process. The cow is
best rolled over into lateral recumbency and then
any remaining afterbirth can be gently detached.Two
wide belts (Fig. 2), such as those used in a foot paring
crush, can easily be looped over the hock joints
Fig. 5: The uterus is washed clean.
Fig. 2: The straps which are used.
Fig. 3: Straps are placed above both hocks.
Fig. 6: The uterus is held above the level of the vulval lips.
minimal help and guidance, to ensure that there is no

rotation of the uterus and thus no uterine torsion,
the uterus slips back remarkably easily (Fig. 7). Once
returned to the inside of the cow, it is a simple matter
to feel into the vagina to ensure complete repositioning
of the uterus through the cervix (Fig. 8). In this
practice, we always suture the vulval lips together
Fig. 4: The rear end of the cow is gently raised. after replacement (Fig. 9).
2 CATTLE l CLINICAL UK Vet - Vol 12 No 1 January 2007

calcium solution. Only when the afterbirth has not
come away completely, or the uterus has been
prolapsed for a long time, do we give antibiotic cover.
Fig. 7: The prolapse is guided in.
Fig. 10: The cow regains her feet.
We have found this to be a quick, easy and essentially

practical method of dealing with a prolapsed uterus
and would recommend it to others. We are aware
that some of our veterinary schools and individuals
(Parker 1986) regard the raising up of a cow to be
welfare unfriendly but, provided the hoisting rope is
Fig. 8: The uterus is completely returned through the a strap at least 2" wide we do not feel this is the case.
cervix. We have no evidence of damage to the muscular
skeletal system as a result of the hoist. During the
procedure illustrated in this case, the cow was
suspended for only six minutes and the whole
procedure from approaching the case to the cow
standing up with uterus replaced, took 25 minutes.
The physical effort required of the vet was minimal,

and the cow stood up immediately after the
procedure.
REFERENCES
FORMSTON, C. (1986) Uterine prolapse in the cow. Veterinary Record
118 p. 492.
JOHNSON, R. W. (1986) Uterine prolapse in the cow. Veterinary
Record 118 p. 252.
LYONS, A. R. (1986) Uterine prolapse in the cow Veterinary Record 118
p. 492.
PARKER, C. D. (1986) Uterine prolapse in the cow Veterinary Record
Fig. 9: The vulval lips are sutured.
118 p. 310.
PLENDERLIETH, R. 1986 Uterine prolapse in the cow In Practice Vol 8
p14.
(For this purpose, I use Finlayson thread to place two

loops horizontally across the vulval lips. This material is
very strong but also quite thin in diameter and thus will
tear through the tissues unless a thicker material such
as tape or thick twine is used as an anchor point at each
end of the horizontal sutures.)
I am not convinced that this is entirely necessary, but

it seems to be tempting fate not to do so. We leave
the sutures in situ for 72 hours. After replacing the
uterus and lowering the cow to the ground (Fig. 10),
because of the associated link between prolapse and
hypocalcaemia, we also administer a full bottle of a
UK Vet - Vol 12 No 1 January 2007 CATTLE l CLINICAL 3

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Uterine prolapse in the cow

Andrew White BVMS CertBR DBR GPCert(FAP) MRCVS

UK Vet - Vol 12 No 1 January 2007 CATTLE l CLINICAL 1

TECHNIQUE (The safety of working underneath the raised fore-

Fig. 5: The uterus is washed clean.

Fig. 2: The straps which are used.

Fig. 3: Straps are placed above both hocks.

minimal help and guidance, to ensure that there is no

2 CATTLE l CLINICAL UK Vet - Vol 12 No 1 January 2007

Fig. 7: The prolapse is guided in.

Fig. 10: The cow regains her feet.

We have found this to be a quick, easy and essentially

The physical effort required of the vet was minimal,

(For this purpose, I use Finlayson thread to place two

I am not convinced that this is entirely necessary, but

UK Vet - Vol 12 No 1 January 2007 CATTLE l CLINICAL 3

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