Many different factors can lead to a uterine prolapse. A difficult calving that causes injury or irritation to the birth canal, straining or excessive pressure with a calving aid are common causes. Low blood calcium (milk fever) and retained placenta are also associated with the condition. Very fat cows but also cows in poor bodily condition are at risk.

If the worst happens and a you find that a newly calved cow has prolapsed then it is important to get veterinary help straight away. An epidural injection can be given by the vet to help ease the cows straining and administration of oxytocin will be needed to help the uterus contract and stay in place. The uterus is cleaned and placenta removed as much as possible. Salt or sugar applied directly may help to draw fluid out of and shrink a swollen uterus. Having extra assistants on hand and being familiar with the procedure of replacement greatly helps and may increase the chance of a good outcome.

There are many different methods used to replace a uterine prolapse and most vets have a preferred one. On occasions where replacement is difficult it may be necessary to adjust the position of the cow during the procedure. Some cows remain standing and in this case it can be useful for two assistants to support the weight of the uterus between them on a towel or sheet while the vet replaces the uterus. When  the cow is down the best position for replacement is lying on her stomach with the hind legs stretched out behind , this helps to tilt the pelvis forward especially if an assistant can sit over the pelvis and help support the weight of the uterus.

 Unfortunately lack of labour often means assistants are scarce. An alternative when little help is available is to raise the rear end of the cow using the front loader of the tractor. Wide straps such as those used in a foot trimming crush should be used on the legs and the cows rear raised to about 1 metre off the ground. The prolapse can be cleaned and the placenta removed before raising to minimise the time the cow is lifted.

Gradually the prolapse must be inverted back in to the vulva. This is often easier said than done and patience is required to ensure no further damage is caused. Once replaced a bottle may be used as an arm extension to completely return the horns of the uterus in to the correct position. A stitch is often placed in the vulva, though this is not thought to be necessary if the prolapse is fully replaced. Antibiotics are often given especially if the uterus has become dirty or damaged.

It may not always be necessary to cull the cow after she has suffered a prolapse.  Although reduced levels of fertility can be expected, many animals will go on to have several normal calvings with no further problems.

David Black

Paragon Veterinary Group