Section: Overview
Uterine prolapse is the protrusion of the uterus, which is the hollow muscular organ that supports the development of the fetus, through the cervix, the part of the uterus closest to the outside of the body. It is a rare condition in small animal veterinary medicine and is more common in the female cat (queen) than in the female dog (bitch).
Uterine prolapse can be seen in all breeds and ages of cats. It usually occurs during or immediately after giving birth, most often after the delivery of the last newborn, but can also be seen following spontaneous abortion.
General Causes
Dystocia (difficult birth)
Excessive pulling on retained fetal membranes or the tissue left behind following the passing of a newborn
Forced fetal extraction, which is manually removing the newborn from the uterus
Excessive straining by the bitch or queen due to inflammation of the uterus (metritis) or a retained placental tissue that is not expelled
Idiopathic (unknown cause)
What to Watch For
Protrusion of a tissue mass from the vulva
Licking of the vulvar area
Abdominal pain
Restlessness
Vaginal discharge
Straining
Self mutilation of the hind end
Severe bleeding
Diagnosis
Baseline tests, to include a complete blood count (CBC), biochemical profile, and urinalysis, are usually within normal limits. Occasionally, in advanced cases or in patients who have infection throughout the body (sepsis), there can be multiple abnormalities that need to be addressed immediately. Your veterinarian may also recommend additional tests:
Careful inspection and examination of the area. This will generally reveal a fairly classic appearance of an obvious mass protruding from the vagina.
Digital (finger) examination. Your veterinarian may need to diagnose partial prolapse.
Vaginoscopy (visual evaluation of the vagina internally with the aid of a scope)
Uterine prolapse must be differentiated from vaginal prolapse.
A biopsy may be recommended in an older cat in order to rule out the possibility of cancer.
Treatment
The objectives in treating uterine prolapse are to return the uterus to its normal position and to prevent or eliminate uterine infection. Whether or not these can be accomplished, depends on the condition of the patient and the integrity of the prolapsed tissue. Immediate hospitalization and intervention is often necessary, either to prevent death (devitalization) of tissue or to treat the problem.
Intravenous fluid and electrolyte therapy may be necessary in these patients.
Antibiotic therapy should be instituted at once.
If the individual is a valuable breeding animal, and the prolapsed tissue appears to be healthy and not devitalized, an attempt can be made to save and replace the uterus, thoroughly cleansing the tissue, and manually replacing it.
If the damage is extensive, or this animal will not be bred in the future, there is no doubt that an ovariohysterectomy (spay) is recommended.
Occasionally, a partial uterine amputation can be performed, leaving the viable portion of uterus intact, allowing for breeding in the future. This is not recommended in most cases.
Home Care and Prevention
Follow all instructions given to you by your veterinarian. Continue antibiotic therapy for the entire recommended time period. If the uterus was replaced and there is full recovery, it may be possible to breed the bitch in the future. The queen has a higher rate of having a litter following a successful uterine prolapse repair than a bitch.
Ovariohysterectomy is clearly the best preventative. Care should be taken when assisting animals during the birthing process not to be too forceful in removing fetuses or associated fetal tissue.
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