Vaginal prolapse is the protrusion of edematous (swollen) vaginal tissue into and through the opening of the vulva, which is the external female genital organ, occurring during certain stages of the estrus (heat) cycle. The entire circumference of the vaginal wall protrudes, giving the exposed tissue a donut-shaped appearance.

Vaginal prolapse is most common in young, intact female dogs. Breeds most commonly affected include the Labrador and Chesapeake Bay retriever, boxer, English bulldog, mastiff, German shepherd dog, St. Bernard, Airedale terrier, Springer spaniel, Walker hounds, and Weimaraner.

The primary cause of vaginal prolapse is estrogen stimulation. Vaginal prolapse almost always is diagnosed when the bitch is in or has recently progressed through proestrus (just before heat) or estrus (heat). Other causes include:

Genetic predisposition

Vaginal hyperplasia, which is the swelling of vaginal tissue with or without protrusion through the vulva

Dystocia (abnormal or difficult labor), tenesmus (straining) associated with constipation or difficult urination, or forced extraction of the male during the genital tie (intercourse) are all thought to cause or contribute to vaginal prolapse.

What to Watch For

Protrusion of a round tissue mass from the vulva

Licking of the vulvar area

Painful urination

Failure to allow breeding

Diagnosis

Baseline tests, to include complete blood count (CBC), biochemical profile, and urinalysis, are usually within normal limits.

Careful inspection and examination of the vulvar area generally reveals a fairly classic appearance of an obvious mass protruding from the vulva. The tissue associated with vaginal prolapse is usually large and soft, and can often be replaced manually (pushed back in by hand).

A biopsy may be recommended in an old bitch in order to rule out the possibility of cancer.

Treatment

Management of vaginal prolapse can be difficult. If the patient can urinate, treatment is generally not an emergency, and outpatient care is recommended. If there is blockage due to the mass, immediate hospitalization and intervention is necessary. Given enough time, most cases of vaginal prolapse are reversible, as certain periods of the estrus cycle allow for it to resolve. Treatment may include:

A urinary catheter in patients who cannot urinate

Hormonal treatment to induce ovulation

Antihemorrhoidal creams applied to prolapsed tissue

Surgical removal of the hyperplastic tissue, especially in cases of severely damaged or devitalized (dead) tissue, or urinary blockages

Home Care and Prevention

Many vaginal prolapses are initially treated at home following veterinary examination and testing. Home care may include:

Daily cleansing of the affected area with saline washes and lubrication with appropriate jellies.

Pad the environment (no direct exposure to concrete or abrasive surfaces) to prevent trauma.

Elizabethan collar to eliminate the possibility of excessive licking and chewing. Diapers may help minimize exposure of the tissue to the environment and the patient herself.

Despite treatment, two out of three affected dogs have a recurrence at the time of the next estrus. Ovariohysterectomy (spay) prevents recurrence and may hasten resolution.