Uterine Prolapse in Dairy Cattle
25 February 2025Uterine prolapses are more serious than vaginal or rectal prolapses, and almost always occur within 24 hours of calving. They are easily distinguished from vaginal prolapses, which tend to occur pre-calving, with the prolapsed tissue being pink and smooth. With a prolapsed uterus, the large red uterine mass may hang down to the hocks and the placental attachment sites (placentomes or small raised dark red bumps) will be visible.
Causes
Uterine prolapses can occur in both thin and fat cows, with reported causes relating to age, confinement and lack of exercise, and calf size. Very large calves, difficult births, assisted calvings and low blood calcium leading to lack of muscle tone are risk factors. Continued straining of the abdominal muscles and muscle fatigue will predispose the animal to uterine prolapse. Cows are more likely to be affected than heifers and it is not usually hereditary. It is rare for this condition to occur in subsequent pregnancies.
Once a cow/heifer has calved or had calving assistance, if you can get her up as soon as possible and moving around the uterus is more likely to drop back into its normal position in the abdominal cavity, meaning a prolapse is less likely.
Pre-veterinary care
While the incidence is reported to be very low (0.002 to 0.6%), a cow that prolapses requires immediate veterinary attention as the uterus needs to be replaced before there is excessive contamination, trauma, oedema or cervical closure. The sooner the animal is dealt with the better the outcome as the uterus will be cleaner, less swollen or damaged and easier to insert back inside.
There is a high risk of the uterine artery rupturing, which can lead to sudden death. Therefore, it is crucial that the affected animal is kept calm and should not be moved before the vet has arrived, but restrained if possible. Remove other animals from the area to avoid the prolapsed uterus being trampled and further stress on the animal. Use a clean towel or sheet to protect and support the uterus. Ensure there is plenty of warm water, soap and clean towels available and have two people ready to assist to manoeuvre the animal if required.
Future productivity
The outcome for affected animals is generally good, with survival rates typically over 70%. Mortality is most commonly down to haemorrhage and shock from severe blood loss. If the animal survives the 24-hour period after the uterus has been replaced, the chances of long-term survival and getting back in calf are good, although the calving to conception interval could be increased by up to as much as 50 days. Future prospects tend to be more positive in heifers, animals that have given birth to a live calf and those that do not experience clinical hypocalcaemia, therefore veterinary treatment is generally cost-effective.
Lorna MacPherson, SAC Consulting
lorna.macpherson@sac.co.uk; 07760 990901
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