Most uterine prolapses in the spring of the year go very uneventfully for an experienced veterinarian and the owner ends up with a lively cow that goes on to breed back and doesn’t miss a beat. As an aside I know lots of producers ship these cows but your veterinarian will tell you this is not a heritable problem like a prolapsed vagina and should not reoccur. If she rebreeds there is no more likelihood she will prolapse next year than any other cow.
Prolapsed uteri seem to increase in harder calvings and when cows get cast and positioned with their back ends pointing downhill. The pull of gravity will facilitate the uterus to push out the back end. If left quiet or caught ever so gently in a maternity pen, the results are usually very favourable. However this article will deal with the severely torn ripped or hemorrhaging ones or instances where cows continue to push and rip the prolapse stitch.
Originally veterinarians were taught to always reduce these but some ingenious ones came up with alternatives in situations which seemed hopeless. We still lose some but the success rate has risen as a result of doing complete uterine amputations.
Most amputations are done when the uterus is badly ripped or abraded and we are concerned about external or internal blood loss. As most of you know, most deaths occur when the large uterine arteries rupture internally causing a huge amount of blood to accumulate in the abdomen. That is why many uterine amputations are done as a life-saving procedure.
Veterinarians will first check to see if any small intestines have gotten to the inside of the uterus before starting the amputation. Various procedures have been described. Some go in internally through this incision and tie vessels close to the ovaries whereas others use very elastic rubber I. V. tubing or umbilical tape or huge Zap straps to basically put a tourniquet around the uterine stump. It is then amputated and the stump automatically falls inside the vagina so there is no need for a purse string suture on the outside. As long as there has not been too much blood loss prior to the amputation and whatever tourniquet format holds the cow should recover. Of course these cannot be kept for breeding as there is absolutely no uterus left from the cervix back.
On one occasion I was called to preg check a cow a client had bought as a cow-calf pair and it took me some head scratching to determine her uterus had been amputated. We see in our practice many heifers as freemartins on preg checking without a uterus but I totally was not expecting it in this cow. The beauty was she raised the calf and there was a healthy live cow to sell in the fall as well.
The only time I will amputate a healthy uterus is in a cow which continues to push despite having a long-acting epidural (spinal block). These prolapses have been replaced at least once and the cow pushes hard enough to rip the sutures. This could be up to several days after calving so the uterus has contracted down substantially and risk of blood loss from amputation is greatly reduced.
Our local veterinarian who mentored me often spoke of a crazy cow that caught her uterus in the bush and ripped it totally off as she kept running and never looked back. This is possible but rare. I have had one which was holding on by a thread so I amputated the rest and she likewise survived.
If you as a cow-calf producer see a prolapse that appears smooth without the many red-coloured cotyledons this most likely is the uterus presented right side out not inside out. It is coming out most likely from a tear in the vagina and is a much more serious situation. This will involve careful examination by the veterinarian to make sure other vital structures like the bladder are not involved. The uterus may be replaced and the tear sutured or in some cases a uterine amputation will be performed. Each case is unique and needs assessment.
Uterine amputations are quite rare but should your veterinarian advise one don’t think all is lost. Just remember, if she survives put her on the hit list for next year as she won’t be calving. And don’t run her through this fall to have some fun with your herd veterinarian at pregnancy checking time.