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Barth encourages producers to address uterine prolapse promptly

by Wyoming Livestock Roundup

Albert Barth of Western College of Veterinary Medicine at the University of Saskatchewan says uterine prolapse is a generally a one-time accident.  Most of these cows will rebreed, if they are not badly damaged.

Causes of prolapse

“Some studies have shown that low calcium can predispose a cow to prolapse, beef cattle may have a marginal hypocalcemia, but they are not like a dairy cow that goes into milk fever and is unable to stand after calving.  The low calcium is not sufficient to give her milk fever, but may increase the chance for uterine prolapse,” explains Barth.

“Calcium is important for proper function of smooth muscle tissue,” he continues. “When the cow is low on calcium, smooth muscle contraction becomes weak.”  

Another cause is difficult calving.  

“If you had to pull hard on the calf, the cow may be more likely to prolapse,” he says.  “If she keeps straining as she is lying there, she may keep pushing on the uterus, turning it inside out.  It’s always wise to try to get the cow up as soon as possible after calving.  Once she stands, the uterus that may have been starting to come out may fall back down where it belongs.”

“Often we’ll give the cow oxytocin after a difficult birth, to help the uterus start shrinking back down again – just to make sure it won’t prolapse.  Normally, once the calf starts nursing, it starts to shrink down, because suckling stimulates release of oxytocin, a natural hormone, within the cow.  But a calf that has been pulled hard, or had a long and difficult birth, may not get up quickly, to start nursing, so we give the cow oxytocin to do what the calf would have done by suckling,” says Barth.


The sooner the prolapse can be replaced, the better, and producers should emphasize keeping the cow calm and quiet in the meantime. After prolapse, the large uterine arteries are tightly stretched and at risk for rupture. 

“If the uterus bounces up and down, or even just hangs there while the cow is standing or walking, this is dangerous,” he explains.

Barth warns to never chase the cow around to try to get her in, if she calved out in a pasture.

“Leave her where she is.  Don’t try to haul her to a veterinary clinic.  It’s always best to have the vet come out.  Leave her lying down, and if weather is cold, protect the uterus by wrapping it in towels or blankets to keep the exposed tissue from freezing or from damage, such as ripping it on a fence if she’s in a corral,” he says.

Replacing the prolapse

“To replace the uterus, most veterinarians prefer the cow lying down rather than standing.  If she’s lying out in a pen or field, and she has a rope on, you can often approach her quietly and may be able to get the needle into the epidural space to anesthetize her hind end, and she won’t get up.  Then we put her in a frog-leg position with hind legs pointing backward, which tips the pelvis up,” says Barth.

“Otherwise the pelvis and vagina are pointing toward the ground and you are working uphill.  We put a rope on each hind leg and tie it back.  A cow is not very strong at pulling her legs forward, so if you have several people, they could just hold the ropes,” he explains.

“Then we remove the placenta and clean up the uterus.  Sometimes it’s easiest just to put the whole thing into a five-gallon bucket of warm water to get the dirt and foreign material washed off.  Then we sit behind the cow, wearing a waterproof suit, put the uterus in our lap and finish washing it,” says Barth.

After the uterus is clean, Barth notes that they begin the process of replacing it.

“We lubricate the clean uterus and start putting it back in.  This is a gradual process; often the cow pushes and you lose what you’ve gained.  Even with the epidural, some cows keep straining.  A rule of thumb is to allow about 15 minutes.  If you haven’t gotten it replaced within 15 minutes, and she’s pushed it out a couple of times, you need to try something different,” he says.  “You will never win once you start to get tired.”

At that point you need gravity to help you.  

“This might mean tipping the cow downhill, or lifting the cow’s hindquarters up with a front-end loader.”  

If she’s in a barn, you might use the rafters for securing a rope to lift her.  Out in a field, you could create a tripod with poles to create a framework for a winch.

After care

“We never give oxytocin until after the uterus is back in place – or the uterus becomes a less pliable mass to work with,” he says.  

Once the uterus is back in, however, oxytocin will help it shrink, making it less apt to be pushed out again.  The veterinarian may place a stitch across the vulva to make sure the uterus cannot prolapse again.

Usually once the cow can get up and around, is no longer lying down straining, and there’s a live calf to start nursing to stimulate oxytocin release, she won’t push the uterus out again.  

“But to be safe, we put a stitch in.  If not completely reverted, the uterus is more likely to come back out,” he says.

If the tip of one horn is not completely reverted, this gives the cow something to push against, and if she strains again she may be able to push it out again.

“The stitch will help keep this from happening,” says Barth.  “The cervix will start to close down, to where it can’t come back out.  By the third or fourth day, the opening will be too small for it to come back through – and it’s safe to remove the stitch.”

In most cases, if the uterus was not damaged, the cow will breed back.  Chances are low that she would ever do it again.  

“We have kept many of these cows in the breeding herd, over the years, and they did not do it again,” he says.

Heather Smith Thomas is a correspondent for the Wyoming Livestock Roundup. Send comments on this article to

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