VCP 511: Gynaecology and Obstetrics Section

TREATMENT

General Considerations

• Method of treatment varies with the species and breed of the animal, the severity of the condition, the stage of pregnancy and the ability of the owner to care for and observe the animal until after parturition.
• Early prompt treatment often permits the use of simple conservative methods and obviates the necessity of using more heroic techniques.
• Operator should select the most conservative method possible under the circumstances and caution the owner that as pregnancy progresses other methods may need to be used to control the condition. Combinations of methods may be used.
• Rectal examination should be made to ascertain whether the fetus is alive and to determine the stage of gestation.
• In mild case when only a slight prolapse occur when the cow lies down the cow may be placed with the rear parts elevated by building up bedding under rear quarters or digging out soil under the front quarters.
• In advance stage of pregnancy when the cow has completed more than 260 days of gestation induction of parturition is done with 25 to 30 mg of dexamethasone combined withnatural prostaglandins at 25mg i/m or 500 to 700 micrograms of synthetic prostaglandins (cloprostenol).The owner may be advised to monitor the process of parturition.
• In chronic prolapse in postpartum cows, treatment with a gonadotrophic hormone rich in the luteinizing factor is indicated, if cystic ovaries are present. 
• Restrain the animal. View video... 
• Reduce straining by administration of epidural anaesthesia.  View video..  
• Relive the urine from the bladder using catheter. View video.. 
• Repair of tear. View video... 
• Reduce the edema. View video... 
• Reposition the prolapse mass. View video... 
• Retension sutures is applied to prevent recurrence. View video... 

Vulvar tape retention sutures

• The sutures should be located at least 2-3 inches lateral to the vulvar lips in the hair line. This affords a much tougher and thicker skin for the suture, which does not tear out as readily nor cause as much irritation as one in the vulvar lips.
• It is desirable use a type of suture that can be untied or released.

Buried or “hidden” purse string type suture, Buhner’s method, for the vulva following replacement of a prolapsed vagina

• This technique may be used in chronic post partum prolapse as well as prepartum prolapse.
• Under epidural anaesthesia  two, half inch incisions are made one to two inches above the upper commissure and below the lower commissure of the vulva.
• With a long eye point needle similar to a seton needle, an 18 inch piece of one-eighth inch nylon cord or heavy vetafil is passed within the tissues from one incision to the other lateral to one vulvar lip.
• The needle is withdrawn and reinserted in the opposite direction lateral to the opposite vulvar lip to the lower incision site and again withdrawn.
• The purse string suture around the vulva is tightened sufficiently to  allow 4 fingers in the vulva, and the knot is tied and buried beneath the skin of the upper incision by suturing the skin leaving it buried within the vulvar tissues until parturition, when it is removed.