Unilateral Uterine Prolapse in a 7-Year Old Multiparous Cat

An intact, 7-year old multiparous queen in a breeding colony was found with a uterine prolapse following the delivery of four live kittens overnight. The queen was systemically stable and the tissue was pink with moderate edema. An attempt was made to reduce the prolapse non-surgically under heavy sedation (dexmedetomidine) and spinal anesthesia (lidocaine), but failed. General anesthesia was induced and a ventral midline incision was made. The right uterine horn was located within the abdomen. The left horn was prolapsed out of the vagina through a tear in the uterine body. The horn was replaced back into the abdomen and an ovariohysterectomy was performed. Recovery was uneventful and the queen raised her kittens without incident.
Uterine prolapse usually occurs within 48 hours of parturition.1 Whole uterine prolapse has been reported in cats from 10 months to 6 years in age2 while unilateral prolapse is unusual in small animals. Uterine prolapse is considered an emergency with guarded prognosis if not addressed quickly due to hemorrhagic shock secondary to rupture of the ovarian or uterine vessels.3,4 Treatment options depend on the severity of prolapse, edema, and tissue damage. When minimal tissue damage is present, the uterus may be replaced vaginally either under general anesthesia or heavy sedation and epidural anesthesia. If there is significant edema or tissue necrosis, a ventral midline incision approach should be made allowing reduction of the uterus internally followed by ovariohysterectomy.1
Uterine prolapse does occur in the cat, but unilateral uterine prolapse is less common. This case demonstrates a positive outcome and survival following a unilateral uterine prolapse. Ovariohysterectomy was a successful treatment option for this cat due to the duration of prolapse and poor prognosis of future fertility based on the tissue condition and her age.