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VIDEO: Prolapses: An inside-out guide

There are three possible types of prolapses at lambing time – vaginal, rectal and uterine. They can be time consuming and troublesome, requiring care and patience at a busy time. Laura Bowyer speaks to Hilary Jones, veterinary surgeon at Usk Vets, Monmouthshire.

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Do you know how to deal with prolapses? Prepare yourself for lambing time now! #lambingtime


Vaginal prolapses most commonly happen in the last two weeks of pregnancy, or at the on-set of lambing. If they are untreated they become very large as the bladder, which is involved in the prolapse, fills.

Vet Hilary Jones says: “Chronic straining caused by a vaginal prolapse can cause a vaginal rupture and the intestines and bladder can become visible. This can happen very quickly and ewes will either die as a result, or need putting down.”

Uterine prolapses can follow a difficult lambing of big lambs with continued straining after birth. They are easily diagnosed, as button-like caruncles are seen on the inside of the uterus and will happen immediately after lambing, says Mrs Jones.

She says: “An infection of the womb or damaged vagina can cause a uterine prolapse and ewes will lie down and strain.

A vet should be consulted and the prolapse replaced under epidural.

“The epidural should stop the straining and reduce pain. The ewe will also require antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs).

Prompt treatment

If a ewe continues straining after birth, or once a prolapse has been replaced, a rectal prolapse may occur. The rectum’s fleshy inside will protrude from the ewe’s anus and is very difficult to replace. Prompt treatment is required to prevent a large amount of intestine showing.

“Prolapses can be managed, but losses can be significant. Poorly handled prolapses cause suffering and are a major welfare concern to the industry,” says Mrs Jones.

“If a ewe prolapses it is almost certain she will do the same the following year so should be permanently marked and culled.”


What can cause a vaginal prolapse?

What can cause a vaginal prolapse?
In the last couple of weeks of pregnancy, unborn lambs can grow significantly and prolapsing ewes usually carry twins and triplets. If ewes are fat at tupping or in early to mid-pregnancy, the abdominal fat limits space for growing lambs.

Mrs Jones says: “Poor quality forage and rough grazing lead to higher volumes consumed to satisfy energy requirements. This forage will take a long time to digest, and ultimately a part of the ewe has to give. Alternatively, they may stop eating the poor forage, possibly resulting in twin lamb disease.”

Excessive gas production caused by consuming too much grain, particularly if finely milled, can again be risky. This gas production can greatly increase the ewe’s internal pressure.

Feeding concentrates twice a day, rather than once, along with good quality ad-lib hay or silage can reduce gas levels produced and consequently prolapse risk.

Mrs Jones says: “Often ewes which prolapse have short tails – docked above the vulva tip – and I think the two must be linked. A ewe’s tail is strong, and if flapped down over the vulva, it will help resist against the prolapse. Also ewes with a calcium deficiency may be more susceptible – this is certainly true in cows.”

How to deal with a prolapsed ewe

Act quickly on vaginal prolapses to minimise the risk of rupture. Mrs Jones advises against holding ewes by the hind legs when replacing prolapses, to avoid damaging unborn lambs, saying most can be replaced in standing ewes. Always:


Have patience:

  • Clean with warm water and mild disinfectant
  • Apply pressure with base of the hand. Do not use finger tips as they could rupture the vaginal wall
  • The use of a lubricant can make the prolapse more supple when replacing it. Once the prolapse is corrected the ewe often urinates, reducing their internal pressure
  • An antibiotic and NSAID should be administered for a few days afterwards
  • Mrs Jones recommends giving calcium to ewes which have experienced a uterine prolapse

managing cases


Managing cases

Plastic retainer ‘spoon’:
Can be strained against, pulling the prolapse back out. But ewes can lamb unattended with a spoon in.

Can be used if spoons and harnesses are not sufficient. Mrs Jones advises against farmers using a boot-string approach or metal ball sutures. Both penetrate the vaginal wall, causing pain and trauma to the ewe.

A purse string or ‘Buhner’ suture causes no internal damage and when placed under epidural, causes minimal trauma.

Mrs Jones says: “Often I will insert a Buhner suture to prevent straining, but also use a webbing or rope harness. As lambing approaches, loosen the suture to allow unsupervised lambing if necessary, reducing the risk of the suture tearing out.”

Re-harness the ewe for a couple of days post-lambing to prevent a reoccurring problem.

Adjustable webbing harness:
Pressure should be applied either side of the vulva, around the tail, not the stomach.

DIY harness or ‘Indian rope trick’:
A harness is made with a piece of soft rope which is completely adjustable. Ewes with early prolapses should be housed two weeks before lambing to avoid the rope chaffing the ewe. Alternatively, if housing is unavailable, they should be kept in a smaller paddock (see below for a step- by-step guide)

Advice on prevention

A nutrition plan needs formulating, based on the ewes’ body condition score and scanning results, advises Mrs Jones.

“Ewes should be grouped according to scanning results and the best quality forage given to those carrying the most.

“Forage, silage and concentrates should be analysed and a nutrition plan formulated for six to eight weeks before lambing.

You cannot play nutritional catch-up when ewes enter late pregnancy.

“Do not bear a lot of prolapses in silence. Your vet and nutritionist may be able to suggest changes to the diet to reduce problems in the same season. The following year consult these specialists and formulate a diet to avoid the same issue arising,” she says.

It can be difficult to deal with ewes which start to prolapse at the point of lambing. The fleshiness of the swollen vaginal wall can block the birth canal, and a caesarean is often needed.

Early lambing can be induced by the continual straining, often causing dead or unviable lambs.

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