Uterine Prolapse in Cows

Vet Teletriage

Worried this is an emergency? Talk to a vet now.

Sidekick.Vet connects you with licensed veterinary professionals for urgent teletriage — get fast guidance on whether your pet needs emergency care. Just $35, no subscription.

Get Help at Sidekick.Vet →
Quick Answer
  • See your vet immediately. A uterine prolapse usually happens within hours after calving, when the uterus turns inside out and hangs outside the vulva.
  • This is different from a retained placenta. Placenta looks like membranes or tissue strands, while a prolapsed uterus is a large, heavy, red to dark-pink mass.
  • Fast treatment matters because the exposed uterus can swell, tear, become contaminated, or bleed heavily. Shock and death are possible in severe cases.
  • Common risk factors include difficult calving, retained fetal membranes, low blood calcium, uterine atony, and excessive straining after birth.
  • Typical 2025-2026 US farm-call treatment cost range is about $350-$1,200 for straightforward replacement, with higher costs if there is severe trauma, shock, surgery, or hospitalization.
Estimated cost: $350–$1,200

What Is Uterine Prolapse in Cows?

See your vet immediately. Uterine prolapse in cows is a postpartum emergency where the uterus everts, turns inside out, and protrudes through the vulva after calving. It most often happens soon after delivery, before the cervix closes, and the exposed tissue can become swollen, dirty, bruised, or torn very quickly.

This condition is not the same as a retained placenta. With retained fetal membranes, you may see hanging afterbirth or foul discharge. With a uterine prolapse, there is usually a large, rounded mass of tissue outside the cow, sometimes with the placental membranes still attached. Because major blood vessels are involved, severe bleeding and shock can occur.

Many cows recover well when your vet can replace the uterus promptly and address underlying problems such as hypocalcemia, exhaustion, or trauma from a difficult birth. Delays raise the risk of tissue damage, infection, recurrence, and poor future fertility.

Symptoms of Uterine Prolapse in Cows

  • A large red, pink, or dark-red mass hanging from the vulva after calving
  • Visible caruncles or placental attachments on the exposed tissue
  • Swollen, heavy, dirty, or traumatized uterine tissue
  • Straining, restlessness, repeated lying down and getting up
  • Weakness, depression, or reluctance to stand
  • Bleeding from the prolapsed tissue or vulva
  • Signs of shock in severe cases, such as cold ears, pale mucous membranes, rapid heart rate, or collapse
  • Placental membranes still attached to the prolapsed uterus

A uterine prolapse is always urgent, even if the cow is still standing and seems calm. The biggest concerns are swelling, contamination, tearing, blood loss, and shock. Call your vet right away, keep the cow quiet, and protect the tissue from further trauma and dirt while help is on the way. Do not confuse this with a retained placenta, which can also hang from the vulva but does not form a large inside-out uterine mass.

What Causes Uterine Prolapse in Cows?

Uterine prolapse usually develops after calving when the cervix is still open and the uterus has poor tone. Predisposing factors described in veterinary references include difficult calving, excessive traction during dystocia management, retained fetal membranes, uterine atony, and hypocalcemia. Low blood calcium matters because it weakens smooth muscle contraction and can leave the uterus flaccid after birth.

Strong abdominal straining can push the uterus outward, especially if the cow is exhausted, carrying twins, or dealing with postpartum complications. Older cows and dairy cows with metabolic stress around calving may also be at higher risk. In some cases, more than one factor is present at the same time.

Prevention starts before calving. Good transition-cow nutrition, careful calving supervision, prompt attention to milk fever or weakness, and thoughtful obstetric technique all help reduce risk. Your vet can help review herd-level patterns if prolapses seem to be happening more often than expected.

How Is Uterine Prolapse in Cows Diagnosed?

Diagnosis is usually based on history and physical examination. Your vet will look at the timing after calving, the appearance of the tissue, whether placental membranes are attached, and whether the mass is truly the uterus rather than vaginal prolapse, retained placenta, or another postpartum problem.

Just as important as identifying the prolapse is assessing the cow's overall stability. Your vet may check hydration, heart rate, blood loss, ability to stand, and signs of shock. They may also evaluate for hypocalcemia, uterine tears, retained fetal membranes, nerve injury, or trauma from a difficult birth.

In straightforward cases, diagnosis happens on the farm and treatment begins right away. If the tissue is badly damaged, the cow is down, or there is concern for severe hemorrhage or rupture, your vet may discuss a guarded prognosis and whether referral-level care or salvage decisions are more realistic.

Treatment Options for Uterine Prolapse in Cows

Spectrum of Care means you have options. Here are treatment tiers at different price points.

Budget-Conscious Care

$350–$650
Best for: Stable cows with a fresh prolapse, limited tissue trauma, and a farm setting where prompt replacement is possible
  • Farm call and urgent physical exam
  • Restraint and positioning to reduce straining
  • Cleaning and lubrication of the prolapsed uterus
  • Manual replacement of the uterus if tissue is still viable
  • Basic medications chosen by your vet, often including epidural anesthesia and calcium support when indicated
  • Short-term monitoring for recurrence, bleeding, and ability to stand
Expected outcome: Often fair to good when treated quickly and the uterus can be replaced without major tearing or shock.
Consider: Lower-cost care may not include extensive bloodwork, prolonged monitoring, or surgery. If the uterus is badly swollen, torn, or contaminated, this level may not be enough.
Most Common

Recommended Standard Treatment

$650–$1,200
Best for: Most cows with uterine prolapse that are standing or can be stabilized on-farm and need a fuller first-line treatment plan
  • Everything in conservative care
  • More complete stabilization, including IV or oral calcium and fluids as needed
  • Sedation or epidural anesthesia selected by your vet to reduce straining
  • Careful removal of debris and assessment for lacerations or devitalized tissue
  • Replacement of the uterus with attention to full horn eversion correction
  • Retention support when needed, such as vulvar retention sutures or other methods chosen by your vet
  • Post-treatment medications and follow-up monitoring for metritis, recurrence, and milk fever
Expected outcome: Good in many uncomplicated cases treated promptly, but fertility and survival depend on tissue damage, blood loss, and underlying metabolic disease.
Consider: Higher cost range than basic replacement, and some cows still relapse or develop postpartum complications despite appropriate care.

Advanced / Critical Care

$1,200–$3,500
Best for: Cows with severe swelling, major trauma, heavy contamination, inability to stand, recurrent prolapse, or life-threatening complications
  • Everything in standard care when feasible
  • Aggressive shock stabilization and IV therapy
  • Bloodwork or additional diagnostics to assess calcium status, dehydration, and systemic compromise
  • Surgical management for severe lacerations, devitalized tissue, or cases where replacement is not possible
  • Hospitalization or intensive monitoring when available
  • Euthanasia discussion if there is catastrophic hemorrhage, uterine rupture, or nonviable tissue
Expected outcome: Guarded to poor when there is severe tissue injury, shock, or delayed treatment, though some cows can still recover with intensive care.
Consider: This tier has the highest cost range and may still carry a guarded outcome. Intensive treatment can be appropriate for valuable breeding animals, but it is not the right fit for every herd or every case.

Cost estimates as of 2026-03. Actual costs vary by location, clinic, and individual case.

Questions to Ask Your Vet About Uterine Prolapse in Cows

Bring these questions to your vet appointment to get the most out of your visit.

  1. Does this look like a true uterine prolapse, a vaginal prolapse, or retained placenta?
  2. Is my cow showing signs of shock, blood loss, or low calcium?
  3. Is the uterine tissue still healthy enough to replace, or is there major damage?
  4. What treatment option fits this cow's condition and our herd goals?
  5. What medications are you using, and what milk or meat withdrawal times apply?
  6. What signs should I watch for over the next 24 to 72 hours, including recurrence, fever, or metritis?
  7. What is the realistic prognosis for survival and future fertility in this case?
  8. Are there herd-level risk factors, such as transition nutrition or calving management, that we should change?

How to Prevent Uterine Prolapse in Cows

Not every uterine prolapse can be prevented, but good calving and transition management can lower risk. Work with your vet on dry-cow and close-up nutrition, especially calcium management in dairy cattle, because hypocalcemia is linked with uterine prolapse, retained fetal membranes, and other postpartum disorders.

Careful obstetric technique also matters. Difficult births should be handled gently, with appropriate lubrication, timing, and traction. Excessive pulling during dystocia can increase trauma and may contribute to prolapse. Cows that are weak, down, or straining hard after calving should be checked promptly.

After calving, monitor cows closely for retained fetal membranes, milk fever, weakness, foul discharge, or repeated straining. Early treatment of postpartum problems can reduce complications. If your herd has repeated prolapse cases, ask your vet to review calving records, mineral programs, body condition, and transition-cow protocols to look for patterns.

Find a Vet Near You