Prolapse

A prolapse in dogs – this sounds abstract at first, but is a very concrete, often frightening situation: An organ or tissue protrudes from its normal position, usually through a body opening or into an adjacent body cavity. In veterinary medicine, this is spoken of mainly with the rectum, the uterus or the nictitating membrane gland of the eye. Prolapses are painful. And they allow no delay – without rapid treatment, serious complications can follow.

Types of Prolapse in Dogs

Not every prolapse looks the same or arises from the same reasons. An overview of the most important forms:

Rectal prolapse:

Here, rectal tissue slips out through the anus – visible as a pink to red, moist protrusion. Frequently affected are young animals with severe diarrhoea; in principle, it can affect animals of any age, breed and both sexes. The trigger is usually persistent straining due to intestinal, rectal or urinary tract diseases. Possible triggers:

• Diarrhoea or constipation
• Parasitic infections
• Intestinal problems such as tumours or inflammation

Uterine prolapse:

The uterus protrudes outwards, usually following a birth. From practice: We advise seeking a vet without delay in this case.

Nictitating membrane gland prolapse (Cherry Eye):

If you haven’t seen it yet: The cherry eye looks at first glance like a small red nodule in the inner corner of the eye. In fact, the gland of the third eyelid has bulged outwards, that gland which produces around 30 to 60 percent of the tear fluid.

• A British analysis of practice data (VetCompass) found the highest risks in Mastino Napoletano, English Bulldog, Cane Corso, Lhasa Apso and American Cocker Spaniel at an annual prevalence of 0.20 per cent; the mean age at first diagnosis was 0.63 years.

Causes of prolapse in dogs

Prolapses rarely come out of the blue. Usually, a triggering factor – or a combination thereof – can be identified:

1. Increased pressure: Persistent severe straining – whether due to diarrhoea, constipation, a difficult birth or chronic coughing – can literally push tissue outwards.
2. Injuries or tissue weakness: An injury or an congenital connective tissue weakness can undermine the supporting structures of internal organs. In some dogs, this is genetic.
3. Birthing complications: Particularly in bitches, a uterine prolapse after birth is a known risk – especially if contractions were very strong or the uterus is exhausted and weakened afterwards.
4. Genetic predisposition: Some breeds are simply more prone to certain prolapses, above all cherry eye.

Symptoms of prolapse in dogs

The signs depend heavily on which tissue is affected – but a few warning signals appear frequently:

1. Visible tissue protrusion: The most noticeable sign is usually also the clearest: protruding tissue at the anus, vulva or in the corner of the eye, which simply does not belong there.
2. Pain and restlessness: Affected dogs often appear restless, are less active and repeatedly lick the affected area. Problems with defecation or urination can also occur.
3. Bleeding or mucous discharge: Particularly in rectal or uterine prolapse, bleeding or mucous discharge can occur – especially if the tissue is already irritated or injured.
4. Impaired organ function: A rectal prolapse can make defecation difficult, a urethral prolapse urination. With cherry eye, the eye often appears red, dry and shows increased discharge.

Diagnosis and treatment of prolapse in dogs

The vet usually makes the diagnosis based on a clinical examination, supplemented by further tests to clarify the cause if necessary. The aim is to prevent infections, tissue damage and circulatory problems.

Treatment options:

Manual repositioning:

• In the case of a mild prolapse, the vet can clean the prolapsed tissue under general anaesthesia or sedation, treat it with lubricant and gently push it back.
• In rectal prolapse, the tissue is flushed with warm saline solution, lubricated and replaced; subsequently, a loose purse-string suture is placed around the anus for 5 to 7 days so that the tissue does not slip out again immediately.

Surgical treatment:

• If the tissue is severely damaged or if relapses occur repeatedly, surgery is unavoidable. In cherry eye, the gland is repositioned; surgical removal is discouraged because it reduces measurable tear production and can lead to dry eye within a year.

Drug treatment:

• Depending on the severity, anti-inflammatory agents or antibiotics can be used to control infections and irritation.

Aftercare:

• After treatment, dogs with a prolapse often require close monitoring for a while. Painkillers can facilitate the healing process, and targeted precautions are necessary for some forms of prolapse to prevent recurrence.

Prevention of prolapse in dogs

A prolapse cannot be prevented in every case – that would be unrealistic. But some measures can significantly reduce the risk:

1. Consistent parasite prevention: Regular deworming and parasite prevention protect the intestines and prevent associated prolapses.
2. Balanced nutrition and sufficient exercise: A fibre-rich diet and enough fluids help avoid constipation – one of the most common triggers for rectal prolapse.
3. Visit the vet early for intestinal or urinary problems: Those who do not wait but act when there are persistent problems with constipation or diarrhoea prevent excessive straining and thus the actual risk.
4. Veterinary checks around pregnancy and birth: Regular examinations are important, especially in pregnant bitches and immediately after birth, to detect an impending uterine prolapse early.