Vaginal prolapse in the rabbit

Esther van Praag, Ph.D.

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Warning: this file contains pictures that may be distressing for people.

Vaginal prolapse is rarely observed in female rabbit. It may be caused by over-expanded blood sinuses located beneath the mucous membrane of the vaginal wall and the vestibulum vaginae - the space region containing the openings of the vagina, urethra, and excretory ducts of the greater vestibular glands. The prolapse often starts from the proximal circular part of the vaginal vault that is located distal to the urethral opening. The dorsal portion of the vaginal vault appears much more distended than the ventral part. It can be accompanied by some degree of vaginal wall prolapse. The protruding mass can be filled with blood clots.

Charlene McGrath

Female rabbit that developed a prolapse of the vagina after being spayed. The organ was cleaned and sutured in place. The rabbit survived the surgical procedure and recovered fine.

The causes that lead to a prolapse in female rabbits are not well understood. It may relate to:

- A trauma sustained during a difficult or long parturition (dystocia);

- The presence of polyps in the urinary tract;

- A painful discharge of urine (straining) caused by a bacterial infection and/or the presence of a stone in the bladder or the kidney;

- An increased mating activity with a male rabbit;

- Ovariohysterectomy;

- Presence of mycotoxins in food.

Mechanical causes include retained fetal membranes in the uterus, or lack of movement. A congenital factor could be involved.

Zahi Aizenberg

Vaginal prolapse with a mass of brown and pink hemorrhagic tissue (arrows) protruding from the vulvar opening in a female rabbit.

Prognosis depends on the extent of the prolapse, the damage of the organ, the amount of blood lost as well as the period of time between the prolapse and the repair. It is generally poor and the doe dies within the next hours.

Differential diagnosis

The condition should be differentiated from:

• Natural abortion;

• Trauma due to the excessive mounting behavoir by a male rabbit;

• Constipation;

• Hernia;

• Rectal prolapse;

• The presence of kidney or bladder calculi;

• Spay;

• Infection of the urinary tract, urine scald caused by incontinence.

Luc Page

Prolapse of the uterus with fetus yet unborn, 24 hours before the expected date of birth. The doe died but her fetuses could be saved. Another doe adopted them and has since cared for them and fed them.

Clinical signs

The female rabbit is often found in a state of severe shock. She is depressed, recumbent, with an increased respiratory rate. This can be accompanied by constipation, difficult movement, difficult urination or incontinence, and bleeding. Typically, a red edematous mass sticks out of the vulva.

The risks of shock, bleeding and thromboembolism raises when treatment is delayed. Hematocrit is 8 to 15%.

In a rare case, eversion of the bladder has been observed in does that gave birth. A mass was found to protrude from the vagina. The rabbit strained to urinate.

Treatment

The rabbit is often found in a state of severe hypovolemic shock, due to blood loss, with pale, cyanotic mucous membranes and ears. The extremities of the limbs feel cold. It can be accompanied by hemorrhaging and/or blood loss.

The treatment depends on the state of the organ. If the tissue is not damaged or necrotic, the prolapsed organ can be cleaned and moved back in place by gentle digital pressure. It is important not to block the urethra during the procedure. Sedation and local anesthesia help in the reduction. Recurrence is possible.

The treatment of choice appears, however, removal of the affected tissue and ovariohysterectomy.

Administration of pain medication is recommended, in order to reduce discomfort after the reduction (e.g. flunixin, meloxicam).

When a bacterial infection is present, a systemic antibiotic treatment must be started.

Acknowledgement

Many thanks are due to Zahi Aizenberg, DVM, (the Hebrew University of Jerusalem, Israel), to Charlene McGrath (USA), to Luc Page (Switzerland) and Michel Gruaz (Switzerland) for their pictures and their help.

Further Information

Greenacre CB, Allen SW, Ritchie BW. Urinary bladder eversion in rabbit does. Compendium on Continuing Education for the Practicing Veterinarian, 1999, 21, 6,524-8.

Meredith A, Flecknell P. BSAVA Manual of Rabbit Medicine and Surgery Second Edition BSAVA, 1 Telford Way, Quedgeley, Gloucester, GL2 2AB, UK. 2006

Quesenberry KE, Carpenter JW. Ferrets, Rabbits and Rodents - Clinical Medicine and Surgery. Second Edition. WB Saunders, Philadelphia, Pennsylvania, USA. 2004.

Sood P, Nanda AS, Srivastava AK. Rupture of vagina in an Angora rabbit. Indian J Vet Surg 1998; 19 (126), 50.

Van Herck H, Hesp AP, Versluis A, Zwart P, Van Zutphen LF. Prolapsus vaginae in the IIIVO/JU rabbit. Lab Anim. 1989; 23(4):333-6.

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