Rectal and Vaginal Prolapse

Causes
Rectal prolapse Sows and growing pigs		Quite common, in sows particular just before and after farrowing
		May be associated with oestrus in sows
		Constipation, low fibre and water shortages
		Excessive slope to the floor. Sow with too short a lying area where their behind over a step
		Excessive abdominal straining associated with feeding or piling of pigs. Note condition of the floor and stocking rates.
		Mycotoxins
		Low fibre in the diet
		Diseases resulting in diarrhoea, colitis and coughing - increasing abdominal pressure
		Too short tail docking resulting in poor anal sphincter action
Vaginal prolapse		More common in older sows than younger, mainly over parity 5
		Fat sows with large litters
		Floors with excessive slope
		High feed intake and fermentable feed increasing abdominal pressure
		Stretching and relaxation of pelvic ligaments
Uterine Prolapse		Occurs infrequently after farrowing. The sow presents with the whole uterus prolapses. Majority of sows will die of shock. It is possible to replace the uterus but is generally fatal. Once the uterus is replaced high concentrations of potassium in the compromised tissues may lead to heart failure in the sow. If the sow survives replacement or amputation, culling should occur.
Bladder prolapse		Rare, but presents during farrowing as a large sack visible at the vulval lips and interferes with the farrowing process. Emergency euthanasia and caesarean section should be performed to save other piglets. It is occasionally possible to drain the bladder and replace through the urethra.
Treatment of rectal or vaginal prolapse
Growing pig rectal prolapse	Leave in pen to be bitten off by pen mates. This might lead to a rectal stricture but the suturing treatment is just as likely to lead to a stricture. This might be considered poor welfare, but in Dr Carr's judgment this has offered the best solution and does not appear to cause undue pain and suffering to the affected pig. If pig over 60 kg it is likely to reach bacon weight. If you are used to replacing and suturing a prolapse, continue to method below. There appears to be an association between wheat feed and rectal prolapse in the growing pig.
Sow	Replace and retain with a purse string suture
Equipment required
		Large curved needle 2 inches or 5 cm and scissors
		Suture tape or nylon stitching for growing pigs
		Warm water and antiseptic
		Obstetrical lubricant
Method
1		If the pig is in a pen remove it and place it on its own
2		Sedate or restrain the pig. In growing pigs it is possible to place a bucket over its head or hold over a wall. In sows place in a crate
3		Clean the area around the prolapse and remove all faeces
4		Carefully return the prolapse into the rectum or vagina. This may take a little time. Be patient and gentle pushing. With vaginal prolapses the wall can become very oedematous (jelly like) and it is easy to push your fingers through the outer wall. Don't worry if this happens once or twice.
5		Once the prolapse has been returned start stitching using a purse string suture. The prolapse is likely to be pushed out again but do not worry continue stitching replacing the prolapse when it gets in the way
6		Infiltration with local anaesthesia around the anal or vaginal ring may be used
7		Start the purse string suture under the tail and move round taking reasonable bites with the needle. It will take 6 to 8 in and out moves to go all the way round.
8		At the end 'over sow' so the area to be tied will be strong
9		Push the prolapse back in again and hold it in
10		Pull the two ends of the suture closed. Place three fingers (depends on the size of the animal) into the rectum or vagina and pull the sutures tight around your fingers. There has to be sufficient room for the animal to defecate and urinate.
11		Inject the animal with a suitable antibiotic for example penicillin/streptomycin
12		Put some liquid paraffin (0.75 litres per adult sow) into the mouth or feed to help soften the faeces

The purse string suture

Prolapsed rectum sow	Prolapsed uterus in the postmortem room
Prolapsed bladder through the vulva	Perineal prolapse/hernia