Alpaca Articles

PROLAPSED UTERUS

By Linda Blake Southern Alpacas Stud

A female alpaca who prolapses her uterus can go on to have a normal healthy breeding life, if you take immediate steps to assist her and protect her uterus from dirt and trauma. 

A prolapse occurs because the dam keeps pushing after the cria is out. Her uterus then follows the cria.  

Uterine prolapses are not common in alpaca - in twenty years alpaca breeding here at Southern Alpacas Stud we have seen and/or been involved in only four uterine prolapses.  

“My alpaca has birthed her cria and passed her placenta, and now another one is coming out” is the general gist of the phone calls we have received. 

This cannot be discounted if twins are involved. A placenta is usually seen as a smooth object, but the inside is textured and red. A prolapsing uterus can look like a placenta that has turned inside out. The placenta may still be attached to the uterus.   

1. STOP. Keep your alpaca still.

The uterus is attached at the vulval opening only and it is a heavy weight dragging out of her insides.

Try to keep the alpaca calm and in one place to prevent damage to her uterus.

The uterus needs to be supported if the alpaca is moved.

Call the vet urgently (and more people to help). 

2. Protect the uterus. Keep it clean. 

This is the inside of the uterus you are seeing – protect it for her future birthings. It needs to be kept moist and clean. If the placenta is still attached, treat it as part of the uterus. 

Wrap or cover the uterus with a clean sheet of preferably non-absorbing material, e.g. plastic. Second best is a clean sheet or tablecloth. Do not use pressure. 

If she sits, put a tarpaulin or plastic or something clean and non-absorbing under her to keep the uterus off the ground. Elevate the uterus to the level of the vagina if you can, but not at the cost of keeping the alpaca quiet and still. 

If you have to move the alpaca, you must support the uterus. This is possible by encasing the uterus in a plastic rubbish bag, and using strong adhesive tape under the bag and then looped around the alpaca’s chest, stuck to the fleece. This helps support the weight and keeps the uterus up off the ground. 

3. The uterus will be re-inserted by the vet. 

Putting a large uterus back through the small vulva opening requires dexterity and people to hold the alpaca. In this case the owners held and comforted the alpaca at the front and a neighbouring alpaca owner, who is also a nurse, assisted the vet, supporting the uterus. The new cria sat kushed, oblivious to the drama.  

The alpaca should be comfortable and quiet during the procedure, so a light to moderate sedation may be required at this stage. This will prevent unnecessary movement and straining. An epidural anaesthetic is often not necessary in alpacas.

 
The uterus is then cleaned with tepid saline and very dilute iodine, the latter only if necessary. This is to reduce the inflammatory response from the uterine lining. Anti-inflammatory treatment (which includes pain relief as well) will be started to reduce swelling caused by the prolapse and the compromised circulation of the uterus, and to reduce inflammation of the uterus.  

If the placenta is strongly attached it is better to leave it than to tear it away from the uterus. Proper medication to treat a retained placenta is indicated.

The re-insertion can be done with the alpaca standing, or lying, depending on the circumstances. The main thing is to have the alpaca comfortable and QUIET. On a smaller alpaca than this large one pictured, the hind quarters were elevated to have some gravity assistance for the uterus insertion. 

Lubricate the vulval lips and perineum area well to reduce friction. The uterus is massaged back through the vagina, using copious amount of lubricant, and keeping the hands as flat as possible, to avoid perforating the uterus.  

The uterus needs to be fully everted carefully. It is important that the horns of the uterus are back in position, which may require the vet to fully insert their arm.  

4. The uterus must be kept inside. 

The uterus normally doesn’t come out again after proper re-positioning.

Stitching together the vulva will keep the uterus in.

In the photo you’ll see the bead to stop the stitches pulling through. A gap is left for urination. 

If one suspects that the uterus is trying to come out again, as evidenced by uterine tissue in the vagina, or maybe straining against the sutures, then this should be checked by a vet.

A female with a uterus prolapsing inside the vagina through the cervix will not be able to get pregnant.  

Antibiotics are administered. Oxytocin is given to assist contracting of the uterus to avoid prolapsing.  

Clean the female’s backside, trimming back the bloody fibre and washing off the blood, to minimize infection and fly attack. 

5. Remove the stitches a few days later. 

You’ll be surprised how quickly the inflammation will go down. Your alpaca should look remarkably normal by the time the stitches are removed by the vet from 2-4 days later.

6. Mate again.  

It is recommended to wait at least three weeks before mating, because of the inflammation. It is advisable to inspect the cervix and vagina to make sure everything is in its proper position and healthy before attempting to mate. Flush if infection is suspected - if the cervix is open and/or pus surrounds the cervix when you view it through a speculum. 

The females we have seen with a prolapse have gone on to mate and birth again normally. It can be more difficult to get the alpaca pregnant again, mainly because of the inflammation and/or infection, not because of the prolapse itself. In most cases, uterine prolapses do not recur, especially in younger females.

Common Factors 

An alpaca that keeps straining with its muscles after birthing creates the conditions for a prolapse, especially if the uterus isn’t contracting properly. Sometimes it is necessary to address the conditions of the inert (non-contracting) uterus by providing the alpaca with some calcium in addition to oxytocin. 

Our experience, and our reading, shows some common factors around alpaca uterine prolapse. 

1. Dystocias. Soft tissues get stretched in a dystocia, and may not be able to immediately recover adequately. Oxytocin is administered to help the uterus contract, preventing prolapse, and helping to detach the placenta and prevent infection.
    

2. Prolonged internal work. Vet assisted births usually have a component in them of prolonged deliveries, which increase the chance of uterine inertia (no contractions), and increase the chance of infection (simply because the vet has inserted their hand and maybe arm). Hence the alpaca needs oxytocin to prevent the conditions for a prolapse to occur.
    

3. Physical pulling. It is known that in assisted births of cows, where the calf has to be physically pulled out, that the placenta and uterus may follow. An alpaca prolapse we were involved with was from physical pulling out of a dead cria.

NB: These photos are of a female who had a normal birth, with no intervention, and no oxytocin. However her previous birth, when she was a first time birther, was difficult as she is obese, and she had a lot of internal intervention to get that first cria out. 

Updated March 2009