K.S. D'Oliveira; G.A.L. Veiga; A. Barbosa; C. Brito; F. Kitahara; J.P. Bernardes Jr; C.P. Carramenha
Uterine prolapse is a low incidence disease characterized by the exposure of one or both uterine horns in the postpartum period. It is considered an obstetric emergency and generally it is associated with dystocia and/or inadequate obstetric maneuvers, exercise lack during pregnancy, laxity of the uterine ligaments due to multiple pregnancies, tenesmus during parturition, incomplete placental detachment, as well as prolonged period of fetal expulsion. Pluriparous cats over two years old are more prone. The objective of this study is to report a uterine prolapse case, once it is a rare disease in veterinary obstetrics. A mongrel 2 years old cat, 3.5kg, multiparous and with no past history of dystocia was seen moments after the parturition, with expulsion of the last newborn about 50 minutes after the occurrence of uterine prolapse. During physical examination, it was observed: both uterine horns prolapsed by the vaginal canal, with exposure of the lumen and presence of devitalized areas of the uterine mucosa, as well as dirtiness throughout the organ. The existence of necrosis areas in the uterine mucosa became the implementation of maneuvers to perform the repositioning and maintenance of the uterus unachievable, being indicated the ovary-hysterectomy. The animal was submitted to inhalatory aesthesia, and so the uterine horns were repositioned from the vaginal canal to the abdominal cavity, followed by sterilization of the patient. During the postoperative period, the animal was medicated with cephalexin and dipyrone sodium, and was given medical discharge in 10 days. The uterine prolapse is an affection that requires emergency treatment, because the continuous tissue exposure results in viability loss of the organ. Previous studies show that recent prolapses with minimal uterine damage can be treated with cleaning followed by lubricating and manual uterus repositioning to the abdominal cavity. Besides, hysteropexy may be necessary in some cases. However, prolapses with intense devitalization of the uterine mucosa must be treated with the ovary-hysterectomy. It is important to emphasize that the uterine prolapses may be associated or not to rupture of ovarian artery with intra-abdominal hemorrhage, predisposing the animal to hypovolemic shock if the ovary-hysterectomy is not immediately performed. In the present study, thorough evaluation of the uterine viability and the choice for the ovary-hysterectomy were indispensable to the treatment success. To conclude, the uterine prolapse prognosis is favorable, provided that the established therapeutic modality is appropriate and applied according to the clinical condition of the organ.