Case Report
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Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review

Year 2024, Volume: 13 Issue: 2, 165 - 172, 18.12.2024
https://doi.org/10.31196/huvfd.1555832

Abstract

Uterine prolapse (UPR) in bitches is a rare obstetric emergency. Generally, it occurs within 48 hours postpartum in bitches. Opposite this datum, in this case report three instances of UPR presented as two during parturition and one at 40 days postpartum. Besides one of them, which occurred during labor, was complicated by uterine rupture. Although no definitive etiology has been determined, it seems that the leading cause is weakness in pelvic connective tissues. Factors contributing to UPR include excessive relaxation of pelvic ligaments, difficult labor, and excessive straining. The extracellular matrix (ECM), composed mainly of collagen and elastin, is crucial in maintaining tissue integrity. Hormones like estrogen, progesterone, and relaxin significantly affect the ECM’s structure during pregnancy and parturition, influencing pelvic elasticity and uterine strength. Besides, our cases showed that poor body condition, parity, age, and breed predisposition are also suspected as contributing factors. All the animals were treated by surgery. Three cases show mothers and/or puppies may survive with timely and appropriate surgery. Besides, we believe that ovariohysterectomy is the best treatment choice with both survivor and prevention effects. However, to clearly define both the primary factors and co-factors speculated by this report, further research is required to investigate.

Ethical Statement

This work involved the use of non-experimental animal only. Established internationally recognized high standards of individual veterinary clinical patient care were followed. Ethical approval from a committee was therefore not necessarily required.

References

  • Ağaoğlu AR, Kocamüftüoğlu M, Çetin Y, Çelik MT, 2012: Uterine prolapse in a Pointer bitch. Eurasian J Vet Sci, 28 (3), 182-184.
  • Angrimani DDSR, Silva MF, Ilkiu AM, Rossi ES, Rodrigues IM, Codognoto VM, Ferreira JCP, 2020: Uterine intussusception in immediate postpartum in bitches: case report. Braz J Vet Res Anim Sci, 57 (1), e158398-e158398.
  • Binli F, Büyükbudak F, İnan İ, Findik M, Ay SS, 2021: Complete uterine prolapse in a cat. Ankara Üniv Vet Fak Derg, 68, 417-421.
  • Binli F, Büyükbudak F, İnan İ, Ferahoğlu V, Aksu AG, Findik M, Ay SS, 2023: An evaluation of canine inguinal hernias containing the uterus: clinical experience of four cases (2017-2022) and literature review. Turk J Vet Anim Sci, 47 (4), 305-315.
  • Boye JK, Bulkeley EA, Dujovne GA, 2022: Good prognosis for survival to hospital discharge in a group of horses with uterine prolapse treated at a veterinary medical teaching hospital. J Am Vet Med Assoc, 260 (2), 80-86.
  • Davidson A, 2003: Disorders of puerperium and lactation. Small Animals Reproduction II, 2, 1411-1416.
  • Fede C, Pirri C, Fan C, Albertin G, Porzionato A, Macchi V, De Caro R, Stecco C, 2019: Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One, 14 (9), e0223195.
  • Feldman EC, Nelson RW, 2004: Periparturient diseases. In: Feldman EC and Nelson RW (Eds), Canine and Feline Endocrinology and Reproduction. 3th ed., Saunders, St Louis.
  • Gendler A, Brourman JD, Graf KE, 2007: Canine dystocia: medical and surgical management. Compend Contin Educ Vet-North American Edition, 29 (9), 551.
  • Greiling MS, Packeiser EM, Gerhauser I, Goericke‐Pesch S, 2023: Uterine prolapse in a non‐pregnant bitch. Reprod Domest Anim, 58 (12), 1773-1776.
  • Gruenheid M, Aarnes TK, McLoughlin MA, Simpson EM, Mathys DA, Mollenkopf DF, Wittum TE, 2018: Risk of anesthesia-related complications in brachycephalic dogs. J Am Vet Med Assoc, 253 (3), 301-306.
  • Guler Z, Roovers JP, 2022: Role of fibroblasts and myofibroblasts on the pathogenesis and treatment of pelvic organ prolapse. Biomolecules, 12 (1), 94.
  • Igna C, Schuszler L, Dascălu R, Zaha C, Sicoe B, Bumb D, 2021: Retrospective study of the rectal prolapse-53 cases of dogs and cats. Lucr Ştiinţ Ser Med Vet, 54, 68-74.
  • Johnston SD, Kustritz MV, Olson PS, 2001: Canine and feline theriogenology. Saunders, Philadelphia.
  • Kanca H, Walter I, Miller I, Schäfer‐Somi S, Izgur H, Aslan S, 2011: Expression and activity of matrix metalloproteinases in the uterus of bitches after spontaneous and induced abortion. Reprod Domest Anim, 46 (2), 197-204.
  • Kapila S, Xie Y, 1998: Targeted induction of collagenase and stromelysin by relaxin in unprimed and beta-estradiol-primed diarthrodial joint fibrocartilaginous cells but not in synoviocytes. Lab Invest, 78 (8), 925-938.
  • Karsdal MA, Nielsen MJ, Sand JM, Henriksen K, Genovese F, Bay-Jensen AC, Smith V, Adamkewicz J, Christiansen C, Leeming DJ, 2013: Extracellular matrix remodeling: the common denominator in connective tissue diseases possibilities for evaluation and current understanding of the matrix as more than a passive architecture, but a key player in tissue failure. Assay Drug Dev Technol, 11 (2), 70-92.
  • Lim VF, Khoo JK, Wong V, Moore KH, 2014: Recent studies of genetic dysfunction in pelvic organ prolapse: the role of collagen defects. Aust N Z J Obstet Gynaecol, 54 (3), 198-205.
  • Mashhadi M, Ganjiani V, Bigham‐Sadegh A, Shafiee AH, 2024: Uterine horn intussusception in immediate post‐partum in a Pomeranian Spitz dog. Vet Med Sci, 10 (2), e1375.
  • Módena SF, Caldeira EJ, Peres MAO, Andreollo NA, 2016: Influence of tobacco, alcohol and diabetes on the collagen of cremaster muscle in patients with inguinal hernias. Arq Bras Cir Dig, 29, 218-222.
  • Myers DL, Sung VW, Richter HE, Creasman J, Subak LL, 2012: Prolapse symptoms in overweight and obese women before and after weight loss. Urogynecology, 18 (1), 55-59.
  • Nallasamy S, Yoshida K, Akins M, Myers K, Iozzo R, Mahendroo M, 2017: Steroid hormones are key modulators of tissue mechanical function via regulation of collagen and elastic fibers. Endocrinology, 158 (4), 950-962.
  • Nelissen P, 2015: Uterine and vaginal prolapse. Small Animal Surgical Emergencies, 420-428.
  • Özyurtlu N, Kaya D, 2005: Unilateral uterine prolapse in a cat. Turk J Vet Anim Sci, 29, 941-943.
  • Payan‐Carreira R, Albuquerque C, Abreu H, Maltez L, 2012: Uterine prolapse with associated rupture in a Podengo bitch. Reprod Domest Anim, 47 (4), 51-55.
  • Peter AT, 2014: Vaginal, cervical, and uterine prolapse. 383-395. In: R.M. Hopper (Ed.), Bovine Reproduction. 1st ed., Wiley Blackwell.
  • Roumans NJ, Vink RG, Gielen M, Zeegers MP, Holst C, Wang P, Astrup A, Saris HW, Valsesia A, Jörg H, van Baak MA, Mariman EC, 2015: Variation in extracellular matrix genes is associated with weight regain after weight loss in a sex-specific manner. Genes Nutr, 10, 1-9.
  • Sansilvestri-Morel P, Rupin A, Badier-Commander C, Kern P, Fabiani JN, Verbeuren TJ, Vanhoutte PM, 2001: Imbalance in the synthesis of collagen type I and collagen type III in smooth muscle cells derived from human varicose veins. J Vasc Res, 38 (6), 560-568.
  • Sathiamoorthy T, Cecilia J, Sridevi P, Kulasekar K, 2013: Manual replacement of bilateral uterine horn prolapse coupled with retained fetus in a Great Dane bitch. Inter J Vet Sci, 2, 125-127.
  • Schulten SF, Claas-Quax MJ, Weemhoff M, van Eijndhoven HW, van Leijsen SA, Vergeldt TF, Inthout J, Kluivers KB, 2022: Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis. Am J Obstet Gynecol, 227 (2), 192-208.
  • Zhang L, Dai F, Chen G, Wang Y, Liu S, Yang X, 2020: Molecular mechanism of extracellular matrix disorder in pelvic organ prolapses. Mol Med Rep, 22 (6), 4611-4618.
  • Zitkute V, Kvietkauskas M, Maskoliunaite V, Leber B, Ramasauskaite D, Strupas K, Stiegler P, Schemmer P, 2021: Melatonin and glycine reduce uterus ischemia/reperfusion injury in a rat model of warm ischemia. Int J Mol Sci, 22 (16), 8373.
  • Zong W, Zyczynski HM, Meyn LA, Gordy SC, Moalli PA, 2007: Regulation of MMP-1 by sex steroid hormones in fibroblasts derived from the female pelvic floor. Am J Obstet Gynecol, 196 (4), 349.

Üç köpekte doğum sırasında ve hemen sonrasında görülen uterus prolapsusu: olgu sunumları ve literatür derlemesi

Year 2024, Volume: 13 Issue: 2, 165 - 172, 18.12.2024
https://doi.org/10.31196/huvfd.1555832

Abstract

Köpeklerde uterus prolapsusu (UPR) nadir görülen bir obstetrik acil durumdur. Genellikle köpeklerde doğumdan sonraki 48 saat içinde meydana gelir. Bu veriye zıt olarak sunulan raporda ikisi doğum sırasında ve biri postpartum 40. günde şekillenen üç UPR olgusu bildirilmiştir. Doğum sırasında şekillenen olgulardan bir tanesi uterus rupturu ile komplike olarak gelişmiştir. Kesin bir etiyolojisi olmasa da başlıca neden pelvik bağ dokularının zayıflığı gibi görünmektedir. UPR'ye katkıda bulunan faktörler arasında pelvik bağların aşırı gevşemesi, güç doğum ve aşırı zorlanma yer alır. Esas olarak kolajen ve elastinden oluşan ekstraselüler matriks (ECM) doku bütünlüğünün korunmasında çok önemlidir. Östrojen, progesteron ve relaksin gibi hormonlar, gebelik ve doğum sırasında ECM'nin yapısını önemli ölçüde etkileyerek pelvik elastikiyetini ve uterus gücünü değiştirir. Ayrıca, olgularımız zayıf vücut kondisyonu, doğum sayısı, yaş ve cins yatkınlığının da predispoze faktörler arasında olabileceğinden şüphelendirmiştir. Tüm hayvanlar cerrahi olarak tedavi edilmiştir ve elle prolabe kitle reddenin küçük ırklarda işe yaramadığı ancak büyük ırklarda bir şans yarattığı belirlenmiştir. Üç vaka da anne ve/veya yavruların zamanında ve uygun cerrahi müdahale ile kurtarılabilmiştir. Hem sağ kalım hem de korunma açısından ovariohisterektominin en iyi tedavi seçeneği olduğu görüşüne de ulaşılmıştır. Ancak bu raporda öne sürülen hem birincil faktörleri hem de yardımcı faktörleri net bir şekilde tanımlayabilmek için daha fazla araştırma yapılması gerekmektedir.

References

  • Ağaoğlu AR, Kocamüftüoğlu M, Çetin Y, Çelik MT, 2012: Uterine prolapse in a Pointer bitch. Eurasian J Vet Sci, 28 (3), 182-184.
  • Angrimani DDSR, Silva MF, Ilkiu AM, Rossi ES, Rodrigues IM, Codognoto VM, Ferreira JCP, 2020: Uterine intussusception in immediate postpartum in bitches: case report. Braz J Vet Res Anim Sci, 57 (1), e158398-e158398.
  • Binli F, Büyükbudak F, İnan İ, Findik M, Ay SS, 2021: Complete uterine prolapse in a cat. Ankara Üniv Vet Fak Derg, 68, 417-421.
  • Binli F, Büyükbudak F, İnan İ, Ferahoğlu V, Aksu AG, Findik M, Ay SS, 2023: An evaluation of canine inguinal hernias containing the uterus: clinical experience of four cases (2017-2022) and literature review. Turk J Vet Anim Sci, 47 (4), 305-315.
  • Boye JK, Bulkeley EA, Dujovne GA, 2022: Good prognosis for survival to hospital discharge in a group of horses with uterine prolapse treated at a veterinary medical teaching hospital. J Am Vet Med Assoc, 260 (2), 80-86.
  • Davidson A, 2003: Disorders of puerperium and lactation. Small Animals Reproduction II, 2, 1411-1416.
  • Fede C, Pirri C, Fan C, Albertin G, Porzionato A, Macchi V, De Caro R, Stecco C, 2019: Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PLoS One, 14 (9), e0223195.
  • Feldman EC, Nelson RW, 2004: Periparturient diseases. In: Feldman EC and Nelson RW (Eds), Canine and Feline Endocrinology and Reproduction. 3th ed., Saunders, St Louis.
  • Gendler A, Brourman JD, Graf KE, 2007: Canine dystocia: medical and surgical management. Compend Contin Educ Vet-North American Edition, 29 (9), 551.
  • Greiling MS, Packeiser EM, Gerhauser I, Goericke‐Pesch S, 2023: Uterine prolapse in a non‐pregnant bitch. Reprod Domest Anim, 58 (12), 1773-1776.
  • Gruenheid M, Aarnes TK, McLoughlin MA, Simpson EM, Mathys DA, Mollenkopf DF, Wittum TE, 2018: Risk of anesthesia-related complications in brachycephalic dogs. J Am Vet Med Assoc, 253 (3), 301-306.
  • Guler Z, Roovers JP, 2022: Role of fibroblasts and myofibroblasts on the pathogenesis and treatment of pelvic organ prolapse. Biomolecules, 12 (1), 94.
  • Igna C, Schuszler L, Dascălu R, Zaha C, Sicoe B, Bumb D, 2021: Retrospective study of the rectal prolapse-53 cases of dogs and cats. Lucr Ştiinţ Ser Med Vet, 54, 68-74.
  • Johnston SD, Kustritz MV, Olson PS, 2001: Canine and feline theriogenology. Saunders, Philadelphia.
  • Kanca H, Walter I, Miller I, Schäfer‐Somi S, Izgur H, Aslan S, 2011: Expression and activity of matrix metalloproteinases in the uterus of bitches after spontaneous and induced abortion. Reprod Domest Anim, 46 (2), 197-204.
  • Kapila S, Xie Y, 1998: Targeted induction of collagenase and stromelysin by relaxin in unprimed and beta-estradiol-primed diarthrodial joint fibrocartilaginous cells but not in synoviocytes. Lab Invest, 78 (8), 925-938.
  • Karsdal MA, Nielsen MJ, Sand JM, Henriksen K, Genovese F, Bay-Jensen AC, Smith V, Adamkewicz J, Christiansen C, Leeming DJ, 2013: Extracellular matrix remodeling: the common denominator in connective tissue diseases possibilities for evaluation and current understanding of the matrix as more than a passive architecture, but a key player in tissue failure. Assay Drug Dev Technol, 11 (2), 70-92.
  • Lim VF, Khoo JK, Wong V, Moore KH, 2014: Recent studies of genetic dysfunction in pelvic organ prolapse: the role of collagen defects. Aust N Z J Obstet Gynaecol, 54 (3), 198-205.
  • Mashhadi M, Ganjiani V, Bigham‐Sadegh A, Shafiee AH, 2024: Uterine horn intussusception in immediate post‐partum in a Pomeranian Spitz dog. Vet Med Sci, 10 (2), e1375.
  • Módena SF, Caldeira EJ, Peres MAO, Andreollo NA, 2016: Influence of tobacco, alcohol and diabetes on the collagen of cremaster muscle in patients with inguinal hernias. Arq Bras Cir Dig, 29, 218-222.
  • Myers DL, Sung VW, Richter HE, Creasman J, Subak LL, 2012: Prolapse symptoms in overweight and obese women before and after weight loss. Urogynecology, 18 (1), 55-59.
  • Nallasamy S, Yoshida K, Akins M, Myers K, Iozzo R, Mahendroo M, 2017: Steroid hormones are key modulators of tissue mechanical function via regulation of collagen and elastic fibers. Endocrinology, 158 (4), 950-962.
  • Nelissen P, 2015: Uterine and vaginal prolapse. Small Animal Surgical Emergencies, 420-428.
  • Özyurtlu N, Kaya D, 2005: Unilateral uterine prolapse in a cat. Turk J Vet Anim Sci, 29, 941-943.
  • Payan‐Carreira R, Albuquerque C, Abreu H, Maltez L, 2012: Uterine prolapse with associated rupture in a Podengo bitch. Reprod Domest Anim, 47 (4), 51-55.
  • Peter AT, 2014: Vaginal, cervical, and uterine prolapse. 383-395. In: R.M. Hopper (Ed.), Bovine Reproduction. 1st ed., Wiley Blackwell.
  • Roumans NJ, Vink RG, Gielen M, Zeegers MP, Holst C, Wang P, Astrup A, Saris HW, Valsesia A, Jörg H, van Baak MA, Mariman EC, 2015: Variation in extracellular matrix genes is associated with weight regain after weight loss in a sex-specific manner. Genes Nutr, 10, 1-9.
  • Sansilvestri-Morel P, Rupin A, Badier-Commander C, Kern P, Fabiani JN, Verbeuren TJ, Vanhoutte PM, 2001: Imbalance in the synthesis of collagen type I and collagen type III in smooth muscle cells derived from human varicose veins. J Vasc Res, 38 (6), 560-568.
  • Sathiamoorthy T, Cecilia J, Sridevi P, Kulasekar K, 2013: Manual replacement of bilateral uterine horn prolapse coupled with retained fetus in a Great Dane bitch. Inter J Vet Sci, 2, 125-127.
  • Schulten SF, Claas-Quax MJ, Weemhoff M, van Eijndhoven HW, van Leijsen SA, Vergeldt TF, Inthout J, Kluivers KB, 2022: Risk factors for primary pelvic organ prolapse and prolapse recurrence: an updated systematic review and meta-analysis. Am J Obstet Gynecol, 227 (2), 192-208.
  • Zhang L, Dai F, Chen G, Wang Y, Liu S, Yang X, 2020: Molecular mechanism of extracellular matrix disorder in pelvic organ prolapses. Mol Med Rep, 22 (6), 4611-4618.
  • Zitkute V, Kvietkauskas M, Maskoliunaite V, Leber B, Ramasauskaite D, Strupas K, Stiegler P, Schemmer P, 2021: Melatonin and glycine reduce uterus ischemia/reperfusion injury in a rat model of warm ischemia. Int J Mol Sci, 22 (16), 8373.
  • Zong W, Zyczynski HM, Meyn LA, Gordy SC, Moalli PA, 2007: Regulation of MMP-1 by sex steroid hormones in fibroblasts derived from the female pelvic floor. Am J Obstet Gynecol, 196 (4), 349.
There are 33 citations in total.

Details

Primary Language English
Subjects Veterinary Obstetrics and Gynecology
Journal Section Case Report
Authors

Anıl Gürkan Aksu 0000-0001-8630-9460

Volkan Ferahoğlu 0000-0002-1553-9733

Fatih Büyükbudak 0000-0002-6993-2514

İpek İnan 0000-0002-9215-5055

Murat Fındık 0000-0003-1408-2548

Serhan Serhat Ay 0000-0003-2116-5149

Publication Date December 18, 2024
Submission Date September 25, 2024
Acceptance Date October 16, 2024
Published in Issue Year 2024 Volume: 13 Issue: 2

Cite

APA Aksu, A. G., Ferahoğlu, V., Büyükbudak, F., İnan, İ., et al. (2024). Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review. Harran Üniversitesi Veteriner Fakültesi Dergisi, 13(2), 165-172. https://doi.org/10.31196/huvfd.1555832
AMA Aksu AG, Ferahoğlu V, Büyükbudak F, İnan İ, Fındık M, Ay SS. Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review. Harran Univ Vet Fak Derg. December 2024;13(2):165-172. doi:10.31196/huvfd.1555832
Chicago Aksu, Anıl Gürkan, Volkan Ferahoğlu, Fatih Büyükbudak, İpek İnan, Murat Fındık, and Serhan Serhat Ay. “Uterine Prolapse Observed During and Immediately After Parturition in Three Dogs: Case Report and Literature Review”. Harran Üniversitesi Veteriner Fakültesi Dergisi 13, no. 2 (December 2024): 165-72. https://doi.org/10.31196/huvfd.1555832.
EndNote Aksu AG, Ferahoğlu V, Büyükbudak F, İnan İ, Fındık M, Ay SS (December 1, 2024) Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review. Harran Üniversitesi Veteriner Fakültesi Dergisi 13 2 165–172.
IEEE A. G. Aksu, V. Ferahoğlu, F. Büyükbudak, İ. İnan, M. Fındık, and S. S. Ay, “Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review”, Harran Univ Vet Fak Derg, vol. 13, no. 2, pp. 165–172, 2024, doi: 10.31196/huvfd.1555832.
ISNAD Aksu, Anıl Gürkan et al. “Uterine Prolapse Observed During and Immediately After Parturition in Three Dogs: Case Report and Literature Review”. Harran Üniversitesi Veteriner Fakültesi Dergisi 13/2 (December 2024), 165-172. https://doi.org/10.31196/huvfd.1555832.
JAMA Aksu AG, Ferahoğlu V, Büyükbudak F, İnan İ, Fındık M, Ay SS. Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review. Harran Univ Vet Fak Derg. 2024;13:165–172.
MLA Aksu, Anıl Gürkan et al. “Uterine Prolapse Observed During and Immediately After Parturition in Three Dogs: Case Report and Literature Review”. Harran Üniversitesi Veteriner Fakültesi Dergisi, vol. 13, no. 2, 2024, pp. 165-72, doi:10.31196/huvfd.1555832.
Vancouver Aksu AG, Ferahoğlu V, Büyükbudak F, İnan İ, Fındık M, Ay SS. Uterine prolapse observed during and immediately after parturition in three dogs: case report and literature review. Harran Univ Vet Fak Derg. 2024;13(2):165-72.