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Uterine prolapse in sheep
Uterine prolapse is the complete inversion of the uterus, which exits through the vulva and hangs behind the ewe like a large red mass, sometimes up to the hocks. It occurs AFTER lambing, almost always in the hours following the release of...
What is it?
Uterine prolapse is the complete inversion of the uterus, which exits through the vulva and hangs behind the ewe like a large red mass, sometimes up to the hocks.
It occurs AFTER lambing, almost always in the hours following the release of the last lamb, more rarely during the following day.
This is one of the most serious emergencies in sheep farming. The released uterus is engorged with blood: it can tear, bleed massively, and the ewe can die within a few hours from shock.
Key point
Absolute life-threatening emergency. A sheep whose uterus has protruded can die within a few hours from hemorrhage or shock. We call the veterinarian immediately, we prevent the ewe from getting up, we elevate the hindquarters and we keep the organ covered with a clean, damp cloth. You never try to put it back on yourself.
Commonly observed signs
These signs are neither exhaustive nor specific. Only a veterinarian can establish a diagnosis.
Related signs — each one links to its page:
Voluminous mass, red to dark red, emerging from the vulva and hanging behind the ewe, appearing just after lambing.
Its surface has rounded reliefs, in small buttons, which correspond to the attachment points of the placenta. The placenta itself is sometimes still attached to it.
The mass quickly becomes dirty with earth, straw and droppings, and visibly swells as time passes.
The sheep pushes, agitates, shows signs of pain, trembles.
She is often lying down and unable to get up, particularly when a lack of calcium is associated.
Pale mucous membranes, rapid breathing, cold extremities: these are the signs of hemorrhage and shock, and they require immediate intervention.
Rapid depression, fixed gaze, refusal of any food.
Lambs that bleat next to a ewe in this state should be sheltered and fed separately.
When to consult without delay
This list does not replace veterinary advice. It gathers situations that justify a prompt consultation.
Causes and risk factors
The uterus turns on itself and comes out when pushing efforts continue after giving birth, while the cervix is still open and the uterus is released.
Difficult lambing, strong traction on a lamb, a large litter, a very large lamb or a dead lamb favor this mechanism.
A lack of calcium around parturition makes the uterus soft and unable to retract: this is a major factor, often associated.
A retained placenta that causes prolonged pushing efforts can trigger prolapse.
A very thin ewe, exhausted by giving birth, or on the contrary very fat, is more exposed.
A backward sloping floor in the lambing pen mechanically makes things worse.
Straining related to irritation, coughing or diarrhea immediately after lambing can also contribute.
Difficult lambing, significant traction when extracting a lamb.
Large litters, large lambs, stillborn lambs.
Lack of calcium around birth, sheep having difficulty getting up.
Retention of the placenta and prolonged pushing efforts.
Ewes exhausted, very thin, or too fat.
Lambing pens sloping towards the rear.
Older ewes, repeated litters.
Unsupervised birth: prolapse often occurs in the hours that follow, and a ewe discovered late has already lost its chances.
Diagnosis and care
Diagnosis is the veterinarian's responsibility, based on clinical examination and laboratory tests. Care is decided case by case.
There is nothing to diagnose: the picture is obvious and there is only one thing to do, call the veterinarian immediately.
While waiting for its arrival, a few simple actions change the prognosis. Prevent the ewe from moving and getting up: each step causes the mass to swing and tears the ties.
If the ewe is standing, have her lie down gently in a clean place.
Raise the ewe's hindquarters by propping it up on a bale of straw: this reduces pressure and limits swelling.
Wrap the uterus in a clean, damp cloth, without rubbing or trying to tuck it in, and keep it moist. A dry uterus becomes damaged very quickly.
Do not place it in dust or mud, or hose it down.
Keep the lambs sheltered, warm, and take care of their first meal separately.
The veterinarian will assess the state of shock, the presence of a tear, anemia, and will decide on the course of action. He often gives a local anesthetic to stop the pushing efforts before putting the uterus back into place.
A pale sheep, which is breathing quickly and whose extremities are cold, is bleeding: report it on the telephone, this changes the urgency.
Treatment
Replacing the uterus is a veterinary procedure, and a difficult one. He asks to clean the organ, to decongest it, to anesthetize the sheep to eliminate the pushing efforts, then to push it back slowly and put it back correctly in its place until the bottom, otherwise it comes out immediately.
Never try to put it in yourself. A uterus pushed with dirty hands, dry, without stopping the efforts, tears, becomes infected, and a tear of the uterus is almost always fatal.
The veterinarian then places a retaining stitch on the vulva, which he removes himself after the time he sets. This point must be monitored: the ewe must continue to urinate normally.
Antibiotic and anti-inflammatory treatment is put in place, because the organ has been contaminated. A calcium intake is frequently necessary.
Sheep in shock or anemia need immediate general support.
If the uterus is torn, gangrenous or if the ewe is dying, the veterinarian may suggest euthanasia or slaughter: this is sometimes the only reasonable decision.
After the procedure, the ewe must be kept calm, on clean bedding, under close supervision for several days. The lambs often need to be fed apart while she recovers.
The meat and milk withdrawal periods for the medicines used must be requested and respected.
Treatment depends on the cause and the animal's condition: it must be determined by a veterinarian. No self-medication.
Prevention
Monitor lambing and return to see the ewes in the hours following lambing: this is where prolapse occurs, and a ewe discovered early is a ewe that can be saved.
Do not exert excessive traction on a lamb. If the birth does not progress despite proper assistance, call the veterinarian instead of pulling harder.
Prevent a lack of calcium through appropriate dietary habits at the end of gestation and a gradual transition: a uterus that contracts well does not come out.
Avoid ewes that are too thin or ewes that are too fat at lambing: the ration for the last third of gestation is the real lever.
Lay out lambing pens flat, without slope towards the rear, clean and well mulched.
Don't let a ewe grow long after the last lamb has come out without having it examined.
Manage retained placentas with the veterinarian rather than letting the ewe grow for days.
Identify and note problem ewes: a ewe which has had a vaginal prolapse before lambing must be monitored very closely at the time of lambing and discussed during culling, as this problem recurs and is passed on to the offspring.
Possible complications
Massive hemorrhage due to rupture of the vessels of the uterus: this is the quickest cause of death.
Shock and death within a few hours.
Tearing of the uterus, sometimes with exit of intestinal loops: extremely serious situation.
Gangrene of the uterus when it has been out too long.
Metritis and generalized infection in the days following replacement.
Recurrence of prolapse if the uterus has not been completely replaced.
Subsequent infertility when the organ has been very damaged.
Mortality of lambs left without milk while the mother is cared for.
When to see a veterinarian
A large red mass comes out of the vulva after lambing: call the veterinarian immediately, it is a life-threatening emergency.
The sheep is lying down, pale, breathing quickly or trembling: report it on the phone, it may be bleeding.
The ewe continues to grow strongly after the last lamb comes out.
A mass appeared BEFORE lambing: it is then more likely a vaginal prolapse, which is also a reason to call, but the behavior is different.
After being put back in place, the ewe grows again, no longer eats, has a fever or no longer urinates normally.
Do not under any circumstances attempt to put the uterus back in place yourself while waiting: cover it with a clean, damp cloth and prevent the ewe from moving.
Prognosis
The prognosis depends almost entirely on the delay. A ewe taken in within an hour or two, before the uterus swells and becomes dirty, often does very well.
After several hours, the organ is congested, soiled and fragile: tears, hemorrhages and infections become the rule and the prognosis becomes significantly darker.
A pale ewe, in shock at the time of the call, has a poor prognosis even when treated.
Unlike vaginal prolapse, which readily recurs with each pregnancy, uterine prolapse does not generally recur at subsequent lambings: a cured ewe can therefore be kept, on the advice of the veterinarian.
Future fertility depends on the condition of the uterus after the episode.
Frequently asked questions
How do you know if it's the uterus or the vagina that has come out?
The moment gives the answer. Before lambing, in the last weeks of gestation, it is a vaginal prolapse: a pink, rounded lump of moderate size, which sometimes goes in on its own when the ewe stands up. After lambing, it is the uterus: a much larger and elongated mass, dark red, covered with small rounded reliefs. Both warrant a call, but an extended uterus is an immediate life-threatening emergency.
Can I try to put it back on while waiting for the vet?
No, under no circumstances. Without anesthesia, the sheep pushes and brings it out immediately; pushed dry and with dirty hands, the organ tears and becomes infected. What you can do is decisive: prevent the ewe from getting up, prop her hindquarters on a bale of straw, cover the uterus with a clean, damp cloth and keep it moist.
My ewe survived, can I keep her for reproduction?
Often yes. Uterine prolapse, unlike vaginal prolapse, does not generally recur with subsequent lambings. It all depends on the state in which the uterus was replaced and the way in which the ewe has recovered: this decision is made with the veterinarian.
Why does this happen especially after a difficult lambing?
Because the ewe continues to push while the cervix is still open and the uterus is relaxed, and because a strong pull on a lamb pulls the uterus with it. A lack of calcium, which prevents the uterus from contracting, is very often added. This is why monitoring the hours following giving birth and controlling the diet at the end of gestation are so important.
References
FAO — Organisation des Nations unies pour l'alimentation et l'agriculture
Content reviewed by the TunisieVet editorial team · Updated 11 August 2026
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