Case of the Month - May 2025

Meet Magnolia, a special cat that needed surgery right away to fix her prolapsed uterus.

As a freelance veterinarian, I go to different hospitals to fill in when they otherwise would not have a doctor.  I am there to see patients, acting as one of their staff doctors in place of their regular doctors if the hospital is short-staffed for the day (or night).

I never know what to expect when I walk into a hospital that I’ve never worked at before.  Double this unknown factor if I am filling in at an emergency clinic—cases can be versions of what I have treated before OR— sometimes I see something I’ve never seen or treated before.   Maybe only read about in a textbook…

Anyways, I was immediately handed a case before I even put my backpack on a chair in the doctor’s office.  It was a young kitty, owned by a family that came to the clinic in desperate need to save her life.  She just had a litter of kittens, and, oh no, her uterus is hanging outside of her body.

Magnolia is sedated and this is a picture of her uterine prolapse

Whaaaat?  It’s hard to believe, but in animals the birthing process can be so hard that in pushing out the babies the mother will also push out part of her uterus.  It’s called a uterine prolapse.  The uterus is still attached inside, but it is stretched and sticking out of the cat’s vulva—inside out.  An analogy would be when one is squeezing out dough from a cookie dough roll and the plastic starts turning inside out as you squeeze out the dough.  Three kittens were born, but unfortunately one did not survive. The owners were scared that maybe there was another kitten still inside of her.   And mamma cat will not survive if not treated.  Her exposed uterus had been out for several hours, oozing blood that whole time.  And the uterine tissue was beginning to die.  Dead tissue still attached to an animal can cause sepsis, a condition when bacteria enter the animal’s blood stream.  It was not good.

Uterine prolapses are rare in cats. I had not performed a surgery on one to fix it, but this is what the cat needs. Magnolia is only about a year old, lethargic, and very anemic from the blood loss.

Treatment

I first had to give her a blood transfusion, to start stabilizing her.   The blood given helped replenish what was lost from the leaking uterine tissue.  But she could also be losing blood internally from a ruptured ovarian artery, tugged on by the stretched-out heavy uterine tissue.  Luckily, I checked her abdomen with a quick ultrasound and there was no internal bleeding.  Immediately after the transfusion, I took her to surgery.   I first put the uterus back inside, returning the uterus to its natural state. 

I shrunk the uterus by drenching it in hypertonic saline, then I was able to push it back inside of her. Now she is prepped for spay surgery.

Then, I removed the entire uterus as I would in a normal spay.   There were no other kittens inside. One of her horns had an intussusception, which means the tube of the horn had telescoped inside itself.  The intussusception may have caused the prolapse in the first place, or happened after the prolapse; I do not know but the condition is in its own a serious condition.   So, spaying fixed two problems.   

And within 2 hours of surgery, she was awake and eating.

Last thoughts

When I was in vet school, I envisioned the job being a lot of saving lives.  I envisioned playing with puppies and kittens, enjoying talking to clients, and saving lives.

What I didn’t really understand what my job was actually going to be.  It is a lot of client communication, a lot of treating pets, occasionally playing with a puppy or kitten, and rarely saving a life.  Maybe I don’t give myself enough credit in the saving lives department, but actually saving a life in a life-threatening emergency does not happen that often.  Not often enough to say it happens everyday.  Maybe I save lives in quiet ways, or help clients’ lives in ways I never will know.  But actually saving a life in the moment just doesn’t occur that often.

In the case of Magnolia, I saved her life and certainly helped the lives of her two surviving kittens.   I am honored and humbled to partake in doing such a task, and this is just one of the many reasons I do what I do.