It looks like uterus. I would like to know the pathogenesis too.

Thank you dr Quik.

No experience with camels but lot of dairy cows. My opinion is that in first photos there is prolapsed vagina wall and in last pictures prolapsed uterus for sure. And the uterus has ruptered so the intestine has fallen out. Pathogenes? My guess is that female camel nutrition status could have been low (too skinny).

Thank you Dr Leena

1. The first case: the ruptured part seems to be uterus because of the color, texture, and thickness. It is too thick as you see the first two pictures. I attached a picture for vaginal prolapse for comparison.

2. The second case: I agree with you, it is the uterus, but how this part came to out said. It is a converted case, the endometrium from outsaid, the fetus inside it? How did happen? 

I would agree with Dr. Suojala. I don't have any experience with camels neither, but with bovine and equine.

If the uterus was expelled as you mention in the second case, it could be the second horn containing the fetus, being expelled through the tear of the vaginal wall, eventually also through a uterine tear, together with parts of the intestine or the bladder, due to the excessive labor/straining. In horses, a rupture can happen when the fetus enters the birth-path in a wrong position, in case of a torsion, retroflexion, or rarely spontaneously, often combined with, triggering or triggered by excessive labor.

In any way, I would suggest an epidural anesthesia, eventually preceded by a sedation, if the animal is very agitated and does not yet show any signs of shock. This should take care of the excessive labor/straining. Repositioning of the torsion or the fetus, if possible. The administration of an uterus relaxant can, in an early stage, spontaneously resolve a retroflexion which can be the cause for excessive labor, and in many cases simplify the reposition and the examination.

In any case, a cesarean should be considered.

I hope this helps.

Thank you Dr Andrian,

I appreciate your suggestion, but when the uterus is dislocated through a ruptured vagina, it would appear in this order: serosa from outside and endometrium from inside. In the second case, you see the uterus is inverted, I mean the endometrium from outside and the fetus inside it. I still confused, how this case was developed to reach this point. I attached a case of vaginal rupture where the pregnant horn, the non-pregnant horn and the ovaries were dislocated from the vulva.  

I tend to think that these cases may be caused by wrong/repeated traumatic manualities or attempted "fetotomy" by the owner/herdsman. Did you had a good talk with the herdsman/owner ? An autopsy of the organs involved may revel an initial  "knife" wound/trauma ....

Thank you Dr Maurizio for your suggestion. It is helpful. Also, very thanks for all opinions and explanations added to these pictures.  

Please understand that it is quite difficult to give a remote diagnosis and scenario  based just on a few pictures.

Proper labelling of the organs in the pictures, and possibly their content,  would help a lot, as we are not on site.

I'm excited to hear the final proposed pathogensis. I do not know if someone interfere in these cases before come to the clinic? Also I recommend hormonal analyses , it may give a message about these cases.

According to the attached history, all these cases except one occurred spontaneously. One case followed a large-sized fetus. Prolapsed uterus occurred for many causes, one of them is the loss of uterine tonocity. Ruptured vagina or uterus may also follow uterine torsion and other spontaneous causes.     

Here, I re-attached the pictures with some labels,  Question was for (A and B) and C is only for comparison.

Re the last 3 photos The clue to understand this is to work out (1) where the cervix is. It still does form a sort of neck or narrowing and then see that the mucosa either side of this neck is different, thus one can see proplased vagina (white smoother)  near the skin and uterus (more red and carpet like) further away. Many possible causes for what has happened but one scenario is (a) insufficient opening of cervix (b) excessive straining (c) prolapse of vagina followed by some of uterus may even have uterine rupture (alas). There are drugs aimed at assisting slackening of cervix not a 100% but may help.

First two A and B looks like poorly dilated cervix appearing

 This a total vaginal l prolapse  in an horse.

Thank you Dr Brown for your comments. Your suggestions is very probable (narrow cervix + severe staining + vaginal + uterine tearing. Some hesitation is with case B. I see it is the non-pregnant horn??.  

Hello Friend

regards

Prolapse of gravid uterus is not possible with fetus in situ. Once fetus is expelled then only uterine prolapse becomes a reality (post partum prolapse, a massive part of uterus is prolapsed). So to say eversion of uterus with fetus in it: obviously fetus is expelled first before prolapse can occur. The non gravid horn - even this has to take same route for eversion.

Excessive straining by animal may result in tare of vagina. Try to locate cervix (cervical rings) and diagnose the condition accordingly. Identifying endometrial tissues and caruncles may also help in this.

In pregnant animals, cervico-vaginal prolapse is a common occurrence.

Some probable reasons have been given above. Additionally deficiency of minerals like Calcium, Phosphorus, selenium and Magnesium; ingestion of estrogenic plants, dystocia, Forced extraction of the fetus and disturbance in hormonal profile may precipitate the condition.

Thank you Dr Neeraj for your valuable addition. I thought  it is impossible to occur uterine prolapse while the uterus is still inside. But as you see the figures, this is already happened. However, the pathogensis  (after this valuable discussion from all colleagues) is now relatively clear. NB: the uterus of camels has no caruncles and the placenta is diffuse type (like mares).

Thank you for all contributors.

I have noticed that here in camel dairy, the recurrent postpartum uterine prolapse 

Our camels are at high quality roughage, so there is no question of ca deficiency. 

What is the treatment? 

Uterine prolapse is virtually unknown in nomadic pastoral areas but common in all areas where camels are permanently confined in paddock ! Uterine prolapse incidence can be minimized by making camels in the last 2 months of pregnancy to walk for 5 km daily.    

Thank you Maurizio for y advice

Ali