Vet’s 2025 Guide to Vaginal Hyperplasia & Prolapse in Dogs 🩺🐾

By Dr. Duncan Houston BVSc

Vaginal hyperplasia—also called vaginal fold prolapse—is an estrogen-driven swelling of the vaginal mucosa during a bitch’s heat cycle, sometimes advancing to a frank prolapse through the vulva. Most often seen in young to middle-aged large or brachycephalic breeds, this condition can recur each season if not properly managed. In 2025, we use staging, modern suture techniques, and telehealth care to achieve the best outcomes. 🐶✨

1️⃣ . What Is Vaginal Hyperplasia & Prolapse?

This condition arises from estrogen-induced edema and epithelial proliferation during proestrus or estrus. It progresses through three stages:

• Type I: Mild eversion of the vaginal floor—tissue remains within the vulva.
• Type II: Tongue-like protrusion of vaginal tissue through the vulvar rim.
• Type III: 360° donut prolapse, often including urethral involvement.

2️⃣ Who Is at Risk?

• Young, intact bitches—typically 7 months to 3 years old, often at first few heats.
• Large and brachycephalic breeds (e.g., Boxers, Mastiffs, Bulldogs, German Shepherds, Retrievers).
• May have genetic or connective‐tissue predisposition.

3️⃣ Signs & Diagnosis

• Visible pink, swollen mass at the vulva during heat; may be moist, ulcerated if prolonged.
• Often accompanied by licking, reluctance to breed, or mild dysuria.
• Physical and vaginal examination confirms the stage and evaluates tissue condition.
• Vaginal cytology and hormone levels (e.g., progesterone) help stage the cycle.
• Biopsy to rule out neoplasia when needed.

4️⃣ Treatment Options

🔹 Conservative Management

• Type I–II often regress with heat cycle end—cleaning, lubrication, antibiotic ointment, Elizabethan collar.
• Topical estrogen blockers aren’t used; instead, inducing ovulation with GnRH or hCG can shorten estrus and reduce edema.

🔹 Surgical & Suture Techniques

Type III often requires manual reduction and vulvar suturing:

• Bühner suture: creates a vulvar tape to reduce opening—prevents recurrence during current estrus and allows urination.
• Ensure no necrosis before repositioning; maintain tissue cleanliness and hydration.

5️⃣ Long-Term Management & Prevention

• Spaying (ovariohysterectomy or ovariectomy) resolves estrogen stimulation and prevents recurrence—ideal for non-breeding bitches.
• For breeding bitches, artificial insemination allows future litters without recurrence risk.
• Monitor subsequent heats; reapply suture in recurring cases or counsel for sterilization.

6️⃣ Supportive At‑Home Care

• Keep area clean—gentle wash, antibiotic cream, use collar to avoid licking.
• Ask A Vet: telehealth support to guide suture monitoring and cycle tracking.
• Encourage gentle movement—avoid straining until tissue fully shrinks.

7️⃣ . When to Seek Veterinary Help Now

• Type III prolapse with difficulty urinating, tissue ulceration, or necrosis.
• Signs of infection: bleeding, discharge, foul odor.
• Recurrent protrusion early in estrus cycles.
• Owner uncertainty—any visible mass on the vulva.

🏁 Final Thoughts

Vaginal hyperplasia and prolapse can be alarming but are often treatable with timely, stage-appropriate care. Conservative handling suits mild cases, while Bühner suture allows tissue protection and urinary function in severe prolapses. Spaying remains the definitive solution to prevent recurrence. With telehealth and recovery tools from Ask A Vet, most bitches go through this with minimal stress or complications by 2025. 🐶❤️

Need guidance with suture care, spay planning, or cycle organization? Visit AskAVet.com and download the Ask A Vet app for expert support anytime 📱.