Mass Protrusion in Vaginal Area in Cats

A mass protrusion in the vaginal area in cats can also be referred to as a vaginal hyperplasia to characterize the vaginal mucosa proliferation. Vaginal hyperplasia is a common result of estrogenic stimulation, as the feline’s body releases proestrus and estrus to encourage the mating process. However, a vaginal protrusion can also be the result of weakened vaginal tissues after giving birth or through a feline’s pregnancy. A mass protrusion in the vaginal area in cats is considered an emergency as the protrusion can lead to shock and toxemia, requiring immediate veterinary attention.

A mass protrusion in the vaginal area in cats occurs when the vaginal tissues push through the external female genitalia. This protrusion in the vaginal area resembles the appearance of a pink, fleshy donut that is often mistaken for a vaginal tumor. Your veterinarian may refer to a mass protrusion in the vaginal area as a vaginal prolapse. A vaginal prolapse commonly affects pregnant felines, cats that have given birth, and young, reproductive felines, as vaginal protrusion occurs during a feline’s heat cycle. 

The initial sign of a mass protrusion in the vaginal area in cats is the smooth, glistening, fleshy tissue mass that has pushed through the cat’s vulva. If the protrusion has occurred in less than 24 hours, the donut-shaped mass will appear swollen and pink in coloration. However, as the internal reproductive tissues are exposed, the tissues will become dull in color, dry out, and may even develop ulcerations. The feline may continuously lick the affected area, strain upon difficult urination and appear depressed. Additionally, a feline with a mass protrusion in the vaginal area may also develop the following symptoms: 

• Dehydration 
• Hypothermia (decreased core body temperature) 
• Painful urination
• Vaginal discharge
• Licking of the vaginal area
• Restlessness 
• Urinary retention 
• Inability to breed
• Hemorrhagic shock: caused by internal bleeding if uterine vessels have been torn or as a result of hypothermia. 
• Toxemia 

Mass protrusion in the vaginal area is commonly seen in young female cats that still have their reproductive organs. Felines usually experience a mass protrusion in the vaginal area during their heat cycles, known as estrogen stimulation, but the prolapse can also be a result of: 

• A genetic predisposition
• A difficult or prolonged labor 
• Oversized fetuses 
• Incomplete separation of the placenta after giving birth
• Decreased myometrial tone after pregnancy that is now allowing the tissues to fold and move away from the pelvis. 
• Anorectal obstructions 
• Obesity 

The diagnosis of mass protrusion in the vaginal area in cats is a straightforward diagnosis as the prolapse is visible. However, your veterinarian will want to complete the baseline diagnostic tools including a urinalysis, biochemistry profile, a complete blood count and a review of your cat’s medical history. Some additional diagnostic tests your veterinarian may also perform include:

• Palpation of the protruded tissues: the act of feeling the tissue to identify structures other than vaginal tissues within the mass protrusion, such as the uterus or bladder. 
• Vaginoscopy: a specialized scope used to visualize the inside of the vagina. 
• Ultrasound: imaging used for visualization of the internal organs. An ultrasound is helpful in a protrusion case because the vet can see which organs have been affected, other than the vagina. The veterinarian can also rule out the possibility of a kitten that has not been born yet, but is stuck inside the cat because of the prolapse. 
• Cornification of vaginal epithelial cells: an act of swabbing the vagina and looking at the cells under the microscope to identify the stage of estrus the cat is currently in. 

The main goal in the treatment of mass protrusion in the vaginal area in cats is to return the vaginal tissues back to their original anatomical position and prevent a bacterial infection. A vaginal mass protrusion can be treated medically or surgically, which is to be decided by the veterinarian and the cat owner. In some cases, a mass protrusion in the vaginal area in a cat requires immediate intervention and hospitalizing the feline may be necessary. 

In the case of a mass protrusion caused by estrogenic stimulation, the veterinarian may treat the cat with hormone therapy to decrease the level of estrogen. Once the cat’s estrogen levels have declined, the vaginal protrusion will spontaneously resolve itself. During hormone therapy, the protrusion may be cleaned daily and treated with anti-hemorrhoid cream to reduce swelling, as well as pain. If the feline is unable to urinate, the veterinarian may find a need to place a urinary catheter until the tissues have been restored back to normal. 

If the prolapse is more severe, the veterinarian may need to manually position the tissues back into the feline, placing sutures outside the vagina until she completes her heat cycle. Any necrotic (dead) tissues will need to be removed, which may decrease a feline’s fertility. 

The treatment option most veterinarians recommend for a cat with a mass vaginal protrusion is an ovariohysterectomy, or the removal of female reproductive organs. 

If your cat has received surgical treatment for her mass protrusion in the vaginal area, the prognosis is very good. The feline may receive intravenous fluid therapy including an antibiotic, pain medication on the day of the operation and, if the female is supporting a litter of kittens, a lactation stimulant. The female is expected to go home the day after the surgery with the use of an Elizabethan collar to prevent trauma to the incision site. The feline will be expected to complete a follow-up appointment, roughly two months after the procedure.  

About two-thirds of cats that have not had an ovariohysterectomy will experience a recurrence of mass vaginal protrusion as early as her next heat cycle.