Treatment should not be delayed. Affected cattle should be handled very gently as there is a high risk of blood loss and shock. If standing, they should be slowly walked to a crush with a head bail, and if recumbent, they should be tied up with a halter.
Wash the prolapsed tissue with warm soapy water, repair lacerations, and remove placenta carefully if still attached. If there is excessive bleeding, then stop trying to peel the placenta away from the caruncles. Apply glycerol to reduce oedema and lubricate in preparation for replacement.
Caudal epidural anaesthesia will prevent straining during replacement. If standing, use a tray or chaff bag held between two assistants to elevate the prolapse. If recumbent, position in sternal recumbency with hind limbs stretched backward to tilt pelvis forward and aid repositioning.
If bladder or intestines are contained within the prolapse, these should be repositioned first by pressure applied gently through the uterine wall. A urine distended bladder may need draining with a needle and catheter passed through the uterine wall. Ensure both horns are completely everted once the uterus is returned to the inside of the body. If this is done properly, there is usually no need for insertion of a perivulvar suture to prevent recurrence. Administer oxytocin and calcium borogluconate solutions to promote uterine contraction. Antibiotic pessaries inserted into the uterus are unnecessary. Instead, systemic antibiotics (procaine penicillin, oxytetracycline, or trimethoprim sulpha) should be administered daily for 3 to 5 days.
If severely necrotic or traumatised, the uterus may require amputation, or alternatively, euthanasia may be warranted on welfare grounds.