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Yes, it appears as if a sac is coming out now. It has been about 3 weeks since the swelling, it started at about walnut sized and now is very heavy fist size. She has bled for at least two weeks.
It sounds like your dog may have vaginal hyperplasia or uterine prolapse. During certain phases in a dog’s heat cycle, vaginal tissue may swell and protrude through the vulva and look like a tongue shaped object. This is seen most often in young intact female dogs.
Symptoms of this are a protrusion of a round tissue mass from the vulva, Licking of the vulva, painful urination and not allowing breeding. If your dog can still urinate, it is not generally an emergency, but your dog should see the vet as soon as possible. If your dog can not urinate, then she needs to see the Vet immediately. You can read about this here:
You vet may be able to suture it back into place and trim away any dead tissue present, however, often it will happen again with the next heat cycle. Spaying can prevent reoccurance. I I would try and get her seen as soon as you can get her in with her vet. .
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Kipper did indeed have uterine prolapse. She was spayed the next day....would have been major $ to correct in order to have pups and the risk of reoccurance was very high, so I could not ever risk her to go the breeding route. She has not fully recovered yet, but the swelling has dropped to walnut size and is starting to look more like a regular dog's female parts. Vet told us her recovery would take longer as the swelling is also a reaction to the hormones which will not level out right away.
So wish us luck we are still holding our breath a little.