Bovine Physical Exam

8/8/2019 Bovine Physical Exam

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Bovine Physical Exam

1. The first procedure is to obtain a urine sample--rub behind vagina-collect urine-for

ketone bodies--ketosis test.2. The second procedure is to insert the thermometer. The pulse can also be taken at

this point. Temperatures range from 101.5° to 103.5°F.

3. Next is the visualization of the vulvar mucous membranes-vulvar mucous membranesshould be moist, shiny, smooth, and pale pink. To assess the mucous membranes,

gentle separation of the vulvar lips using both hands is preferred.

4. Auscult Heart--The most successful way of examining the heart is to place the bellof the stethoscope sufficiently forward between the upper foreleg and the chest wall.

The heart is located in the ventral part of the thorax between the third and sixth ribs.

Careful interpretation of rate, rhythm, and heart sounds is necessary.

5. It is also advised to observe the jugular vein and mammary vein for any signs of distention or pulsation while you are ausculting the heart. Most dairy cows with

cardiac disease have tachycardia at rest, but many diseases result in high heart rates

(such as infectious diseases).

--Bradycardia (40-60 bpm) is often associated with vagal indigestion.--Muffled heart sounds occur with pericardial and pleural effusion.

--Increased intensity of the heart sounds is associated with increased cardiaccontractility.

--Cardiac diseases such as bacterial endocarditis and some cases of lymphosarcoma

can be accompanied by fevers. The most common cause of murmurs is bacterial

endocarditis. The most common valve is the tricuspid on the right side followed by themitral valve on the left.

--Cardiac diseases may occur secondarily to GI diseases such as "hardware",

traumatic reticulopericarditis. Muffled heart sounds with or without a washing machine-like murmur, distended jugular veins, jugular pulse and brisket edema are compatable

findings with hardware disease.--Atrial fibrillation causes a irregularly, irregular heart beat, and is generallyassociated with a GI problem such as an LDA.

-- Edema in the neck and brisket area are often associated with cardiac disease, or low

plasma protein as is seen with Johne's disease, enteritis, or parasitism.--The jugular and abdominal veins should be palpated to assess the venous system.

Distention of these veins are indicative of increased venous pressure. Assessment of the

jugular pulses is best done with the head elevated and it is normal to see pulses at the

level of the heart. With the head being elevated, make sure nothing is occluding the jugular veins to give a false positive. The vein will fail to empty with the occlusion of

the vein with your hand and then the release of the occlusion when cardiac disease is

present. Normal resting heart rate is 60 - 80 bpm. (Calves = 110 - 120 bpm.)

Auscult Lungs--

6. The assessment of abnormal lungs can be extremely difficult in the cow. The reasonfor this is that they have a smaller area to auscult due to the reduced number of ribs

and a steeper angle of the diaphragm. The caudal border is the 11th rib and 9th and 5th

rib respectively. Observation of rate and effort is important during auscultation. Cattle

normally have a costoabdominal effort. The normal rate is 12 -36 bpm.



Note the area of auscultation that is outlined with tape in

the picture to the left. Caution: Significant pathological lesions may be present withoutany abnormal lung sounds.

Pings on the Left Side--

Ping the left side of the cow bysimultaneously percussing and ausculting

the whole left side of the cow by firmly

flicking your finger against the body wall of the cow. A "ping" represents a fluid-gas

interface. On the left side of the cow, gas may be present in the abomasum (LDA),rumen, or peritoneal cavity.

LDA pings are variable in tone, and often tinkling sounds are heard over the area of theLDA.

--Rumen pings are located over the rumen area and tend to be monotone. LDA and

rumen pings often occur together and are usually distinguished by two distinct pings of different tones.

LDA Ping

This is “A”: This is the typical area for a left displaced abomasum (LDA). The ping inthis area can and most often is loud and easily heard. Classically, the LDA ping ismid-thorax on a line from the point of the elbow to the hip. The most common

question asked about LDAs is "why did it happen?". The best response to this questionis that anything that causes the cow to go "off-feed" could result in a LDA. This is a

very important point to remember. Some common causes of cattle to go "off-feed"include: metritis, mastitis, milk fever (periparturient hypocalcemia), nutritional,lameness, any other systemic illnesses.

Rumen Ping-This is the typical area for a rumen gas cap. The ping in this area is most

often loud and easily heard. Classically, the rumen gas cap is extremely dorsal in anarea over the last few ribs, lumbar vertebrae, paralumbar fossa and hip. The rumen



normally has a gas cap. However, when the rumen becomes atonic with decreased

ingesta, a larger gas cap develops. Cattle that have been diagnosed with severe or septic

illnesses usually lose their desire to eat that results in decreased rumination. If theseconditions are allowed to go untreated, then rumen atony occurs. Typically these cows

have a poor prognosis, since it is often

difficult to jump start the rumen.This is “B”

LDA + Rumen Gas Cap

This is the combined area for a left displaced

abomasum and a rumen gas cap.

Auscult the Rumen

Listen to the rumen contractions by placing your

stethoscope in the left paralumbar fossa. Normalrumen contractions (1-3/minute) are strong, and

can be felt and seen. Palpate, auscult, and ballot

the rumen to assess consistency. A gradation inconsistency exists from the dorsal to the ventral

sac of the rumen. The dorsal sac of the rumen

generally has a gas cap and becomes more doughyin consistency (feed layer) towards the ventral

fluid-filled sac of the rumen. A rumen ping is

differentiated from an LDA ping by its location

over the left paralumbar fossa. It is possible to have a rumen ping and an abomasal pingat the same time, but they generally have different tones. If a ping with the same tone

extends over both the rumen and the abomasal area, and rectal examination reveals a very

small rumen with a distended gas-filled dorsal sac, the ping is most likely a rumen void ping.

Pinch Withers-- Withers Pinch Test- Many gastrointestinal diseases cause abdominal pain in the cow. Cows with GI pain often stand hunched up with their elbows

abducted. The withers can be pinched as shown in the picture (sometimes it



requires two hands). A normal cow will dorsiflex her back when her withers are

pinched as seen above. A cow who is painful will not dorsiflex. False negatives

are common. Common reasons for abdominal pain are hardware, abomasalulcers, or distention of the small intestine with gas.

Grunt Test--Either by using your fists pushed up with your knee or by using a board

with one person on each side lifting the board up, apply pressure to the xyphoid region.If the cow grunts, kicks, or acts uncomfortable, you can assume she is painful. Often,

you have to listen over the trachea to hear a grunt.

Examine Udder-- The ideal udder has symmetrical quarters and teats that subjectivelylook ideal for milking. Pendulous and irregular quarters are generally the result of

stretching due to repeated episodes of edema after calving or inflammation. These udders

can be more difficult to milk, but are probably not making the cow sick. Palpation of the

udder gland is an art.--The best starting place for inexperienced students is to compare the quarters to each

other. It is rare that all 4 quarters have mastitis, but common that all 4 quarters have

edema. Generally an abnormal quarter will be obvious compared to the other 3 normalquarters. Abnormalities in consistency of the glandular tissue of the udder include edema,

hardening, and acute swelling. The palpation findings should be integrated with the

examination of the mammary secretions and the physical exam findings.--First, milk should be stripped from each quarter onto a strip plate. Any deviation from

normal milk in color and consistency is abnormal. Then strip each quarter's secretion on

top of each other and repeat in the reverse order. Any subtle abnormalities in secretion



from quarter to quarter will be picked up in this method. This technique of stripping a

quarter's milk onto a pooled milk sample is an excellent way to pick up watery milk.

--It is critical to evaluate the mammary gland and integrate your findings with the rest of the physical exam to arrive at an accurate diagnosis and treatment plan. For example, a

cow with clots in the milk or a watery secretion accompanied by a normal physical exam

is handled differently than a cow with a watery secretion, elevated heart rate andtemperature, rumen stasis and diarrhea.

--In general, contagious organisms, such as, Staphylococcus aureus, Streptococcus

agalactia, and Mycoplasma bovis tend to cause sub-clinical mastitis.----The udder palpates normally, the milk grossly looks normal, and the cow's physical

exam is normal. Special tests, such as, the cow-side CMT test, DHIA somatic cell

counts would be needed to quantitate any inflammation in the udder, and bacterial

culture would be necessary to make a diagnosis of the organism causing the sub-clinicalmastitis.

----In general, the environmental organisms cause clinical mastitis (abnormal milk +/-

swelling in the udder). The Strep. nonag. group of organisms cause clinical mastitis 50%

of the time, and the coliform organisms ( Eschericia coli, Klebsiella, Enterobacter sp.,etc.) cause clinical mastitis 90% of the time. Probable diagnosis of the organism causing

the mastitis can be made in certain cases.Secretions that smell foul and have a necrotic odor are usually caused by

Arcanobacterium pyogenes or some anaerobe.

--Secretions that are very watery accompanied by a swollen udder are generally caused

by coliform organisms. Secretions: watery, but red accompanied by a sick cow aregenerally caused by Staph. aureus and carry a poor prognosis for recovery.

All other gradation of secretions between the normal milk and the extreme watery

secretion are indistinguishable from each other, and culture would be necessary toidentify the organism causing the mastitis.

Auscult right side of heart —similar to left side. The tricuspid valve is located between

the shoulder and elbow at the third intercostal space.Auscult lungs on the right side of the cow--

Right-sided Pings -- Ping the whole right side of the cow carefully. Pings on the right

side are confusing, so care must be taken to delineate the borders of the ping. On the

right side of the cow, gas may be present in the cecum, spiral colon, small intestine,

duodenum, uterus (after calving), peritoneum, rectum, and abomasum (RDA, or

RTA). Pings on the right side can be confusing, and location and repeatability of the

ping are probably the most useful indicators as to the organ involved. While most pings

http://cal.vet.upenn.edu/projects/fieldservice/Dairy/CMT.htm



http://cal.vet.upenn.edu/projects/fieldservice/Dairy/dhia.htm


http://cal.vet.upenn.edu/projects/fieldservice/Dairy/milkcult.htm










on the left side of the cow are LDA, most pings on the right side of the cow are from

spiral colon and cecum. Commonly, cows that are sick, especially with GI disturbances

have pings in the right paralumbar fossa. A distended or displaced cecum will produce aconsistent, large ping that is always palpable per rectum. RDA and RTA (right abomasal

torsion) pings are usually cranial to the 8th rib. The RDA/RTA pings on the right side

are more cranial in location compared to the LDA ping on the left side, which can beheard as far caudal as the cranial aspect of the left paralumbar fossa. Most right-sided

abomasal problems have some degree of torsion associated with them, but the overall

condition of the cow (heart rate, and degree of dehydration) indicates the severity anddegree of torsion of the abomasum.

Right DisplacedAbomasum +/-

Torsion

A __This is the typical area for a right displaced abomasums-cranial to 8

th

rib

Spiral Colon



This is the typical area for a spiral colon ping.

Cecum ping

This is the typical area for a cecal ping

Uterus ping

The uterus can be heard in this general area.



Rectum

A pneumorectum can be heard in this general area

Rectal Examination-- The rectal exam should be performed last to avoid creating

pneumorectum and confusing the interpretation of abdominal auscultation and percussion. The rectal examination is an extremely important part of the physical exam

and even if a sure diagnosis is made prior to this procedure, it should never be skipped.

A routine sequence of examination should be established and the examiner should use alot of lubrication.

Manure and Uterine Discharge-- Examine the perineal and tail area for evidence of blood,

mucus, discharge or feces. Fresh blood on the tail suggests the cow has just gone through

estrus. A moderate stream of clear, highly viscous (stringy) mucus suggests a cow may beclose to or in estrus. Sometimes a thin clear mucus may be seen with urine

poolers(vaginitis) or cows with cystic ovarian disease.

A variety of vaginal/uterine discharges may be evident depending on the stage of

lactation. Fresh cows (cows that have calved recently) can have normal lochia (3-12 days

postpartum) or depending on the severity of metritis may have thin, watery brown-red totan discharge that is malodorous. The more mucoid the discharge, the less severe the

metritis is for the cow.

Normally cows should have a clean tail, perineal area. If there is a lot of manure on thetail, the cow may have diarrhea or perhaps tail paralysis. Inspect the manure for volume,

color, fiber length, consistency, mucus-covering and odor. Absence of production of

feces during the physical examination suggests reduced fecal output. Off-feed cows may produce scant, pasty feces and cows with intestinal stasis may have no feces or scant

blood-tinged, thick mucous-covered feces. The color of the feces varies with feed and

bile secretions.

Feces covered with orange mucus is typical of bile secretions seen in cows with fattyliver. Excessive amounts of mucus may be seen with constipation or inflammatory bowel

disease. Digested blood appears black (melena) and is caused by blood in the abomasum

or proximal small intestine, and would typically be found in a cow with a bleeding

abomasal ulcer. Fresh blood indicates bleeding from the distal intestine, and may occur with colitis caused by coccidiosis or clostridium enteritis. Fibrin occurs in severe

inflammation such as that caused by salmonellosis and may appear as casts. Diarrhea can



be associated with forestomach diseases such as displaced or ulcerated abomasum, or

small intestinal problems. In general, large quantities of liquid feces suggest a small

intestinal problem such as Johnes disease, winter dysentery, salmonellosis, or enteritis of unknown origin (bad feed?). Large quantities of well digested soft feces may suggest a

large intestine problem.

Pelvic Inlet-- Easily recognizable landmarks are the pelvic inlet, the pelvic/pubic brim,

and the iliac shafts. The pelvic brim is useful because of its central location. It isnecessary to do a thorough exam of the pelvic canal for gross changes that could be

caused by severe vaginitis from birth trauma, abscesses or tumors. The reproductive tract

including the cervix, and uterus should be located. The cervix is located in the middle of the floor of the pelvic cavity and should be freely movable. The uterine horns may be

located in the pelvis or abdomen.

Physiological and pathological conditions that affect the position and freedom of

movement of the cervix are listed below:

Cervix predominantly pelvic and freely movable ----Normal nonpregnant uterus

----Pregnancies up to 60 to 70 days---Postparturient involution more than 14 days after

parturition ---Pyometra and hydrometra with exudates or secretion <2 liters --Chronic

metritis without appreciable accumulation of exudates

Cervix abdominal and fixed ----Pregnancies after 70 days --Uninvoluted postpartum tract

--Pyometra and hydrometra with exudates >2 liters ---Extensive adhesions --Tumors

(Lymphosarcoma)

See Reproductive Exam for more details... The bladder is palpable ventral to the

reproductive tract if it is distended, but will not be palpable if it is empty. The deepinguinal lymph nodes can be palpated just cranial and lateral to the brim of the pelvis

along each shaft of the ilium. Enlargement of these lymph nodes suggest pelvicinflammation, mastitis or lymphosarcoma. The iliac lymph nodes are palpated along the

termination of the aorta.

Rumen-- Next the rumen is palpated for size and consistency which varies with disease

states. The rumen is palpated from the left of midline and cranial. The dorsal contentsof the rumen may have some gas and are generally doughy, while the ventral contents are

more fluid-like. Absence of a readily palpable rumen in an off-feed cow sometimes

results in a "rumen void" ping which can be heard during simultaneous auscultation and

percussion of the left side of the abdomen. This "rumen void" ping can be confused witha diagnosis of LDA.

Kidney-- To the right of the rumen in the midline area is the left kidney. The arm is

normally inserted beyond the elbow to find the left kidney unless it is enlarged. The mostcommon reason for enlargement of the kidney is pyelonephritis. Often a kidney with

pyelonephritis is painful on palpation.

http://cal.vet.upenn.edu/projects/fieldservice/Dairy/DPERrepr.htm





Right Quadrant-- Small bowel and cecum are palpated ventral and to the right of the left

kidney. The right side of the abdomen will feel empty if everything is normal. Potential

pathological conditions such as a distended cecum or small intestine are readily palpablein this region.

Bovine Physical Exam

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