Physical Exam

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Equipment :

thermometer, stethoscope, ketone test, strip cup, rectal sleeves, lube, strong flashlight.

Make sure the cow is well and safely restrained. Rule #1 is always: DON'T GET HURT!

• First, examine the cow from a distance for her attitude, stance, general condition and skin. If you can, try to tell it she has been eating; assess abdominal fill. Look at her eyes to see it they are sunken or dull. Assess her body score.
• Attempt to get a urine sample for ketones by rubbing on the skin just under the vulva. Run the ketone test. This is best done before disturbing the cow by examining her.
• Take the cow's temperature (normal is 100 to 102.5 degrees F; 37.8 39.2 C).
• Examine the vulva and skin below it for any discharges, mucus, etc. Pay attention for foul smells. Palpate the supramammary lymph nodes if they can be felt. Assess the degree of edema in the udder from the rear.
• Look down along the cow's side and watch her ribs move in and out and count her respirations. Normal is 20 to 40 per minute, but it will definitely go higher in hot weather. Assess the pulse from the tail artery.
• Move up her left side and listen to her rumen in the triangle formed by her last rib and the spine at her loin (the paralumbar fossa). Also feel for how much each rumen contraction moves her paralumbar fossa in and out. The degree of motion is a better measure of strength of rumen contractions than the amount of sound you hear. The normal cow has about two rumen contractions per minute (typically one at time zero, then 20 seconds or so later, then quiet for 40 seconds or so). Ballotte the rumen to see how firm or fluid it is, for normal stratification of contents, listen simultaneously for splashy sounds. As you stand there listening, look at the left hind leg for injury, swelling, etc and palpate her left pre-femoral lymph node.
• Ping the left side of the cow by listening with your stethoscope while striking hard next to it with a flicked finger. Move around and ping over a wide area under the back of the ribs and the flank from top to bottom. If you find a ping, determine its size by moving the head of the stethoscope around and pinging. The ping is where the stethoscope is, not where you hit.
• Listen to the heart under the left elbow and count beats and listen for murmurs. Normal heart rate in the cow is 60 to 80 beats per minute. As you listen, look at the left front leg for injury, swelling, etc. Check the left pre-scapular lymph node. Strip blood from the mammary view and observe for backfill.
• Listen to the lungs on the left side. This takes a lot of practice and experience to tell normal from abnormal. You should be able to just hear air moving in and out in most cows. You may also listen to the trachea from the left.
• Look at the left side of her neck and head for obvious problems. Pick up a fold of skin and let it go to test for dehydration. With experience you will be able to tell if the skin stays puckered up too long (dehydrated). A more reliable test is to pinch the skin just above the eye and to look to see it the eye looks dull or sunken into the socket. Check the brisket, particularly for edema.
• Smooth your hand across the top line feeling for swelling, emphysema, warbles, etc.
• Check for abdominal pain by squeezing down on the withers while watching the cow's expression or listening at the trachea. A similar test can be done by pushing in the xiphoid region.
• Move back around to the right side and ping the right side of the abdomen. Pings here are harder to interpret. While there, look at the right hind leg and check the pre-femoral node.
• Listen to the heart and lungs on the right side. Look at the right front leg and check the pre-scapular node.
• Look up the right side of the head and neck and check the top line on the right.
• Palpate the udder, check for pyoderma. Examine each teat. Strip milk from each quarter of the udder and examine the teats and udder, looking for any abnormality.
• Put on a rectal sleeve and reach into the rectum, pulling a sample of the manure out and examining it. Check the cervix, uterus, ovaries, left kidney, rumen, iliac lymph nodes, and sweep the right abdominal space for abnormalities.
• Look at the cow from the front and make sure that both sides of her head are symmetrical, she is alert, bright, and the eyes are not sunken, and her nose is clean.
• Examine the nostrils, submandibular lymph nodes, and open the mouth and check for lesions, blunted papillae, etc. Smell the breath; some people can smell ketones. Look at the eyes (abnormalities, pupilary response) and sclera and tent the skin on the upper eyelid for dehydration.