I find that certain diseases or conditions go unrecognized on many dairies because a complete exam is not done on a routine basis.

But if you don’t look for it, you won’t find it.

Not every cow reads the book. This means that in most cases of a displaced abomasum (DA), for example, the cow is ketotic. But not in every case; that’s why you need to do a complete physical exam. 

Use the right tools

First, you need to have the proper equipment. A thermometer, stethoscope, urine or blood ketone strips/meter, California Mastitis Test paddle and solution, rectal sleeves and clean warm water with disinfectant scrub/soap should all be handy.

Try to do your exam the same way each time so you don’t forget to examine an area or system. You will not become an expert overnight, and there are many skills within the exam that require further training and practice, but your goal is to diagnose and treat common conditions.

Follow a routine

You have obviously determined that this cow needs an exam, so you have already made some general observations on how she looks. Note if her eyes are sunken, if she’s lame, whether she has abnormal discharge, and so on.

Then, begin the hands-on portion of the exam.

  • Test urine for ketones using a urine test strip. If no urine is available, use a blood meter test.
  • Take her temperature. Normal range is 101.5-102 degrees F. Check the vulva for mucous membrane color.
  • Examine milk from all quarters for abnormalities.
  • With your stethoscope, start on the cow’s left side:
    • Listen to the rumen. Two to three contractions per minute is normal.
    • “Ping” the left side, listening for the distinctive tin can sound indicating a left DA, rumen bloat or rumen void.
    • Listen to her heart and lungs.
    • Palpate her lymph nodes in front of her shoulder and in front of her rear leg.
  • Move to the cow’s right side:
    • “Ping” the right side to detect a right DA.
    • Listen to her heart and lungs.
    • Palpate her lymph nodes in front of her shoulder and in front of her rear leg.
  • Move to the front of the cow:
    • Feel her ears; are they cold to the touch? This indicates poor circulation, as seen with milk fever in the fresh cow
    • Look at her eyes. Are they sunken? This indicates dehydration. Are they bloodshot? This can indicate a severe problem, such as toxemia or septicemia.
    • Look for a nasal discharge. If present, is it cloudy or clear?
    • Does her breath smell abnormal?
    • Is blood present in her nostrils?
  • Move behind the cow:
    • If the cow is fresh and has not cleaned, conduct a vaginal exam.
    • Wash the vulva/perineum three times with disinfectant scrub and water.
    • Determine if cleanings are present, the nature of uterine fluid and whether there an abnormal odor.
    • Perform a rectal exam to feel the uterus and rumen. 
    • Examine the manure. Is it firm, scant and pasty or indicative of diarrhea?
  • Examine her feet and legs:
    • Is she lame? Lift the appropriate foot and look for a cause.
    • If the cow is lame and nothing can be found in the foot, the injury may be further up the leg or in the upper joints (stifle, hip).

When you can’t find an explanation for why the cow is sick or your diagnosis is unclear, have your veterinarian evaluate the cow.

Meanwhile, ask your veterinarian to review a hands-on physical exam at his or her next visit. This may also be a great time to review treatment protocols.

Again, you will not become an expert overnight, but if you don’t look for it, you won’t find it.

Mark J. Thomas is a veterinarian and partner in Countryside Veterinary Clinic, LLP in Lowville, N.Y.