Fresh cows have the greatest production potential in a dairy. However, fresh cows are very susceptible to diseases. The most frequent disorders observed in fresh cows are: mastitis, metritis, injury or lameness, milk fever, ketosis, displaced abomasum, pneumonia and enteritis. Losses associated with those diseases are estimated from $200 to $400 per case per lactation. Furthermore, 15% to 25% of all cullings take place during the first 60 DIM. Early identification and treatment of sick animals may reduce the overall cost of the disease (drugs and milk production), increase the chances for a full recovery, improve animal welfare, and reduce culling, especially of fresh cows. These benefits should motivate dairy producers to work with their herd veterinarians to implement a herd health program that will successfully identify, examine and treat sick cows in the herd.

While some dairies find it valuable to routinely check all fresh cows, others, due to time and labor, may limit physical exams to cows showing signs of disease or with abnormal attitude. The objective of this article is to describe a comprehensive way that may help dairy workers to identify sick cows requiring a thorough physical examination.

Some reasons that justify the need for a detailed cow exam are: 1) difficult calving, 2) twins, 3) retained fetal membranes, 4) foul smelling vaginal discharge, 5) abnormal udder, 6) deviation in milk production, 7) reluctant to lock, 8) poor appetite, 9) abnormal rumen fill, 10) diarrhea, 11) lame or walking with difficulty, 12) down cows, 13) fever, 14) extremely fat cows at calving, and 15) cows listed as recheck. All cows presenting any of these conditions should be included in the “list of cows to examine”. In most operations, these cows will be added to the list the day prior to the exam or the morning of the exam.

In order to ensure that the “list of cows to be examined” is complete, a systematic approach to observation and recording is necessary. The identification of sick animals in the fresh pen can be accomplished by teaming up two people who walk simultaneously through the front and the back of the cows.

Walking in front of the cows – check for and take notes on:
o Appetite. Note if cows are eating, sorting or are not interested in feed at all. Check for undisturbed feed sitting in front of the cow at lock up. Before releasing the cows from the lock-ups, check for cows that consumed feed at a lower level than their neighbors.
o Attitude. Healthy animals are curious about their surroundings. Their ears are waggling and if you approach them, they will try to smell or lick you. Sick animals tend to have their head down, dropped ears, dull eyes and are too tired to groom their noses.
o Ears. Compare among cows the attitude and temperature of the ears. In healthy animals, ears are positioned above the point of
attachment to the head, whereas sick animals have ears that are below. Droopy ears suggest a sick cow that is depressed, in pain or with fever. Cold ears will indicate decreased blood flow to the periphery which could be related to milk fever, acidosis or severe toxic states.
o Eyes. Cows with sunken, dull and crusty eyes may be dehydrated and/or in pain. Note if there are visible eye lesions (pink eye, trauma).
o Nose. Check for abnormal nasal discharge (white, green, yellow, or bloody) that may indicate pneumonia or acidosis. Sick cows are too depressed to maintain their noses licked clean and feed particles and nasal discharge will stick on their noses. It is also important to check if the nostrils appear dry, as it may suggests fever.
o Cough. Cows that are coughing two or three times should be noted for observation.

Walking behind the cows – check for:
o Manure. Check the floor, vulva and tail for manure with
abnormal consistency (too loose to form a pile), color (almost
black) and/or foul smelling. Abnormal manure can be found in
cows suffering from acidosis, digestive upsets, toxic diseases,
or enteritis.
o Retained Fetal Membranes. Retained fetal membranes are not
a health problem per se, but increase the risk for metritis. If
you find retained fetal membranes, you should also look for
abnormal vaginal discharge.
o Vaginal discharge. It is normal to find vaginal discharge for up
to two weeks after calving. However, dark red and foul
smelling vaginal discharges are found in cases of uterine infection.
o Abnormal abdomen. Cows with their left flank tucked in have poor rumen fill because of anorexia. If the abdomen is distended, cows may be bloated due to rumen gas accumulation.
o Breathing rate. The basal respiration rate is 12 to 36 breaths/min. Note if the animal has an abnormal respiration rate or if inspiration and/or expiration require additional efforts. Pneumonia, bloat and toxic diseases may cause difficult breathing.
o Abnormal udder. Note udders that are unbalanced, swollen, with abnormal color (reddish or bluish), or with damage in their suspensory ligaments. Check udder fullness; poor appetite will result in poor udder fill.
o Cows that did not lock up after feed was delivered. Sick cows are reluctant to lock up as they lack the drive to eat.
o Cows’ posture that indicate pain.
- Tail away from the body: irritation in the perineal region, vagina or rectum, or severe metritis.
- Elbows pointing out: pain in the rib cage.
- Arched back: peritonitis, severe lameness.

Some large dairies use colored chalk on the back of the fresh cows to write relevant information (calving date, calving difficulties, disease findings, and so on), and easily identify cows needing examination.

Sick cows can be found elsewhere in addition to the fresh cow pen. Therefore, all dairy workers, but especially those involved in feeding, breeding, moving cattle and milking should be trained to identify sick cows. They all should carry a little notebook and contribute with their observations to complete the “list of cows to examine”. Feeders should look for cows reluctant to move when fresh feed is delivered. Workers moving cattle have an excellent opportunity to observe cow’s gait and posture. They should look for cows that are depressed (react slowly to stimulus), with heads down, droopy ears, arching their backs, with the elbows pointing out, walking slowly and favoring one limb, or that have difficulty standing up and moving. Breeders will walk behind cows and should look for any cow with abnormal attitude, manure, vaginal discharge or abnormal udder. During rectal exploration, they can gather information on the uterus status and the temperature of the cow. In the milking parlor, milkers can easily note swollen quarters and discolored udders. Udder fullness prior to milking (too baggy) or after milking (swollen) should always be evaluated. By stripping udders, clinical mastitis cases can be identified in the milking parlor. Dairies recording individual milk weights should look for cows deviating from the expected production.

Recommended Reading:
Terra, R. 2001. Ruminant history, physical examination and records. In: Large Animal Internal Medicine by Bradford Smith, Chapter 1: pg 3-14
McGuirk, S. Examination of Fresh Cows:

Source: Noelia Silva-del-Rio, University of California Cooperative Extension - Tulare