Clinical diagnosis of ruminants

What information is gathered from a history?

• Animal details & history —> age, production stage, clinical signs

• Herd history

• Farm and the client

On-farm stage of examination

• Full clinical examination

  • general inspection, vital signs, specific exam

• Sampling for laboratory exam if required

• Environment

• Further history e.g. housing, nutrition

• Rest of the herd?

How to approach clinical exam of cows

Cows are head shy —> used to being approached from behind:

1. Tail end 

2. Udder 

3. L side (abdomen & chest)

4. R side (abdomen & chest)

5. Head 

6. Vaginal &/or rectal exam 

What is checked at the tail end?

Temp, abdominal symmetry, vaginal discharge?, metritis, endometritis, bulling, faecal staining/faeces, BCS, coat condition (no rectal yet because it will introduce air —> gives false “ping” on RHS)

Temperature of adult vs calf 

Adult = 38.5 

Calf = 39

push thermometer to side so touches rectal wall and gives accurate reading

What is examined in the chest area?

• Heart —> listen under elbow, rib spaces 3-5 

  • murmurs = endocarditis

  • quiet/absence/splashing = traumatic pericarditis

• Lungs

  • small lung field —> listen in several different areas (triangular, see image)

  • examine both sides 

  • abnormal sounds = damage been there a while 

  • heat stress at in warmer temps

DO ON BOTH LEFT AND RIGHT

HR in adult vs calf?

Adult = 60-80bpm

Calf = 80-120 bpm

RR in adults vs calves?

Adult = 15-30 breaths per min

Calf = 24-36 breaths per min

What is examined on the left abdomen?

• Rumen

  • fill (score 1-5)

  • gas/bloat

  • consistency of contents

  • 3 turnover movements in every 2 mins —> use bent fingers in L sub-lumbar fossa

What is the Eric Williams test?

• Palpation of rumen & auscultation of trachea 

• Primary cycle = no sound, feel rumen contract (mixing)

• Secondary cycle = eructation sounds

• Grunt before primary contraction = peritonitis caused by wire

• Turnover + nothing then turnover + burp sound = normal

Describe displaced abomasum (“pinging”) 

• Spontaneous = tinkling & gurgling 

• Ping = tap rib hard —> resonate ping, indicates gas fluid interface, map out area of “pings” 

• Absence of rumen sounds over displaced abomasum 

• Fat cows = no ping 

What is examined in the head?

• Eye

  • Conjunctiva colour e.g. pink, red, white, petechiae

  • Discharges

  • Lesions

  • Keratoconjunctivitis

  • Iritis

• Nose

• Palpate LNs e.g. submandibular

• Symmetry

• CRT & skin tent for dehydration

• Mouth

  • pull tongue out to side

  • lesions

  • ulcers/vesicles

What is examined on the right abdomen?

Ping & listen but no need to do Eric Williams test (done on left)

What to examine in udder?

• Palpate (care with suckler cow)

• Take milk sample from lactating animals, clots & colour (only if reason in dry cow or suckler cow)

• California milk test

• Sterile milk sample for bacteriology

What is examined in vaginal exam?

• Discharge (calving date) 

• Vaginal wall 

• Cervix —> open/closed uterus & contents

• Uterus & contents 

What is examined in rectal exam?

• Faeces consistency 

• Presence of blood?

• Rectal tone

• Rumen

• Uterus & ovaries

• L kidney (midline or on RHS) —> kidney infection painful

• Distended abomasum/caecum

• Gut contents

Skeletal examination

Lameness

Mostly foot but can get higher limb issues

What is examined in calves?

• Initially won’t have a functioning rumen

• Have neonate specific things to check for —> joint/navel ill, congenital abnormalities

• Calving history —> colostrum intake (how much, how quickly)

What is the “Blunderbuss” approach?

• Examine top to toe

• Get every conceivable test carried out 

• Fit results to textbook model/vets own database of disease 

What is the hypethetico-deductive model

Generation of hypotheses 

Testing of hypotheses