Ruminant Physical Exam

What are the general things that should be assessed in a distance exam?

• Environment & housing

• Mentation & behavior

• Body condition & coat

• Gait & Posture

• Visible system check

What should be assessed in a distance exam of the environment and housing?

• Pen conditions

  • Ventilation

  • Footing

  • Stocking density

  • Hazards

  • Hygiene

• Feed & water access

  • Clean?

  • Sufficient?

  • Accessible?

What should be assessed in a distance exam of the patient’s mentation and behavior?

• Alertness

• Behavior

• Interaction with environment

What to look for when assessing alertness

• Is the animal tracking your movements with head, ears, and eyes?

• Are they reacting appropriately to stimuli?

What to look for when assessing behavior?

Normal species behavior

What would be considered normal species behaviors for cattle?

grazing, rumination, herd interaction

What would be considered abnormal species behaviors for cattle?

isolation, stereotypies, excessive vocalization, unprovoked aggression

What should be assessed in a distance exam of the patient’s body condition and coat?

• Coat/hide condition

• Visible wounds (lesions, swellings, hair loss)

• BCS/fat deposits

Dull, rough, or overly long hair coat can indicate…

early signs of chronic disease, parasitism, or poor nutrition

BCS scale for cattle

1-5 (emaciated to obese)

BCS scale for small ruminants

1-5 (emaciated to obese)

BCS scale for llamas

1-9 (emaciated to obese)

BCS scale for alpacas

1-5 (emaciated to obese)

What should be assessed in a distance exam of the patient’s gait and posture?

• Stance

• Weight bearing

• Gait

• Back posture

• Head carriage

• Tail activity

How is weight typically distributed in ruminants?

Bear 60% of weight on forelimbs and 40% on hindlimbs

What does a normal gait look like?

Fluid, symmetric, 4-beat cadence, minimal head bob

What are signs of an abnormal gait?

Short-striding, head-bobbing, reluctance to advance a limb

What to look for when assessing back posture

Normal: straight, roughly parallel to ground

Abnormal: Arched back - can indicate abdominal or back pain

What can a low head carriage indicate?

Pain or depression

What can an extended head or neck indicate?

Attempt to reduce resistance to airflow in resp. disease

What are abnormal tail acitivties?

Held away from body, clamped down, paralyzed

What should be assessed in a visible system check?

• Eyes/vision

• Nasal discharge

• Ear position

• Respiratory effort

• Abdominal contour

• Rumen fill

• Feces observed

• Limb swelling

• Udder symmetry

• Perineal discharge (genital area)

What should be assessed in visible check of the eyes?

• Dullness

• discharge

• partial/full lid closure

• abnormal globe position

What can drooped or pinned ears indicate?

illness, pain, facial nerve deficit (if unilateral)

What are you looking for when assessing abdominal contour?

Distension or a tucked-up appearance

What are you looking for when assessing rumen fill?

Looking at the paralumbar fossa - should have some fullness

A sunken fossa suggests reduced food intake or systemic illness

What are you looking for when assessing limb swelling?

Grossly visible, joint effusion, cellulitis, or asymmetry

What can asymmetry of the udders indicate?

Mastitis, injury, agalactia

How should the thorax be evalualted?

Observation, auscultation, & palpation

What should be included in thoracic observation?

• Resp. rate

• Resp. effort

• Breathing pattern

• Nostril flare

• Coughing

Normal resp. rate in adult cattle

12-36 bpm (~10-30)

Normal resp. rate in sheep

12-72 bpm

Normal resp. rate in goats

15-40 bpm

Signs of dyspnea (increased resp. effort)

• labored breathing

• flared nostrils

• extended head & neck

What are you evaluating when observing breathing pattern

Balance of inspiration, expiration & pause between them

What does a prolonged inspiration indicate?

Upper airway obstruction

What does a prolonged expiration indicate?

Lower airway/lung pathology (ex: emphysema)

What coughing can be considered normal in sheep and goats?

Occasional dry cough when rising

What should be evaluated in thoracic auscultation and palpation?

• Heart rate

• Heart rhythm

• Murmurs

• Lung sounds (R & L)

• Trachea - palpation & auscultation

Normal resting HR in adult cattle

60-80 bpm (~60)

Normal resting HR in adult sheep

60-120 bpm (~75)

Normal resting HR in adult goats

70-110 bpm (~85)

Normal resting HR in calves

80-120 (~120 bpm)

What should be noted when a heart murmur is heard?

Where it falls in cardiac cycle (systolic vs diastolic); point of maximal intensity (PMI)

Where should lung sounds be auscultated in cattle?

In the triangle formed from:

• Vertical line caudal to scapula

• Horizontal line immediately ventral to transverse spinous processes T8-T11

• Diagonal line from top of the 11th rib, through middle of 9th rib, to point of the elbow

Why is tracheal auscultation important?

To distinguish upper airway noise from true lower-airway lung sounds (ensure abnormal lung sounds are truly coming from the lungs)

What should an abdominal examination include?

• Observation

• Auscultation

• Palpation

• Lymph node assessment

• Rectal exam

What should be assessed in abdominal observation?

• Abdominal contour

• Rumen fill

• Feces observed

What should be assessed in abdominal auscultation & palpation?

• Rumen motility

• Percussion (R & L)

• Succussion (R & L)

• Ballottement

• Withers pinch

• Umbilicus

Percussion

Using fingers to tap a structure (typically abdomen) listening for changes in pitch or tone of expected sound (pinging) that would indicate gas distention

Ballottement

To displace abdominal contents via vigorous external manipulation assessing for a fluid/solid mass interface

Succussion

Listening for a fluid sound (sloshing) while balloting/rocking/splashing motion, typically using a stethoscope

A sloshing sound during succussion indicates…

A fluid- & gas-filled viscus (abomasal or intestinal fluid accumulation)

How is rumen motility assessed?

Auscultating the left paralumbar fossa and counting/characterizing contractions over a set period

How can rumen motility be classified?

Normal, hypermotile, hypomotile, or atonic/absent

How is a withers pinch performed?

Grasping the spinous processes at the withers with both hands and squeezing while applying downward pressure to encourage animal to drop its back

Abnormal withers pinch reactions

Resistance to flexing, breath-holding, & audible grunt - indicate cranial ventral abdominal pain

Grunt test

Thrust fist upward just caudal to xiphoid process to assess for pain response (Resistance to flexing, breath-holding, & audible grunt) - often performed with withers pinch

What should the umbilicus be examined for?

Signs of umbilical hernia or omphalitis (navel infection)

• Heat

• swelling

• pain

• drainage

What lymph nodes are externally palpated near the abdomen in ruminants and where are they found?

Prefemoral lnn. - Located in flank along a line dropped straight down from tuber coxae roughly halfway to the flank fold, found when pulling this tissue cranially

What would enlargement of prefemoral lymph nodes indicate?

Inflammation or infection of associated pelvic limb

What should be evaluated during a rectal exam?

• Rumen

• Lymph nodes

• Pregnancy

• Left kidney

• Additional abnormalities (pelvic masses, adhesions)

What can be assessed about the rumen from a rectal exam?

Fill, position, & consistency

What lymph nodes can be palpated in a rectal exam?

Internal pelvis lnn. such as cranial iliac nodes along pelvic brim

What would enlargement of pelvic lymph nodes indicate?

Pelvic, caudal abdominal, or urogenital inflammation, infection, or neoplasia

How should the head and neck be evaluated?

• Observation

• Basic assessments/tests

• Lymph nodes

• Dentition

What should be assessed in head and neck observations?

• Sclera

• Vision

• Nasal discharge

• Muzzle/nares moisture

• Ear position

• Facial symmetry

• Jugular vein fill

What can a dry muzzle indicate?

Dehydration, fever, or reduced grooming behavior in systemic illness

Asymmetry of the face can indicate

Facial nerve/CN VII deficit

The jugular vein should only fill in the ______ of the neck when occluded at the base

lower third

Jugular distension extending up the neck or refilling quickly from below can indicate…

backflow from right-sided heart failure

Basic assessments of the head & neck

• Oral mucous membranes

• CRT

• Hydration

• Tongue

Where should mucous membranes/CRT ideally be assessed in ruminants?

External genital openings

Where is a skin tent hydration test most reliably performing in ruminants?

On the eyelid

“wooden tongue”

Rigid, swollen tongue that cannot be retracted - indicative of actinobacillosis

What lymph nodes can be externally palpated near the head and neck?

• Submandibular ln.

• Prescapular ln.

Location and characteristics of submandibular lymph nodes

• Location: Medial to the angle of the mandible, near salivary gland

• ~walnut sized

• Firmer and smoother than salivary gland

Location and characteristics of prescapular lymph nodes

• Location: Just cranial to the shoulder roughly halfway between point of shoulder and top of scapula

• Cigar-shaped

• 1-2 cm around & 3-5 cm long

• Enlargement can indicate bronchopneumonia or forelimb infection

What should be assessed on the integument?

• Hair/fiber (quality, distribution, hair loss)

• Skin (elasticity, color, lesions, parasites, discharge)

What should be assessed in the perineum?

• Vulvar mucous membranes

• Discharge

• Feces

• Urine

• Scrotum

• Sheath

What should the urine/external urinary openings be assessed for?

Color, odor, & evidence of straining, scalding, or dribbling (UTI)

What should scrotum be assessed for?

• Symmetry

• Size (important for breeding soundness)

• Skin condition

What should the udders be evaluated for/how should they be assessed?

• Symmetry

• Palpation (all quarters)

• Teats

• Strip Cup

• CMT

• Mammary lymph nodes

What to evaluate during udder palption

• Consistency

• temp.

• Presence of fibrosis or firm areas

Strip cup

Small amt. of foremilk is stripped from each quarter onto a dark surface and examines for clots, flakes, or abnormal color (quick mastitis screen)

CMT (California Mastitis Test)

A reagent is mixed with milk sample from each quarter and gels in proportion to somatic cell count - rough estimate of subclinical inflammation

How are the mammary lymph nodes found?

Slipping the tissue at the junction of the udder and body wall through fingers caudal to the gland

What should be evaluated in the limbs?

• Musculature

• Joints

• Hooves

Evaluation of hooves in ruminants

Inspect & palpate hoof wall, sole, & coronary band for overgrowth, heat, or discharge; hoof tester may be used to apply greater pressure distal to coronary band

All 8 incisors are present by…

4 weeks of age

_____ are usually erupted at birth

premolars

How many teeth will immature ruminants have?

20 — (3 upper and lower premolars & 4 lower incisors on each side)

How many teeth will mature ruminants have?

32 — (3 upper and lower premolars, 3 upper and lower molars, & 4 lower incisors on each side)

Center incisors eruption time

18 months

Medial incisors eruption time

30 months

Lateral incisors eruption time

3.5 yrs

Corner incisors eruption times

4.5 yrs

Center incisors tooth numbers

01’s

Medial incisors tooth numbers

02’s

Lateral incisors tooth numbers

03’s