||The rectal exam should be performed last to avoid creating pneumorectum
and confusing the interpretation of abdominal auscultation and percussion. The
rectal examination is an extremely important part of the physical exam and even if a sure
diagnosis is made prior to this procedure, it should never be skipped. A routine
sequence of examination should be established and the examiner should use a lot of
Click on your next PE point to continue with
your physical exam.
Manure and Uterine Discharge
|Examine the perineal and tail area for evidence of blood, mucus, discharge
or feces. Fresh blood on the tail suggests the cow has just gone through estrus.
A moderate stream of clear, highly viscous (stringy) mucus suggests a cow may be
close to or in estrus. Sometimes a thin clear mucus may be seen with urine
poolers(vaginitis) or cows with cystic ovarian disease. A variety of vaginal/uterine
discharges may be evident depending on the stage of lactation. Fresh cows (cows that
have calved recently) can have normal lochia (3-12 days postpartum) or depending on the
severity of metritis may have thin, watery brown-red to tan discharge that is
malodorous. The more mucoid the discharge, the less severe the metritis is for the
cow. Normally cows should have a clean tail, perineal area. If there is a lot
of manure on the tail, the cow may have diarrhea or perhaps tail paralysis. Inspect
the manure for volume, color, fiber length, consistency, mucus-covering and odor.
Absence of production of feces during the physical examination suggests reduced fecal
output. Off-feed cows may produce scant, pasty feces and cows with intestinal stasis
may have no feces or scant blood-tinged , thick mucous-covered feces. The color of
the feces varies with feed and bile secretions. Feces covered with orange mucus is
typical of bile secretions seen in cows with fatty liver. Excessive amounts of mucus
may be seen with constipation or inflammatory bowel disease. Digested blood appears
black (melena) and is caused by blood in the abomasum or proximal small intestine, and
would typically be found in a cow with a bleeding abomasal ulcer. Fresh blood
indicates bleeding from the distal intestine, and may occur with colitis caused by
coccidiosis or clostridium enteritis. Fibrin occurs in severe inflammation such as
that caused by salmonellosis and may appear as casts. Diarrhea can be associated
with forestomach diseases such as displaced or ulcerated abomasum, or small intestinal
problems. In general, large quantities of liquid feces suggest a small intestinal
problem such as Johnes disease, winter dysentery, salmonellosis, or enteritis of unknown
origin (bad feed?). Large quantities of well digested soft feces may suggest a large
|Easily recognizable landmarks are the pelvic inlet, the pelvic/pubic brim,
and the iliac shafts. The pelvic brim is useful because of its central location.
It is necessary to do a thorough exam of the pelvic canal for gross changes that
could be caused by severe vaginitis from birth trauma, abscesses or tumors. The
reproductive tract including the cervix, and uterus should be located. The cervix is
located in the middle of the floor of the pelvic cavity and should be freely movable.
The uterine horns may be located in the pelvis or abdomen. Physiological and
pathological conditions that affect the position and freedom of movement of the cervix are
Cervix predominantly pelvic and freely movable
- Normal nonpregnant uterus
- Pregnancies up to 60 to 70 days
- Postparturient involution more than 14 days after parturition
- Pyometra and hydrometra with exudates or secretion <2 liters
- Chronic metritis without appreciable accumulation of exudates
Cervix abdominal and fixed
- Pregnancies after 70 days
- Uninvoluted postpartum tract
- Pyometra and hydrometra with exudates >2 liters
- Extensive adhesions
- Tumors (Lymphosarcoma)
See Reproductive Exam for more details... The
bladder is palpable ventral to the reproductive tract if it is distended, but will not be
palpable if it is empty. The deep inguinal lymph nodes can be palpated just cranial
and lateral to the brim of the pelvis along each shaft of the ilium. Enlargement of
these lymph nodes suggest pelvic inflammation, mastitis or lymphosarcoma. The iliac
lymph nodes are palpated along the termination of the aorta.
|Next the rumen is palpated for size and consistency which varies with
disease states. The rumen is palpated from the left of midline and cranial.
The dorsal contents of the rumen may have some gas and are generally doughy, while the
ventral contents are more fluid-like. Absence of a readily palpable rumen in an
off-feed cow sometimes results in a "rumen void" ping which can be heard during
simultaneous auscultation and percussion of the left side of the abdomen. This
"rumen void" ping can be confused with a diagnosis of LDA.
|To the right of the rumen in the midline area is the left kidney.
The arm is normally inserted beyond the elbow to find the left kidney unless it is
enlarged. The most common reason for enlargement of the kidney is pyelonephritis.
Often a kidney with pyelonephritis is painful on palpation.
|Small bowel and cecum are palpated ventral and to the right of the left
kidney. The right side of the abdomen will feel empty if everything is normal.
Potential pathological conditions such as a distended cecum or small intestine are
readily palpable in this region.