Examine the head last. Cattle resent manipulation of their head. Examine the head for symmetry and ocular and nasal discharges. Neurologic signs, such as, head tilt, droopy ear, muzzle deviation, lip drooping, eyelid paresis (+/- exposure keratitis) are most commonly associated with listeriosis. Failure to swallow (feed the cow to assess) are suggestive of listeriosis or botulism. A dry, dirty nose indicates the cow is sick. Nasal discharges are commonly associated with respiratory conditions. Very ketotic cows may have a sweet, acetone-type odor associated with their breath. Bad offensive breath is commonly associated with anaerobic infections. Prominent eye position is commonly associated with a tumor, such as lymphosarcoma, or a retrobulbar abscess. Tent the skin of the eyelid to assess dehydration. Dehydration causes the eyeball to be recessed into the orbit. Assess the eyes for vision, eye position, and pupillary reflexes. Blindness is associated with polioencephalomalacia, and constricted pupils with organophosphate toxicity. Check the sclera for icterus indicative of liver or a hemolytic disease. Large, prominent scleral vessels (scleral injection) are associated with septicemic, toxemic, or endotoxemic conditions, such as, salmonella or coliform mastitis. In neonates, scleral injection and hypopyon are suggestive of septicemia. Pale sclera indicate anemia due to blood loss possibly caused by abomasal ulcers (common in adults), parasitism (more common in neonates on pasture, than neonates and adults on concrete), or coccidia (generally cattle under 1 year of age). Examine the mouth by putting the hand in the interdental space and pressing the fingers against the hard palate. Examine the gums for ulcers and vessicles which are seen in bovine virus diarrhea (BVD). Check mucosal papillae for blunting (BVD). Check the nasal passages for vessicles commonly seen in viral infections. If indicated, the pharynx can be palpated by wedging the back of the hand against the medial surface of the molars pushing the tongue against the opposite arcade of teeth. Retropharyngeal abscesses and Actinobaccillus (wooden tongue) are common palpable conditions. Vomiting is unusual and can be caused by toxic plants, such as, azalea or rhododendrum, or inflammation of the reticulorumen.
This completes the physical exam.