The face should be assessed for asymmetry. Unilateral cranial nerve damage resulting in flaccid paralysis of the ear, eyelid, muzzle, cheek, and/or nostril combined with excessive drooling and/or tongue protrusion indicating an inability to swallow is highly suggestive of listeriosis. Examine the eyes noting eye position, pupillary light reflex, and menace response. No menace response with an intact pupillary light reflex is common with polioencephalomalacia. A bilateral, clear to serous nasal discharge is normal. Mucopurulent discharges are commonly associated with respiratory disease. Crusting of the nose occurs in sick animals that fail to clean their nose. The presence of ulcerative or proliferative lesions on the lips, muzzle, and nostril may indicate ORF or bluetongue. An accumulation of fluid in the submandibular space (bottle jaw) is often secondary to gastrointestinal parasitism particularly if the animal also has pale mucous membranes. An acetone odor to the breath indicates ketosis typically associated with pregnancy toxemia in the sheep. A foul odor from the mouth suggests necrotic stomatitis, pharyngitis, or even pneumonia. Vomiting in the small ruminant is almost always associated with a toxic plant ingestion, rhododendron and azalea commonly recognized in the Eastern US.