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Physical examination of cattle: parts I and II (Proceedings)

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Nov 01, 2009

I fear that the physical examination is becoming a lost art. Perhaps every generation of veterinarians has had the same feeling as they see more and more technology enhancing our ability to reach a diagnosis, but at the same time replacing some of the time-tested techniques of the physical examination. I am certainly not against technological advances-most of us at academic institutions are drawn there because of the advanced diagnostic equipment available to us. I am, however, chagrined by the growing dependence upon imaging, laboratory evaluation, and other sophisticated techniques to make a diagnosis when often a physical examination and a very simple confirmatory test would reach the same conclusion in less time and for less cost. My goal in this presentation is to review the techniques of physical examination both for the part-time bovine veterinarian as well as the experienced bovine veterinarian. There is no question that the combination of excellent physical examination and excellent use of sophisticated diagnostic equipment will achieve the optimal results.

We often hear the term "complete physical examination," but how often do we perform one? The truth of the matter is that we do not need to perform a complete physical examination on every patient, nor do we have the time. We routinely perform what might be called a "standard physical examination" which includes a brief review of all important body systems. Based on the history and the results of the standard physical examination, we then perform one or more focused physical examinations. If we performed every one of the focused physical examinations that we knew, we would then perform a "complete physical examination." But let's not argue over semantics. Let's try to learn how to efficiently evaluate an animal by use of the standard physical examination and how to focus on particular areas to gain the most information possible from a physical examination.

There are many ways to approach a physical examination; many correct ways. The approach that I will use in this paper is to begin with observation at a distance and then examination of the restrained animal. I'll then discuss the acquisition of vital signs and basic auscultation, concluding with regional focused examinations beginning at the head. Because neurological examination is frequently difficult and confusing, I'll spend a bit more time on that aspect.