1. Home
  2. Knowledge Base
  3. Animal Guides
  4. Cows
  5. How to Conduct A Cow Health Examination

How to Conduct A Cow Health Examination

A younger cow looks at the camera through a fence outside.

Updated April 10, 2020

Much like the common advice given to humans, it’s important to regularly check the health of cows with a routine physical examination rather than waiting until a cow is showing signs of distress or illness. Not only will this help you get to know what all aspects of a healthy cow look and feel like, but familiarizing a cow with human handling might help them stay more calm in stressful situations. Be prepared to check them over every six to eight weeks*! For more information on why regular health examinations are important, check out our resource here.

*An Exam Every Six to Eight Weeks Means Daily Observation

Our recommendation to conduct routine health examinations every six to eight weeks must be done in conjunction with daily observations.  Caregivers should be trained to observe animals both for behaviors that are abnormal for the species and also behaviors that are abnormal for each individual, keeping in mind issues that are common in a particular species and their warning signs.  Thoughtful observation plays a crucial role in catching health issues before they progress into more serious situations.

Residents With Challenging Backgrounds

Close daily observation can be difficult with certain individuals or groups who come from challenging backgrounds. They may be more likely to hide signs of illness or injury, or may not allow you to come close enough to them to thoroughly assess their well being on a regular basis. Challenging backgrounds may include individuals who are not socialized, have lived feral, or were abused or malnourished. If you care for individuals who came from a challenging background, it is imperative to make time to foster a bond of trust so careful observation is possible. A monthly health exam is recommended for these individuals until they exhibit signs that they feel safe and you are confident that close daily observation is possible.

New Resident? Conduct An Intake Examination!

If you are conducting an initial health examination on a new resident, check out our intake examination resource to learn about what you should check for and document!

Problem Signals

By paying regular attention to the herd, you may see some subtle cues in the event that something is amiss. A sick, injured, or otherwise distressed cow may:

  • Hide more often than they used to
  • Change their daily schedule or general behavior
  • Have labored breathing, coughing, sneezing or a constantly open mouth
  • Have excessive amounts of discharge from their eyes or nostrils
  • Have low or lowered ears
  • Have foam around their nose or mouth
  • Be immobile, inactive or unresponsive to your approach
  • Be lying down, unable to get up and potentially bellowing (a downed cow must be gotten back up on their feet as soon as possible to prevent permanent injury)
  • Be stretched out in order to relieve bloat
  • Be sitting far more often than usual; or “dog sitting” with front end up and rear end down
  • Avoid or be rejected by the rest of the herd
  • Be stamping their feet
  • Grind their teeth frequently
  • Have a limp in their step
  • Have unusual or abnormal droppings including diarrhea, blood in stool, or worms
  • Be less hungry or thirsty, or drink water excessively
  • Have a gaunt appearance, or a “bouncing” abdomen while they walk
  • Have an odd posture like hunching over or avoiding putting weight on one of their legs
  • Have a bulge or non-uniform abdomen on their left side (can indicate bloat), or kicking at their abdomen
  • Have an abnormally strong odor
  • Have an internal body temperature not in the range of 100.5-102.8 degrees Fahrenheit
  • Have a swollen jaw
  • Have unusual abscesses on their body or in their mouths
  • Be reluctant or averse to urinating or urinating frequently
  • Standing with back legs extended behind them
  • Have red, hot, or swollen udders
  • Show signs of weakness
  • Have swelling above the front of the hoof or underneath the dewclaws
  • Have raised red or white lesions on their third eyelid
  • Have cloudy spots on their eyes
  • Regularly drop wads of cud as they chew

In cases of symptoms such as the ones above, it’s especially important to conduct a health examination on a cow. Generally, where you begin the exam should be determined by the symptom you are seeing.  If someone is limping, you will likely want to start with the foot they are limping on.  If they have signs of bloat, you will likely want to start by checking their rumen.  During routine health examinations, it’s good to have a set order that you follow (such as starting at the head and working down to the hooves, or visa versa) in order to ensure you do not miss a step. It’s important to keep regular documentation of these checkups, including weight and any abnormal findings, in order to keep an easy-to-follow set of information in case a veterinarian needs the cow’s history.

Safety First!

Cows can become ill with disease that is highly transmissible to humans. It’s very important to wear gloves when conducting health examinations! If you have never approached a cow before, read our guide to safely being around a cow. Never put your hand inside a cow’s mouth!

Conducting The Exam

Ask An Expert

Prior to regularly conducting cow health examinations, you should have a veterinarian or compassionate care expert give you hands-on training in order to be the best cow health advocate possible. Being trained to rapidly distinguish healthy conditions from abnormalities can be crucial in early health problem detection and effective treatment!

It can be easier to conduct the examination after a cow has eaten or as they’re tucking in for the evening as they tend to be less fussy. Before stepping into their living space, you should take note of the cow’s behavior. Are they acting differently than they usually do? How are they getting along with fellow herdmates? These clues can say a lot about a cow’s health.

If necessary, you may have to have a second caregiver on hand to help manage the health examination or help restrain the cow with a halter. Once you have the cow calm and ready, conduct the following observations:

When In Doubt...

Unless you are a qualified veterinarian or have been trained to handle specific conditions, The Open Sanctuary Project strongly advocates that you promptly report any health concerns you find during the course of an exam to your veterinarian or care expert. Unless they’re in a life-threatening situation, you should be your resident’s advocate, not their doctor.

Check their weight and body condition

It’s important to keep regular measurements or estimates of the cow’s weight. If a cow has lost a lot of weight, this could indicate a sickness, malnutrition, worms, or other parasites. It could also be a symptom of Johne’s Disease. If a cow is mature and has gained a large amount weight in a short time, it’s critical to ensure that you aren’t overfeeding them, especially with alfalfa, treats, and snacks. Obesity-related complications can regularly lead to dangerous conditions in cows.  Be aware that your veterinarian may think that all of your cows are overweight if they are comparing them to the cows they have worked with at farms raising them for profit.  For example, a Holstein at sanctuary who is not constantly impregnated and milked will be heavier than a cow used for dairy production because her body is not putting energy into milk production. Pay close attention to the cow’s body condition. The spine, ribs, and hip bones should not be prominent.  Focus on these areas rather than their belly- an emaciated cow may still have a large belly.

Check their head

How are they holding their head? It’s best if they’re holding it up on their own volition. If they’re shaking, hunching, or tucking their head, this can be a sign of illness or injury. Ensure that their horns are not causing them harm with excess growth. Check their jaw for abscesses, which could be a symptom of Lump Jaw, which is contagious if oozing, and requires intervention to prevent a bacterial infection from spreading into their jawbone. Also check for any swelling or fluid under their lower jaw as this could be bottle jaw stemming from a serious health issue.  Look for any signs of facial paralysis- a droopy eyelid or droopy ear- as this can be a sign of listeriosis.

Check their eyes

A cow should have bright, clean, alert eyes. They should be free of discharge and clear. Cloudy, watery, dry, swollen, sunken, reddened, constantly blinking, or crusty eyes indicates likely illness or injury. The above symptoms could be signs of pinkeye, which is highly contagious to other cows and humans. Cow eyelids are normally pale; this does not indicate anemia. Their pupils should be about the same size and react properly to bright light (get smaller and then return to normal). If their pupil takes a very long time to contract, it could indicate low calcium.  Check their third eyelids for any red or raised spots as these can be early squamous cell carcinoma.  If you catch it when it’s the size of a grain of rice, it is much easier to remove without risk that it has spread beyond the third eyelid.

Check their ears

Their ears can have a modest amount of earwax or debris in them, but should be clear of any ear mites. Excessively sticky, yellow, or odorous earwax needs addressing. You can use a gauze pad to clear out excess earwax or to sample potential ear mites. If their ears are very cold, this could indicate illness or distress.

Check their nose

A cow’s snout should be free of any discharge, fluid, crustiness, or blood. Their nose should be soft and moist, and not cracked. An excessively runny or blocked nose could be a symptom of an upper respiratory infection or pneumonia. They should be exhaling evenly between both nostrils.

Check their mouth

You shouldn’t be able to hear a cow breathe in ideal circumstances. Their breathing should not be labored, loud, wheezy, rattly, sneezy, whistling, or squeaky. Generally, a mature cow should have between 10-30 breaths per minute. A breathing-impaired cow might have lungworms, a serious and potentially deadly infection in their respiratory system. They should not have a wet or dry cough. Many of these symptoms could be a result of pneumonia which cows are highly susceptible to. Abnormalities should be immediately reported to your veterinarian. If they’re reluctant to eat, they might have a problem with one or more of their teeth that needs to be managed. Now take a look in their mouth. Cows have lower incisors, but no upper incisors; instead, they have a dental pad.  Their gums should not be red, and there should not be any sores, abscesses, or scabs in their mouth, which can be a sign of Sore Mouth. A cow’s jaw should not be swollen or enlarged, which could be a symptom of Lump Jaw. A swollen tongue could be indicative of Bluetongue. If a cow has particularly bad breath, it could be symptomatic of an infection and require deeper examination.

Check their digestive system

It’s critical to check the cow for symptoms of bloat. Ensure that their abdomen is equally rounded and uniform across their body. If a cow has a bulge on their left flank, is grinding their teeth, stamping their feet, kicking at their belly, has difficulty breathing, are stretching themselves out, or bellowing frequently, this could indicate bloat. If you are at all concerned that a cow might have bloat, contact your veterinarian as soon as possible. Serious bloat cases can kill a cow in 15 minutes if no intervention is taken. Gassy bloat might require the use of a stomach tube for immediate relief. Other causes for abdominal pain include “hardware disease”, where they may have consumed screws or nails, or a displaced abomasum. If you suspect either condition, contact a veterinarian immediately. You can put your ear to a cow’s midsection on the left to listen for typical rumen activity if concerned; a rumen sounds a bit like a muffled thunderstorm passing through them every minute and a half or so. If you place a stethoscope on the left side of the cow’s chest right behind the elbow, you will be able to hear their heartbeat. A cow’s typical heart rate is around 72 beats per minute, but can be quite variable like a human’s and still be healthy.

Check their skin

Check around the cow’s entire body to ensure healthy skin. This is the time to ensure you are checking and feeling every area of the cow’s body, not just those included in this list.  This thorough section of the exam is critical to ensure that nothing that can be addressed early is missed. Their skin should not have lice, mange, itchiness, mites, nits, lumps, cuts, cysts, bruises, gangrene, larvae, maggots, dry patches, blisters, or pressure sores. Abscesses on their body should be reported to a veterinarian immediately. Their hair should be shiny and flat against their body, and their skin should be bright and not tough. Their hair should not be standing on end. Ensure they do not have any patchy hair loss, which could be a sign of parasites or a mineral deficiency. Check their tail for hair loss and parasites as well. If the hair at the end of their tail is close to touching the ground, it should be trimmed to prevent other cows from stepping on it.  If they are holding their tail away from their body, it could indicate irritation in their rear end or udder.

Check their joints

It’s important to check a cow’s joints in their legs and shoulders for swelling or tenderness. They should not be warmer than the rest of their body. Ensure that the cow doesn’t have pain when they move their joints. There should be no cracking or crunching sounds when they move, and they shouldn’t be avoiding putting weight on any of their joints in particular. Joint inflammation could be a sign of arthritis, which is prevalent in cows as they get older. If their leg or shoulder muscles are twitching, this could be a sign of low calcium.

Check their hooves and feet

Ensure that the cow’s hooves are a reasonable length and free of cracks, heat, swelling, debris, or abscesses. Any of these symptoms can cause lameness, discomfort, and could possibly contribute to infections and further damage. A cow with an abscess in their foot may refuse to put any weight on the affected foot, which can be quite alarming.  However, once the abscess is opened, either by a veterinarian or by rupturing on its own, the cow will be much more comfortable.  If you are concerned that a cow has a hoof abscess, have your veterinarian out right away to assess.  Check the skin above the hoof for swelling and warts.  They should be able to put their full weight on their feet and they shouldn’t limp. If they are limping, check their hoof bottoms for uncomfortable debris. If their hooves are overgrown, schedule a trimming as soon as you can. Generally, cows should have their hooves trimmed about every six months, though cows with chronic hoof issues may need to be trimmed more often. If a cow has any of the above issues with their feet, or if you smell a foul, sulfurous odor coming from their hooves, it could be a sign of hoof rot, requiring immediate treatment.

Check their rear end

A cow’s rear end under their tail should be relatively clean. It shouldn’t have any discharge, excessive accumulations of fecal matter around it, nor should it be crusty or bloody. Ensure that it doesn’t have any mites, lice, tapeworms, or other parasites. Make sure that it isn’t irritated or prolapsed (protruding). If it’s prolapsed, you should consult with a veterinarian immediately. Check the cow’s udders and ensure that they are not hot, swollen, tough, or painful which can be a symptom of Mastitis and requires treatment. If a male cow is struggling to urinate, it can be a sign of urinary calculi and require treatment. Check a male cow for sheath rot, which is a type of scald that can damage their penis.

Check their poop

It’s important to monitor a cow’s poop and to recognize what healthy cow droppings look like. Keep in mind that their poop will change depending on if they are on an all hay or all pasture diet.  Healthy cow poop forms in a relatively solid, but not dry, pile during times when the cow is eating all, or mostly, hay. If they are mostly eating grass, the poop will be loose and runny, but should never appear watery.  If it’s poorly formed, watery, strong smelling, or bloody, it could be a sign of diarrhea, parasites, illness, or improper nutrition. If you’re particularly concerned by a dropping, you can bring it into your veterinarian for analysis, though you should consider fecal testing healthy-seeming cows at a regular interval to check for internal parasites. Conversely, ensure that the cow has regular bowel movements, as they are prone to constipation. Their urine should not be very dark and concentrated. When checking females, check vulva for signs of discharge and scabbing.

Isolate if necessary

If you notice that a cow is unhealthy, it’s crucial to consult with a veterinarian or compassionate care expert and prioritize accurately diagnosing the problem. Depending on the health concern, it may be necessary to isolate the cow in order to protect the rest of the herd from a potentially infectious disease.  However, with some illness, such as pneumonia, often once a cow is showing symptoms, the other residents in the herd have already been exposed. In these instances, you will need to weigh what is in the best interest of all of your residents. A sick cow who is isolated from their herd may become more stressed, which could delay recovery.  Depending on the health concern, separating the cow with a calm companion might be a good compromise.

Though it may seem like an overwhelming amount of factors to be aware of, once you’ve gotten to know a cow and what good cow health looks like, you’ll be an excellent cow health ally in no time!

Writing It All Down

As you may know, regular documentation is a critical part of responsible sanctuary animal care. In order to maximize the value of your cow health examinations, we’ve developed a free printable cow health exam form for sanctuaries and rescues!


Cattle Care | Farm Sanctuary

Clinical Examination Of The Cow | University Of Glasgow (Non-Compassionate Source)

Treating And Preventing Lump Jaw In Cattle | Yankton (Non-Compassionate Source)

Identifying Sick Or Injured Cattle | The Cattle Site (Non-Compassionate Source)

Cattle Disease Guide | The Cattle Site (Non-Compassionate Source)

Healthy Cow Check-up | Extension (Non-Compassionate Source)

Identifying Sick Cows That Need To Be Examined | Dairy Herd (Non-Compassionate Source)

Non-Compassionate Source?

If a source includes the (Non-Compassionate Source) tag, it means that we do not endorse that particular source’s views about animals, even if some of their insights are valuable from a care perspective. See a more detailed explanation here.

Updated on July 28, 2021

Related Articles

Support Our Work
Please consider supporting The Open Sanctuary Project by making a donation today! We are 100% donor-funded and rely on the support of generous individuals to provide compassionate resources to animal caretakers worldwide.
Donate Now HERE