Frothy bloat usually affects groups of animals within an hour of feeding. Free gas bloat occurs sporadically in individuals. Distension of the left flank is detected during pen inspection. The right flank will also be distended in severe cases, and there may also be respiratory distress (mouth breathing, tongue protrusion, outstretched neck).
Cattle with tetanus, rabies, oesophageal obstruction and ruminal acidosis may also develop bloat. With tetanus the animal is also stiff, with rabies there is aberrant behaviour, with oesophageal obstruction there is profuse salivation and bilateral nasal discharge, and with acidosis there is also dehydration and liquid, rich-smelling, brown faeces.
Cattle often develop bloat when lying down. This is because it is difficult for cattle to burp unless positioned almost exactly upright. When they become too uncomfortable they will reposition themselves or stand, belch and be okay. If they are unable to reposition themselves, for example if they get stuck under a pen rail, sat on by another animal, or if weakened by hypocalcaemia, they are in danger of bloating and asphyxiating.
Bloat is confirmed by the history and gross pathology. Cattle affected by bloat may die suddenly and are unexpectedly found dead during pen inspection. At necropsy there is intense congestion of the head and neck (especially the tongue, eyes and tonsils), relative pallor of the chest and abdomen, and moderate congestion of the hindquarters. The abdomen is hugely distended by the rumen which may still contain some froth in cases of frothy bloat. The sudden death and rapid decomposition can make differentiation from clostridial diseases difficult.
Note: well-conditioned animals dying of other causes can bloat quickly after death and develop signs resembling true bloat such as congestion of the head and neck, and an oesophageal bloat line (if post-mortem bloating occurs before blood coagulates).