With LDA and RDA, scanning of left flanks during pen inspection will detect hollowing and prominence of transverse processes reflecting reduced rumen fill and loss of condition from reduced appetite. An individual examination may additionally detect faeces that is pasty or fluid. Heart rate, temperature, respiration and demeanor are usually normal. Lifting of hind legs and looking at the flank are signs of abdominal pain that may be observed.
With an abomasal volvulus, the animal will likely be found recumbent, weak and depressed during a pen inspection. An individual examination will detect elevated heart rate, sunken eyes and cold clammy skin, all signs reflecting shock, dehydration and toxaemia. Deterioration will be rapid and death will occur within hours.
A displaced or torsed abomasum will be distended with gas and fluid enabling its detection with a stethoscope on the left or upper right side of the abdomen. Gas tinkling sounds and fluid sloshing can be heard if the area is pushed in and released a number of times with a fist, a process known as ballottement. A pinging sound will be heard when the area is flicked with a finger (percussed). The gas tinkling, sloshing and pinging should occur over a discrete area matching the size of the distended abomasum. These sounds must be differentiated from fluid and gas in the rumen or caecum.
With abomasal volvulus these sounds will be elicited from a very large area on the right side, the right flank will be grossly distended and faeces will be tar-like and mucoid.
Left and right displaced abomasa must be differentiated from other causes of illthrift such as mild ruminal acidosis, liver abscess, low grade pneumonia and vagus indigestion.
Cases of abomasal volvulus may look similar to other causes of gastrointestinal obstruction such as intestinal volvulus (mesenteric torsion), intussusception, dilatation or torsion of the caecum, acute diffuse peritonitis and intestinal foreign body such as a phytobezoar.
Necropsy findings in animals that have died following an abomasal volvulus include oedema and purple to black discolouration of the abomasum (from strangulated blood flow). The abomasum may be hugely distended with fluid and gas if it has not ruptured. A twist may be palpable at the root.