The Ambulatory and Production Medicine Clinic was called for physical examination of a 2nd lactation Holstein cow, with a primary complaint of a decrease in feed intake, dark loose manure, and no increase in milk production since calving 4 days prior. On physical examination, the patient had a depressed mentation and was dehydrated, as evidenced by sunken eyes, with a prolonged skin tent and tacky pink mucous membranes. Abdominal auscultation and simultaneous percussion revealed no pings on the left side, and weak ruminal contractions. On the right side, a ping was heard from the paralumbar fossa extending cranially to the 9th rib. Rectal examination revealed a gas-filled viscus to the right of midline in the area of the right paralumbar fossa and the presence of melena was confirmed. The patient was diagnosed with a right displaced abomasum or abomasal volvulus and surgical correction was pursued.