Bovine High-Mountain Disease: Brisket Disease in Cattle Explained
- See your vet immediately. Bovine high-mountain disease, also called brisket disease, is right-sided heart failure caused by high blood pressure in the lungs, usually after cattle spend time at higher elevations.
- Common warning signs include brisket or lower chest swelling, distended or pulsating jugular veins, exercise intolerance, weakness, fast or labored breathing, and sudden decline.
- Moving affected cattle to lower altitude is a core treatment step. Your vet may also recommend supportive care such as thoracocentesis, diuretics, and treatment for any concurrent lung disease.
- Pulmonary artery pressure, or PAP, testing helps identify cattle that are more likely to develop disease at altitude and is an important herd prevention tool.
- Affected cattle should generally not return to high elevations and should not be kept in the breeding pool because susceptibility has a heritable component.
What Is Bovine High-Mountain Disease?
Bovine high-mountain disease, often called brisket disease, is a form of pulmonary hypertension that can progress to right-sided congestive heart failure in cattle kept at higher elevations. The name comes from the soft swelling that often appears in the brisket area, but the underlying problem starts in the lungs and heart.
At altitude, oxygen levels are lower. In susceptible cattle, the blood vessels in the lungs constrict too strongly in response to that lower oxygen. Over time, pressure inside the pulmonary arteries rises, the right side of the heart has to work harder, and fluid can begin to leak into tissues and body cavities.
This condition is seen most often in cattle living above about 5,000 feet, with risk increasing further at higher elevations. Not every animal at altitude gets sick. Genetics, breed differences, time spent at elevation, and other health stressors all affect whether a cow or bull develops disease.
Because brisket disease can worsen quickly and may lead to death, cattle showing swelling, breathing trouble, or collapse need prompt veterinary attention.
Symptoms of Bovine High-Mountain Disease
- Brisket swelling or edema under the chest and lower neck
- Distended or visibly pulsating jugular veins
- Fast, labored, or difficult breathing
- Weakness, lethargy, or reluctance to move
- Poor exercise tolerance or falling behind the herd
- Bulging eyes or a stressed facial expression
- Diarrhea or dark, loose manure in some cases
- Collapse or sudden death
When brisket disease develops, signs often reflect right-heart strain and fluid buildup. Swelling in the brisket region is classic, but some cattle first show reduced stamina, depression, weight loss, or increased breathing effort. In rugged pasture settings, early signs can be easy to miss.
See your vet immediately if a cow has brisket swelling, jugular distention, open-mouth breathing, marked weakness, or collapse. These signs can overlap with other serious problems, including pneumonia, toxic plant exposure, parasitism, or other causes of heart failure, so a veterinary exam is important.
What Causes Bovine High-Mountain Disease?
The main trigger is chronic low oxygen exposure at higher altitude. In cattle, low oxygen causes the small arteries in the lungs to constrict. If that response is strong or prolonged, the vessel walls thicken, resistance to blood flow rises, and pulmonary artery pressure increases.
As pulmonary pressure climbs, the right ventricle has to pump harder to move blood through the lungs. At first the heart muscle enlarges. Later, it can dilate and fail. Once right-sided heart failure develops, fluid may collect under the skin of the brisket, in the chest, or in the abdomen.
Not all cattle are equally affected. Inherited susceptibility plays a major role, which is why PAP testing and selective breeding are used in high-altitude herds. Cattle moved from lower elevations to mountain pastures may be at higher risk if they are not adapted.
Other stressors can make the problem worse or muddy the picture, including chronic respiratory disease, parasite burdens, cold stress, poor forage conditions, and locoweed exposure. Your vet may need to sort out whether brisket disease is the main problem or part of a larger cardiopulmonary issue.
How Is Bovine High-Mountain Disease Diagnosed?
Diagnosis starts with a history and physical exam. Your vet will consider altitude, how long the animal has been at elevation, herd history, and visible signs such as brisket edema, jugular pulses, weakness, and breathing effort. Body temperature and routine bloodwork may be normal unless another disease is present.
The most specific herd-level and individual screening tool is pulmonary artery pressure testing, often called PAP testing. This involves passing a catheter through the jugular vein into the pulmonary artery to directly measure pressure. In general, higher PAP values mean greater susceptibility to altitude-related pulmonary hypertension.
Your vet may also use ultrasound, thoracic evaluation, or fluid assessment to look for pleural effusion and heart changes, especially in sick animals. If a cow dies suddenly, a necropsy can help confirm the diagnosis and rule out pneumonia, toxic plants, hardware disease, or other causes of heart failure.
Because brisket disease can resemble other conditions, diagnosis is often about combining clinical signs with altitude history and PAP results rather than relying on one finding alone.
Treatment Options for Bovine High-Mountain Disease
Spectrum of Care means you have options. Here are treatment tiers at different price points.
Budget-Conscious Care
- Farm call and physical exam
- Low-stress handling and immediate removal from exertion
- Prompt relocation to lower altitude when feasible
- Basic supportive medications chosen by your vet
- Monitoring appetite, breathing effort, and swelling
Recommended Standard Treatment
- Farm call or haul-in exam
- PAP-focused cardiovascular assessment
- Supportive care before transport
- Diuretics or other medications if your vet feels they are appropriate
- Thoracocentesis when pleural fluid is present
- Treatment for concurrent respiratory or parasitic disease if identified
- Follow-up plan and breeding recommendations
Advanced / Critical Care
- Emergency stabilization
- Repeated thoracocentesis if needed
- Oxygen support or referral-level critical care for valuable animals
- Ultrasound and expanded diagnostics
- Hospitalization or intensive monitoring
- Coordinated transport planning and post-crisis reassessment
Cost estimates as of 2026-03. Actual costs vary by location, clinic, and individual case.
Questions to Ask Your Vet About Bovine High-Mountain Disease
Bring these questions to your vet appointment to get the most out of your visit.
- Do this cow’s signs fit brisket disease, or do we also need to rule out pneumonia, hardware disease, parasites, or toxic plants?
- Is this animal stable enough to move now, and what is the safest way to transport her to lower altitude?
- Would PAP testing help for this animal or for the rest of the herd?
- Is there fluid in the chest, and would thoracocentesis improve comfort or survival?
- What supportive treatments make sense in this case, and what response should we expect over the next 24 to 72 hours?
- Should this animal ever return to high pasture, or should she stay at lower elevation permanently?
- Should affected cattle or close relatives be removed from the breeding program?
- What prevention steps are most useful for our herd before the next grazing season?
How to Prevent Bovine High-Mountain Disease
Prevention focuses on reducing altitude risk and selecting less-susceptible cattle. In herds that graze mountain country, PAP testing is one of the most useful tools. Animals with high PAP values are more likely to struggle at elevation, so many producers work with their vet to avoid keeping those cattle in the breeding pool.
Careful sourcing also matters. Cattle developed and tested for high-altitude environments may perform better than animals moved in from lower elevations without any screening. If your operation uses bulls, ask about PAP history and altitude suitability before purchase.
Good herd health lowers the overall cardiopulmonary burden. Work with your vet on respiratory disease control, parasite management, nutrition, and pasture planning. Avoiding locoweed exposure is especially important in areas where that plant is present because it has been linked to congestive heart failure in cattle.
If an animal has already had brisket disease, prevention usually means not sending that animal back to high altitude. Early recognition of subtle signs in the rest of the herd can also prevent losses, since cattle treated before severe heart failure develops have a better chance of stabilizing.