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Unfortunately, economics dictate what practitioners are able to offer the client and the patient. Additionally, some clinical options available to other species are just not practical in bovine practice. If the problem is not obvious after visual examination, the next step is to properly restrain the patient on a hydraulic tilt table or tilt chute. Casting the animal is another option, but it is difficult without an abundance of labor and may not allow for an accurate examination. It is possible to cause harm or even create a new injury by tying a leg in a squeeze chute with the good intention to examine a lesion more closely. Since approximately 70% of bovine lameness is in the hoof, hoof testing while the patient is in lateral recumbency is an important part of the examination. If hoof testing reveals a painful area, explore the area by paring the hoof and examine any cracks, crevices, or wall separations. Often aggressive trimming of the sole will provide evidence of a puncture, laceration, or developing crack that can lead to an abscess. If no pain is elicited on hoof testing and no direct visual abnormalities are noted, attention should be directed further up the limb. Each joint should be palpated and individually flexed and extended, including the shoulder or hip. Most often, lameness caused by a joint in the lower limb can be identified by flexion or extension of the joint, eliciting a painful withdrawal of the limb by the animal. The flexor and extensor tendons must be evaluated for evidence of sepsis or rupture. If the examination at this point has still not revealed the cause for the lameness, the animal may have to undergo local anesthetic nerve or tissue infiltration in order to isolate the painful area.