Coughing and bleeding cow

History of Present Illness

A 2-year-old female Holstein cow is brought to the clinic for evaluation. The cow has been coughing and has had nasal discharge for the past several weeks. She recently started to spontaneously bleed from the nose. The owner separated the cow from the herd and attempted to treat the cow for pneumonia with an unknown antibiotic for 3 days. When bleeding started, the cow was brought to the clinic.