In severe cases, where a bloated animal is panting to breathe, treatment is a matter of great urgency. Even a 30 minute delay can be fatal. Use a double-bladed bloat knife with a guarded blade to protect your hand- cow skin is tough to penetrate. Stab through the upper left flank into distended rumen, the cut should be vertical and at least a hand-sized cut. This produces an explosive release of rumen contents and immediate relief for the cow. Your vet will need to be called to suture up the cut and administer antibiotics to help fight infection.