The Physical Exam – What Exactly Are We Looking For?
Once a year, we call you up, ask you to load your crew (dog, cat, or multiples of both) into the car and head over to see us for your pet’s Annual Physical Exam. You come, we poke and prod for a few minutes, ask some questions, update their vaccines, and maybe take a blood sample. Sometimes I think we forget to take the time to really tell you what we are checking for, so here is a break down.
This, we get from talking to you. We want to know if anything has changed in your pet’s life (or in your life) in the past year. A move or change in location could mean your pet is going to be exposed to different parasites or more or less susceptible to contracting different diseases and we want to be able to inform you of the risks. If cats go from being indoor cats to being outdoor cats the risk for picking up parasites from hunting rodents changes drastically. A new family member can be a big change for your pet and we want to make sure everyone is transitioning well, and if not, point you in the right direction to fix the problem.
We want to know if you have changed your pet’s diet, treats, or added a supplement; and if so, why? – do you think they have an allergy to a certain ingredient, or they weren’t doing well? We want to keep that information in their medical file. If there have been changes in their eating/drinking/bathroom routine we need to know that too. Changes in these basic functions can alert us to problems internally and hint that we might need to do further testing, like get a blood sample, to make sure that your buddy isn’t getting sick.
The history we get from you is sometimes even more important than what we can see and feel during the physical exam itself, so no matter how silly it may seem, we want you to tell us about all the changes and quirks you notice at home. After all, you spend much more time with your fur-kid than we can, and you are the best to detect small changes in them. Plus, we love seeing your pet, but we also love having a relationship with you, so keep us updated!
We go through each body system to ensure there is nothing for you to be worried about.
I actually start the physical before you even enter the room. With dogs, I watch their gait as they walk in – is there a limp, any stiffness in their movement? I assess their disposition – are they happy or nervous, are they quiet compared to their usual? With cats, it’s a little trickier due to their carriers, but I usually will do the same type of quick assessment once we take them out in the exam rooms. And of course, we get their weight so we can monitor fluctuations over time.
I then start with the head – it helps that I can start at the same time that I’m saying hi to them.
I look in both eyes to make sure there is no redness, discharge, or abnormalities with the exterior structures (the iris or lens). If I do see anything abnormal, I will pull out the ophthalmoscope and have a closer look into the eye if I suspect any deeper issues. I then move to the nose to make sure the skin appears normal and there is no discharge there either. Then on to mouth – most don’t love this part of the exam but it’s a very important one! Dental disease is a serious problem for most of our pets. Just think about it – we brush our teeth twice a day, floss and use mouth wash and we STILL need to go see a dentist at least once a year to get a proper cleaning and oral exam. When you look at it like that, our pets do pretty well with minimal care. Most owners should expect to have their pet come in and have a full dental cleaning at least twice during their lifetime. I take a quick look for tartar build up, gingivitis, broken teeth, and for any abnormal oral masses.
Once the oral exam is over, I move onto the lymph nodes under their chin – these glands swell when there is an active infection or problem in their immediate vicinity and can clue us in to problems we might not be able to see from the outside. After that, it’s onto the ears to check for redness, debris, and make sure there is no infection or growths in the ear canals.
Moving along, I feel for any lumps or bumps along your pet’s skin. I have a good look at their coat, evaluating their skin underneath as well as the hair itself and at the same time, asses their weight. I then palpate their abdomen, feeling for certain organs and land marks to make sure there are no masses or trouble spots there. On a normal pet, we should be able to feel their bladder, kidneys, spleen, and sometimes the tip of their liver. Everything else is too small, or too hidden underneath the rib cage for us to feel from the outside. However, if we do feel other organs, that can signal to us that something is abnormal and we need to investigate further (with bloodwork, an xray, or sometimes even an ultrasound).
I palpate down, along all 4 legs to make sure I don’t feel any heat, pain, swelling, or masses to signal an injury or abnormality in the joints. I do a quick flexion and extension of the joints – in particular the hips and knees – the most common problem joints for our 4 legged friends.
Then finally, I’ll pull my stethoscope off the wall and have a listen to their chest. I’m not just listening for a heartbeat – obviously your bouncing, panting, or purring pet has a heartbeat. I’m listening for abnormalities to that beat – heart murmurs, abnormal rhythm of beats, or even if the heartbeat is easy to find or if it sounds muffled. These are all signs that there is some type of cardiac disease and we need to investigate. Luckily, dogs and cats don’t have to deal with high blood pressure and clogged arteries like people, but there are lots of other things that can happen to them like heart valves that don’t close properly, or stretching of the heart muscle causing inefficient pumping or electrical abnormalities. I also listen to the lungs to make sure I don’t hear any crackles or wheezes and that breaths are coming easily and un-interrupted.
And that’s that – another annual physical exam complete!