Animals are hard-wired to hide signs of illness or pain and will often begin to give an indication that they are sick only after their disease is quite advanced. Even the most astute and loving pet owner can easily miss the very early signs of disease.
Regular physical exams and screening your pet for risk factors indicating predispositions to certain conditions can lead to earlier diagnosis and better outcomes. Regular wellness exams thus can save you money — that is inherent in prevention.
So what exactly do we do during a physical exam? Here it is, broken down into 10 steps:
Most physical exams start with a nurse taking down notes on weight and vitals––temperature, pulse rate, respiratory rate, etc.––but we’ll also include immediate impressions — “bright, alert and responsive” (abbreviated as BAR) or “depressed,” “quiet,” “recumbent” and/or “unresponsive.” We note the animal’s “body condition score,” to denote the pet’s degree of heaviness or thinness.
#2 The head
We look at ears, eyes, nose, mouth and teeth. We check for discharge, normal appearance of structures, details on dentition and periodontics, character of the mucous membranes to assess hydration, etc.
#3 Skin and coat
Some pets have such dense hair that getting to the level of the skin in key areas can be like wading through a forest of fur. Finding fleas, ticks and lumps is extra-tough on these pets, especially if they have a large surface area. We also check for hydration here by “tenting” the skin at the shoulders.
#4 The chest
We use our stethoscopes to listen to the heartbeat and breathing. We try to alter your pet’s breathing pattern with our hands on the nose and mouth and feel the pulses as they relate to the beats of the heart.
This is sometimes done as part of steps #1 and #4 where we check mucous membranes for their refill time and when we feel pulses during our chest exam to make sure they synchronize well with the heartbeat.
We assess the symmetry (or lack thereof) of the musculature, observing how the pet moves/ambulates and physically manipulate limbs and their joints. We also address the spine individually, feeling down every intervertebral junction to identify painful spots.
#7 The abdomen
Palpating the abdomen is not easy in some cases. Some pets hold their abdomens tightly, refusing to allow you a good feel. What we’re feeling for is the size and texture of the organs and the possible presence of abnormal masses. Sometimes we can’t feel much though, even if a pet does let us, and usually that’s because they’re overweight or obese.
#8 Lymph nodes
We feel all the peripheral lymph nodes that are typically palpable: in the neck, in front of the shoulders, and behind the knees. We’ll also check those spots where enlarged lymph nodes will make themselves known (but are otherwise not palpable).
We typically evaluate the cranial nerves as part of the head exam and address some basic reflexes.
#10 The invisible intangibles
These are the issues you may not notice us addressing specifically by the way we are looking at and touching your pet, but which we are picking up as we perform the exam. Issues such as your pet’s scent, and little things that might set off our intuitive alarms; that almighty sixth sense we all cultivate with experience.
How long does all this take? The best answer is that it takes as long as it takes. What’s important is to thoroughly cover all the bases, picking up on historical and physical cues. Please feel free to ask questions and involve yourself in the process. It doesn’t cost you one dime more to do so.