Posted on March 24, 2011
A Truly Hands-On Physical Examination
Have you ever gone to the doctor and realized after the visit that those healing hands never actually touched your body? C’mon now, that’s not okay! Nor is it okay for your veterinarian to skimp when it comes to examining your pet. In veterinary school, we are taught to perform a thorough physical examination on each and every patient. It would be a travesty to miss a new heart murmur or enlarged lymph node on a patient that presented for limping. The sooner abnormalities are detected the more likely we are to gain an upper hand.
Listed below are the elements of a thorough physical examination for your dog or cat. Bear in mind, it takes no more than a minute or two for a seasoned vet to competently complete the following (by the way, it helps if you are not talking when the stethoscope is being used!):
- Assessment of overall alertness and appearance
- Evaluation of gait
- Evaluation of the skin and haircoat
- Measurement of body weight, temperature, heart rate, respiratory rate, and capillary refill time (the time it takes for the gum line to become pink after it has been blanched by finger pressure)
- Examination of the eyes, ears, nose, and oral cavity
- Palpation of lymph nodes
- Palpation of the thyroid gland (specific for cats)
- Auscultation of the heart and lungs (listening with a stethoscope) on both sides of the chest
- Palpation of the abdomen
- Rectal examination (specific for dogs that are middle aged and older)
Vets perform physical exams differently in terms of order of events. No matter in the least as long as everything is included. And please remember, such thorough exams are not to be reserved for only the annual office visit. If your kitty is vomiting or your dog has an ear infection, you should expect the whole shebang (although your dog or cat would probably prefer a mini-exam).
Is your veterinarian “hands-on” and doing one heck of a thorough job when it comes to the physical exam? Please share your experiences.
Best wishes for good health,
Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
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Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.
My vet does a pretty thorough job, though she has recently stopped taking a temperature on routine checkups. I have never seen her do a rectal exam, but then, I only have cats. She will generally check the rectum for presence stool.
Once when my cat developed a limp, I simply videotaped her walking toward me and in front of me and sent the two videos to her via email. I knew that I’d never get the cat to walk at the clinic!
We are very fortunate to have an extremely thorough veterinarian. The only thing that I have ever seen him NOT do is the evaluation of the gait. I am sure that if something about the gait of either of our girls were abnormal, and brought to his attention, he would make that part of the exam. He even goes so far as to get down to the pet’s level and smell her breath, which can be telling for diseases like diabetes or renal failure. He examines her pupils to make sure that they are equal in size, and I must say, I am very pleased with the level of thoroughness with each “hands on ” examination that our girls get from our vet.
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Just wanted to chime in that it is important that we as our pets’ advocates do our part to insure that they can receive a thorough physical examination! Much of the handling that dogs and cats have to endure during an examination are not natural things that they can be expected to accept without some work on our part. I want pets to not just tolerate handling, but to actually enjoy it, so I like to work with them at home and teach them that handling and restraint mean an opportunity for treats or other experiences they enjoy. Then I like to take the training on the road… take them to the vet office at first just for fun visits where they get cookies, play and pets, and then incorporate the handling and restraint training into the visits. Your vet and your pet will both thank you for helping to make health care safer and more pleasant for everyone!!
Our new vet is awesome hands-on guy. (well, I call him new, we had him for two years now) One of the reasons we love him.
From the day one, when we brought Jasmine in for a consult about her knee. He started at the tip of the nose and checked her out all the way to the tail.
He also has magic hands and can feel things others cannot.
My dog did not recieve this kind of examination the last time we were in and I think some of the fault is with me. I came specifically to check out his skin for mites or allergy. I think when I started getting the run down of tests adding up to $350 for scrapings and meds I went a little blank with shock. The vet did listen to his chest but went right to looking for skin problems announced “Demodex” and “ear mites”. He was a recent rescue with a thick wire coat that I had been working on for about a month. Tests showed no mites and 2 months on a a regular diet cleared up his “allergies” without any special treatment.
As it turns out dogs can look like they have allergies even causing red, bare areas from stress. I noticed he only scracthed when I was on the phone with a customer or wanted my attention I started distracting him with a toy. The scabbs on his face healed after he stopped shoving his face in the cats belly as well. I wondered if I should tell the vet or just find a new one?
My Missy had a sudden strange limp and I took her to the vet, who determined it was “soft tissue injury” and sent us home with meds. Then I saw Missy jump from the sofa to the chair and miss, which she never did!
Well, it turns out that when the owner of a dog that’s blind in one eye moves the furniture to vacuum it’s VERY important to put it back EXACTLY where it was! Missy’s leg injury turned out to be due to her (existing) eye problem!
I have always loved that about veterinarians – when I go to the doctor with my kid for a respiratory issue they grab their light and focus right in on the throat – when a pet comes in for a respiratory issue, we check all of those things that you mentioned!
I know they are different, and people can give MD’s more of an explanation than pets can give us, but I have always been proud of that aspect of our profession.
And yes I get strange looks for looking at a sore leg very last after everything else (including, next to last, the other three limbs :)) but clients are grateful when they understand why we are being so thorough!
…on a more positive note, my first dog, Missy, was terrified of being handled especially by men. My vet recommended a trainer who used to be a vet tech. My trainer showed me how to go nose-to-tail examining Missy on a table, and where to pull on her skin to imitate when she’d get shots. Then, for about two weeks before each annual I’d go through the motions with Missy on a table and give her plenty of treats and praise. She never really liked vets but she accepted routine exams.
Knowing what to expect helped he to help her.
The last time I saw Dr. BadVet was when my beloved cocker spaniel that had a head tilt was starting to show insecurity when walking and doing strange hops. The vet agreed it could be neurological, and he said “maybe her vision is going… ” and didn’t examine her eyes… and then he said “well, she’s just an old dog.”
My current vet is a practice that values old dogs as much as I do.