what happens during a routine checkup?
You’ve heard me talk about the importance of a yearly (or, for older pets, twice yearly) physical exam in all of our pets, but maybe you’ve wondered what exactly a physical exam entails? I consider the physical exam one of the most important tools of the trade. It’s relatively non-invasive, generally painless and incredibly important for vets to check what is normal – and might be abnormal – in your furry friends.
Usually, the first step is your pet will step on the scale and have her temperature taken. Even healthy animals will have their weight and temperature checked because it’s good to have a baseline reading. Sometimes your veterinarian will do this, and sometimes the veterinary technician will do it first, and then pass the information along when the vet comes into the exam room.
From head to tail
First, your pet’s general appearance is assessed. I usually step back and take a look at your pet from afar, allowing your pet to check me out as well. Your pet’s body condition score is noted. This is a number that describes your pet’s weight – kind of like a BMI in human medicine.
When assessing general appearance, I also will note your pet’s attitude – is she a happy dog or cat? Or quiet? Or does she feel too ill to even give me a little tail wag? If your pet is free to roam around the room, I note any changes to her gait that may indicate lameness.
Eyes, ears and mouth
Next, I begin the hands-on portion of the exam. I always start at the top and assess your pet’s eyes, ears, and mouth. Using a light and an ophthalmascope, I check your pet’s pupillary reflexes and examine the retinas at the back of your pet’s eyes. I’m also looking for cataracts and redness, swelling or eye discharge that may indicate ocular disease.
Your pet’s ears are checked for discharge, which may indicate an ear infection or ear mites. Often, I’ll use the scope to check down your pet’s canals all the way down to the ear drum just to make sure everything looks fine.
An oral exam is performed, provided your pet is willing. In this line of work, I’ve learned that often times, a pet’s bark is worse than his bite, and you’d be surprised at the number of times I’ve been able to sweet talk a shy or nervous dog or cat into letting me examine his teeth and gums. Still, though, it’s safety first – if I think there’s a chance your pet may bite myself or my staff, we’ll skip the oral exam and consider a soft muzzle.
I’ve written many times about the importance of oral health. Dental disease is not only painful for your pet, but can exacerbate certain cardiac and kidney issues and make your pet feel just plain bad. When performing an oral exam, I’m looking for signs of dental disease, such as gingivitis, tartar buildup and loose teeth. I am also looking for oral masses.
Cardiovascular and respiratory
From here, I usually move backward to the chest.
With my stethoscope, I listen to your pet’s heart and lungs. I am listening for a nice, steady heart rate with no murmurs. In addition, quiet lung sounds on both sides indicate healthy lungs.
While I am listening to your pet’s chest, I am also feeling an artery on the inside of her hind leg to make sure that her pulses are strong and coincide with her heartbeat.
Even pets who come in for a routine exam should have their skin examined. Dry skin is a common problem in the winter when forced air heat makes the house a little drier than normal. The presence of ectoparasites, like fleas and ticks, is noted, and the general condition of the skin is assessed. Conditions such as skin infections will be further investigated.
When examining the skin, I’m also looking for suspicious lumps or bumps. If you notice a new lump, bring it to the attention of your vet while she’s doing your pet’s exam so that she can assess it. I try to be thorough during a skin exam, but some lumps are easy to miss.
I’ve already assessed the front end of your pet and listened to his chest. Moving on back from the chest, I focus my attention on the abdomen. So much information can be gained here. First and foremost, I want to see if your pet is painful when I palpate her abdomen. Is she tense or relaxed when I’m feeling around? A painful abdomen will warrant further investigation.
When palpating the abdomen, I’m also looking for any changes in the size of the major organs. I’ll be able to feel if the liver, kidneys or spleen are enlarged. I can feel loops of intestines and the bladder as well. Intact females may be harboring surprise puppies or kittens – depending on their size, they can be detected on abdominal palpation.
Peripheral lymph nodes
Throughout the exam, I’ve been feeling your pet’s peripheral lymph nodes, or the nodes that can be felt from the outside. Specifically, she has some in her neck (just like us) and behind her knee that are particularly easy to feel. Enlarged lymph nodes can mean systemic infection, local inflammation or something more sinister, like cancer.
Genito-urinary and beyond
This is likely your pet’s least favorite part of the exam, and for good reason, because we’re about to get pretty personal. Male dogs will get a quick check of their penis and if they’re intact, both testicles will be checked. On more than one occasion I have discovered a missing (or undescended) testicle in a dog and wondered how in the world they went so long with no one noticing! Undescended testicles are prone to developing cancer, so the sooner we know about them, the better. Older male dogs should also have their prostates checked. Unfortunately, this will entail a rectal exam, but it is necessary to check for prostate enlargement, which may indicate benign hyperplasia or a more serious condition like prostate cancer.
Female dogs aren’t off the hook. Anal glands are present in both male and female dogs and should be palpated. Not only is this a good opportunity to express the anal glands if necessary, anal glad palpation checks for the presence of glands that may be enlarged due to cancer.
Cats, however, usually are off the hook. A quick glance of their parts is all that I generally do – it turns out that cats don’t really appreciate rectal exams, so unless it is absolutely necessary, I avoid that at all costs.
Female pets need to have their mammary glands checked, especially if they are not spayed. Any lumps should be biopsied, or at the least, aspirated with a needle.
During your pet’s exam, I’ve been noting how your pet’s nervous system is working. I’ve looked at several reflexes so far, such as those that affect the eyes and face, and have noticed if your pet has had any slow postural responses in her limbs.
I usually finish up my physical exam by assessing your pet’s joints and musculature. I’ve already had my hands all over her body while assessing her skin and looking for lumps and bumps, so I’ve noticed if she’s evenly muscled. Muscle wasting occurs when a limb isn’t used equally with its counterpart, and is a good indication of arthritis or other musculoskeletal disease. I’ll also flex and extend the joints in each leg to look for signs of discomfort. I’ll check for signs of pain along the spine as well, by palpating the vertebrae and the surrounding muscles.
And with that, our exam is finished! Your pet can breathe a huge sigh of relief as he is let down off of the exam table or loaded back into the cat carrier. At this point, we can discuss anything that I found that concerns me during the exam, as well as address any of your concerns before we finish up. Don’t hesitate to mention things to your vet – even the smallest concern may be the start of something serious.
Now the visit is officially over, but I forgot the best part! No exam is complete without a treat – even the shyest dog or cat can’t resist a little post-exam goodie!