let's get physical, part 2: behind the scenes of exams
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!