Everyday Medicine: Physical Examination

physical exam

“Everyday Medicine” is an intermittent series of blog posts highlighting tests, treatments, and procedures common in daily Animal Medical Center practice. Some past examples of this type of blog post include “Cytology” and “PCV.” Today’s post focuses on the physical examination.

A physical examination is the foundation of your pet’s medical care. Abnormalities of the eyes, ears, skin, and mouth are easily visualized during an examination. A physical examination identifies any deviations from normal, such as pale gums or weight loss which require further testing, like blood counts or x-rays. If the examination is normal, your veterinarian will recommend preventive care like a heartworm test, fecal analysis or vaccinations.

Head
When I examine a patient, I try to follow a set order. I usually start at the head, open the mouth, look at the teeth and under the tongue. Then I use a special light and lens to look inside the cat or dog’s eyes. The same light has an adapter which allows me to look inside the ears.

Chest or Thorax
Examination of the thorax involves using a stethoscope. During examination of the thorax, I count the heart rate and respirations. I listen to the heart in several different places to identify heart murmurs. Then, I feel the pulse on a hind leg and listen to the heart at the same time to confirm the pulses match the heartbeat. Each heartbeat should generate one pulse. Next, I move my stethoscope around on both sides of the chest to listen to the sounds made by the lungs.

Abdomen
Depending on the size of the patient, I can feel the kidneys, intestines, liver, spleen, and bladder. In really big dogs or really obese patients, I can’t feel too much. (Another good reason to keep your pet trim is that they get a better physical examination!). In vomiting pets, we might be able to feel a stuck toy or a tumor of one of the abdominal organs. In dogs, I typically do a rectal examination. Cats are not big fans of this procedure and only in select cases will I do a rectal examination on a cat. Sometimes this procedure requires sedation. A rectal examination is critical in cases of diarrhea, constipation or when a pet is excessively licking at their rear end. If necessary, I can also obtain a fecal sample or express the anal glands during a rectal examination.

Skin
While I am working my way from nose to toes, I look at the skin, feel for lumps and also run my hands down the legs feeling for any swellings or lumps. Being an oncologist by training, I can’t resist checking the lymph nodes under the chin, in front of the shoulders, in the armpits, and behind the knees.

Exam Room Testing
In the exam room, I perform some small tests like measuring a pet’s temperature and body weight. I will also look at the pet and determine the cat or dog’s
body condition score which is a veterinarian’s version of a BMI. I might also sample the ears or skin and look at it under the microscope to determine the cause of an infection.

Once the examination is completed, all the information collected is recorded in your pet’s medical record for comparison to last year’s findings and next year’s findings. Monitoring trends in a pet’s status helps veterinarians recognize subtle but important changes so we can keep your pet in tip-top health.

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