Before the Tests Begin: The Physical Exam
© Cindy Mendonca, LVT
Most people take their dogs and cats to see the veterinarian every year for vaccinations. Chances are they will swear their pets have never received a physical exam or that the vet just looks at and touches the animals for a few minutes. Yet the vet will reply that the annual visit’s most important feature is the physical exam!
Why is there such a difference in perception? The main reason is that often the vet doesn’t explain what he (or she’s) doing or what he’s looking for during the exam. It takes much longer to explain everything than it actually does to do it. What he sees and what he hears in answer to his questions will determine if any further testing is needed.
In that three to five minute time frame, your vet is actually examining 13 different systems or organs. These include the nose; the mouth, teeth, and gums; the eyes; the ears; the lymph nodes; the heart; the lungs; the abdomen, the appendages; the urogenital system; the hair coat and skin; the central nervous system; and the gastrointestinal system. In every case, the first thought in the vet’s mind is, “Is this normal? If not, what is making it abnormal?” The list of things for each system is very long, but I’ll highlight some of the questions the vet has in mind while doing the exam. The answers to these questions let the vet know whether further diagnostic and lab testing are needed.
The nose knows… when there’s something going on. Are there any growths or discharges? If there is a discharge, what color is it? Is the Beardie able to breathe through the nose when the mouth is closed? Is the nose leather normal? Is the pigment even?
The bark is worse than the bite… but as the vet looks in the dog’s mouth, he wants to make sure those teeth, gums, and the palate are healthy. He knows that tartar buildup, inflammation of the gums, and periodontal disease can lead to heart and liver problems as bacteria enters the blood stream. Are the teeth loose, signaling oral and possibly bone diseases? Are there tumors or ulcers? Are the pharynx and tonsils inflamed? Is the color of the gums good? Are the gums moist or dry?
The eyes have it… And they’re more than “windows to the soul,” wonderful as a Beardie’s soul is. Are the “whites” of the eye really yellow? If so, we need to look at testing for liver and kidney disease. Are any of the parts of the eye inflamed…. the iris, the conjunctiva, the optic nerve? Is there retinal disease? Are there ulcers or hardening of any parts? What about glaucoma? Do the eyelashes curl in or out, causing irritation to the eye or not protecting it enough?
Hear no evil… Are the ears infested with mites or bacteria and yeast? Is there excess hair which traps moisture leading to infections? Is there excess wax? Are they inflamed?
A disease fighting “highway”… The lymph nodes run in a network throughout your dog. Are they enlarged? If so, what’s causing them to pump up to work harder?
The beat goes on… Is the heart beating abnormally fast or slow? Does it beat with the proper rhythm? Is there a little “whooshing” sound signaling a murmur?
A sigh of relief… Can the dog breathe easily? Does it cough? If so, what does the cough sound like? When the vet listens to the lungs, does he hear congestion or uneven breath sounds? Does the dog breathe too quickly under normal conditions?
Gut instinct… Can the vet palpate the abdomen or is it tense and painful? Do the organs feel enlarged? Is there a mass or fluid inside?
Walk a mile in their paws… Is the Beardie lame? Do the joints feel stiff or do they move smoothly? Does the knee cap stay in place? Are the nails normal? Is there redness between the toes?
I thought you said I was going to be tutored!!!! Whether neutered or intact, the urogenital system tells us a lot about the health of the dog. Did the kidneys and bladder feel normal during the palpation? Are there stones in the bladder? What about mammary tumors? Do the genitals look normal or are they enlarged, recessed, small? Is the prostate gland enlarged?
Blowing in the wind.. The Beardie’s hair coat and skin are more than just a thing of beauty. Is the hair dull or dry? Is it shedding excessively? Are there thin patches? How about dandruff? Is the skin thickened or is there excessive pigmentation where it shouldn’t be? Are there wounds, abrasions, scars, crusting, inflammation, hives, acne, infections, cysts, nodules, tumors, abscesses, or fleas?
Steady as a rock… The central nervous system is observed in many ways. Are the pupillary reflexes normal? Is the dog uncoordinated? Are any of the limbs weak or paralyzed? Are the neurological reflexes normal? Are the muscles twitching or shaking? Has the owner noticed behavior changes or seizure activity?
What goes in must come out… The gastrointestinal system probably gets the most attention from owners and this is where most vets get answers to their questions! Have there been any “accidents” at home? What is the consistency of the stool? When was the dog last treated for parasites? How did the intestines feel to the vet during the abdominal palpation? Is the dog overweight or underweight? What, when, and how much does it eat?
The vast majority of the things the vet looks for during the physical exam are not things that most owners notice or realize could be signals for problems. We tend to take our Beardies to see the vet only once a year for the annual vaccinations. As research comes out indicating that annual vaccinations are probably not necessary, we need to remember that the most important part of that annual visit is the physical exam. In addition, dogs age rapidly in comparison to humans, so regular checkups become even more critical for preventive medicine. And while you’re scheduling your Beardie’s check up, make an appointment for your own. You’ll bounce together longer!