What happens during a dog's physical exam is something new puppy or dog owners may wonder about. What will the vet do to my dog? And what to expect? On the other hand, perhaps you are a seasoned dog owner and have taken your dog to several vet visits, but you would like to better understand in detail what your vet is looking for when he's checking your dog and palpating him all over. In this guide, veterinarian Dr. Eric Weiner of Orlando, Florida goes into the nitty gritty details of what happens during a dog's physical exam.
What Happens During a Dog's Physical Exam?
Let's get physical! Physical exams, that is. Ever wonder what your veterinarian is doing, or what they are looking for? The art of a good physical exam is invaluable. The wealth of information that can be obtained by a physical exam is staggering. Your pet is getting evaluated from nose to tail for abnormalities ranging from subtle to obvious and extreme.
Physicals help identify and localize problems to specific areas or body systems. They help map out irregularities so that they can be monitored for changes over time, allowing the proper action to be taken. This is why your pet should get a good physical exam every time they come into the clinic, even for wellness or vaccine visits.
There have been so many instances where significant abnormalities have been detected before they have even presented as a problem at home, giving the opportunity for swift and proactive treatment instead of reactive and rushed.
As soon as the doctor walks into the exam room, that examination has begun. While your vet is saying hello, he or she is assessing mentation. Is the dog bright and alert, or more quiet and sluggish? Is the pet able to stand or walk? If so, is there any limp or lameness detected? Is the dog acting painful or fearful, perhaps guarding certain areas of the body like a hurt paw or painful belly?
Evaluating The Dog's Head and Face
Next the veterinarian will evaluate the head and face. By the way, every doc may have a slightly different order, but this is the general sequence of events. By evaluating the face, we are looking for any abnormalities with the cranial nerves, eyes, nose, mouth and ears. Are both halves of the face symmetrical?
Any squinting, discharge, or issues with the structures within the eyes? Vets will either use an ophthalmoscope or lens to look at the structures in the back of the eye like the retina and optic nerve.
Is air moving through both nostrils equally? Next is the mouth. Dental health is so under-appreciated in veterinary medicine. Dental disease is significant because it can be a chronic source of pain or discomfort, inflammation, and bacteria that can enter the blood stream and predispose the pet to several other systemic issues…and bad breath.
Are the gums pink and moist like normal, or more blueish, indicating a respiratory issue, or pale, possibly indicating a bleeding or clotting issue? Here is another biggy—anything underneath the tongue? That is a good hiding place for foreign material (strings) or ulcers where owners may not notice. Then the doctor will check the gag reflex to make complete the cranial nerve evaluation.
Last but not least, on the head are the ears. Any abnormalities with the ear flaps? Your vet will use an otoscope to view the inside of the ear canals to look for inflammation, excessive discharge, and the status of the ear drums.
Evaluating the Dog's Neck and Chest Area
Moving down to the neck the doctor will feel for lymph nodes under the jaw and in front of the shoulders. At this point I turn the patient around and feel inside the back legs for femoral pulses, and count them to assess pulse rate.
Then, using my stethoscope I listen to the heart. I am listening for heart sounds (is there a crisp lub-dub, or do I hear a murmur?), rate (is the heart beating too quickly or slowly?) and rhythm (are the beats evenly spaced, or are there beats out of sync?). If there is a murmur, how loud is it and where on the heart is it the loudest? This helps distinguish between different heart conditions.
Then I listen to both sides of the chest for breath sounds. Are there any crackles or wheezes, increased respiratory effort or rate? I will then place one hand on the chest and thump on my finger as I move my hand up and down the chest, listening for how well the sound resonates. Does it sound like a drum, as it should, or is it more dull, suggesting possible fluid in the chest.
I will then palpate the dog’s abdomen, looking for any painful areas, checking organ size, or for objects that do not belong, like masses or hernias. This is one of the most difficult skills for veterinarians to develop. Obviously there are some limitations to this, especially with deep chested dogs where some organs are out of reach, but still very important.
Evaluating The Dog's Skin
Next is the biggest organ of them all—the skin. This includes assessing for health of the coat (shinny or dull and scaly?), signs of skin infections, hair loss, mites, fleas, or lumps and bumps? Any abnormalities will be notated on a body map in the record to monitor for changes of size, appearance, or development of new growths.
Evaluating The Dog's Muscolosketal System
Then, I will assess the musculoskeletal system. Lifting all four feet, I can look for abnormalities in the paw pads, nails, and go through range of motion on all four limbs. There is another set of lymph nodes to feel behind the knees as well.
Lastly, and not all vets do this routinely, there is the final indecency…the rectal exam. Although uncomfortable, this exam can assess for abnormalities within the pelvis, colon, stool, and anal sacs. There are certain types of tumors that can grow around the anus that can often get missed without performing this infamous test.
If there are specific issues or painful spots the owner is concerned about, I will usually save that for last. This way I cannot get distracted by the shinny object and forget to look at everything else. Also by saving the ouchy part for last, I have a better chance completing the examination before my patient loses patience with me.
Of course if there are abnormalities detected, those systems may get evaluated more closely. For example, if there is back pain, I will then perform a complete neurological exam, which looks much more in depth for neurological abnormalities, like irregular reflexes, motor function, etc.
As you can see, there is so much information obtained on a good physical exam. With that intel, appropriate diagnostics can be chosen more specifically for the body system involved. This will cut down on cost, time, and less poking and prodding for the patient by avoiding unnecessary tests.
We all want what is best for Fluffy. Being thorough by performing complete physicals help determine how he is doing, and what we can do about any abnormalities to get him feeling better as soon as possible.
About The Author
Dr. Eric Weiner is a small animal veterinarian practicing in Orlando, Florida. He is a third generation veterinarian as both his father and grandfather are vets.