When we perform a physical exam, we’re usually talking, laughing, and trying to snuggle or spoil your pet. It might not look like it, but a lot is happening in my mind, hands, and eyes (OK, sometimes nose) while we are snuggling your pet.
Here’s what we’re actually doing while they get their ears scratched or enjoy our snacks…. or glare at us. (Hey, we can’t win them all!) You may be surprised how one body part can indicate a problem in another system!
Initial impression – I can glean a wealth of information just by walking into the room! My first thing I check is body language. Are we happy or shy? What is going to be our approach? But I also look at the skin, coat, and musculature. If they are walking, I watch them move. Before I even touch them, I’m looking for any muscle or boney asymmetry, as well as eyes, coat (any hair loss or staining from licking) and nose. If they are panting I look at their tongue. I also check how they are breathing.
Eyes – Is there redness or squinting? Are the pupils the same size? Are the lids and lashes the same? The eyes can also indicate neurological problems, and some systemic infections, like FIP in cats or fungal infections in dogs, show up first in the eyes!
Ears – We check if they are red and goopy, since ear infections are common. Are they full of hair? We also check the floppy part of the ear, since a systemic vascular disease will show up on the tips of the ears first, before anywhere else!
Nose – subtle changes to the texture of the nose can signify an auto-immune disorder. Believe it or not, it doesn’t matter if the nose it hot or cold, wet or dry. It’s more the pigmentation and texture that we care about…. or if anything funky is coming out of it!
Mouth – Dental disease is very common in dogs and cats. Are there broken or cracked teeth? Masses along the gum? Is the breath really bad? You might even see me give your dog or cat my “sniff test” as some oral cancers, organ failure, and auto-immune disorders will smell before we can see them! We look for baby teeth that should have fallen out, but didn’t. We also notice if there’s more tartar on one side than the other, indicating the pet is chewing more on one side, likely due to pain. Finally, we check the mucus membranes to make sure the pet is not dehydrated, and has enough oxygen and red blood cells.
Lymph nodes – We feel the lymph nodes under the jaw, in front of the shoulders, in the armpits, groin, and behind the knee. Some cancers show up first in the lymph node. Or if there is a local infection, only one lymph node can bring attention to the area.
Heart and lungs – Listening with the stethoscope is important. Sure, I often hear purring, growling, slurping, you name it! But I’m listening for wheezes (asthma in cats) or harshness, which can indicate anything from bronchitis to pneumonia. I listen to the heart for murmurs, which would indicate a problem with a valve in the heart. I also listen for the rate and the rhythm.
Neck and back – I feel along the neck and back muscles for symmetry and tightness. This comes from my acupuncture training. I might feel tightness or heat in a certain area, so I know to look closer at the muscles and nerves that branch from that region. If a leg or foot is sore, dogs and cats compensate with their neck and back, so it’s a great indicator.
Abdomen – I feel the abdomen – is it painful? Do I feel a mass that I shouldn’t be feeling, or is something bigger than it should be? Does the bladder hurt when I touch it? Are they loaded with poop? Some patients give me “abs of steel” and I don’t get a great feel, but we do out best!
Skin and coat – I’ve been looking at the skin and fur the whole time as I start with the front and work my way back (or vice versa). Are there flakes? Bald spots? Ticks or fleas? Any growths or tumors? Is the fur stained from licking? Sometimes an area gets licked because it’s sore, or it itches, so we look closer at those. Some skin infections or hair loss can by symptoms of an internal disease, like thyroid disease. Also, any bruising or discoloration (especially on the belly) would indicate an internal disease.
Muscles of the limbs – We check all 4 limbs for symmetry. Does one side have less muscle than the other? That likely indicates chronic pain. Are any joints abnormal or painful? How is their posture when they sit or stand? I also look at toenails. Is one foot more worn than the other? That means they are favoring one leg and we need to find out why.
Butts and privates – yep we check those too! If our older boys are having an issue, I’ll do a rectal to check the prostate. And of course, we often check the anal glands! And if cannot check the mucous membranes of the mouth, the skin around the prepuce and vulva has mucus membranes! I can check hydration status and make sure they aren’t anemic by looking in some inappropriate places if I have to!
Fatness – Yep, I said the F word! I check your pet’s overall body fat. Am I complimenting you on a fantastic physique? Or are we a pudge and need to talk about that. I score them on a scale of 1-9, with 1 being emaciated, and 9 being fatty fatterson. And yes, I have pets who are 10 and 11 on this scale! 4-5 is considered ideal, and can assign your pet a number and go over it.
So those are all the things we look for as we are hanging out with your pet. My goal is for them to feel like they got a massage (OK, a weird massage) and not an exam, so they want to come back!