The Physical Exam – Why is it so Important?
While technology has vastly expanded our diagnostic capabilities, we still rely heavily on the oldest and simplest diagnostic in the medical book, the physical exam. Although wellness checks might seem silly when your pet is acting healthy (and we always hope that they are, indeed, healthy), we can detect a lot with our exam and a few simple tools. So what are we checking for when we do a physical?
Mouth:
Dental disease is the #1 problem we diagnose during physical exams! The build up of tartar that leads to infection and inflammation (and stinky breath!) is very painful for our animals, and can actually lead to multiple health problems throughout the rest of the body.
What we’re checking for:
– tartar/gingivitis
– oral masses
– trauma or fractured teeth
Eyes:
Eyes can be a complicated organ. What we assess during yearly physicals is relatively brief, unless we see reason to dig further with more diagnostics.
What we’re checking for:
– lens opacity (cataracts vs. lenticular sclerosis)
– conjunctivitis
– corneal ulcers
– retinal abnormalities
Ears:
Almost as bad as dental disease – ear infections are a very common problem in dogs!
What we’re checking for:
– ear infections/inflammation
– foreign bodies (ie. grass seeds)
– ear drum abnormalities
– parasites
Skin:
As the largest organ of the body, there’s A LOT that can be abnormal! Allergies, endocrine diseases (ie. thyroid disease), some cancers and many other diseases can manifest in the skin.
What we’re checking for:
– lumps
– infections/wounds/inflammation
– hair loss or general coat quality
– excessive itchiness
– evidence of fleas, ticks or mites
Lymph nodes:
Lymph fluid is like the “highway” for the cells of our immune system. Lymph nodes are located in multiple parts of the body. We feel for these to ensure they are normal size and non-painful, as certain diseases can cause them to get bigger and inflamed.
Cardiovascular (Heart and blood vessels):
It goes without saying that this body system is extremely important. There are three major areas we’re investigating during a physical exam – the heart, strength of pulses and gum color.
What we’re checking for:
– heart murmurs
– abnormal heart rate/rhythm
– pulse strength and symmetry
– color of gums (can be indicator for anemia, respiratory problems, blood loss, systemic infection)
Respiratory (Lungs, trachea and nasal passages):
Again, this is obviously an important one. Like most parts of the body, the lungs and nasal passages are susceptible to infection, inflammation, cancer, and other systemic diseases
What we’re checking for:
– abnormal lung/nasal sounds
– abnormal breathing rate or effort
– color of gums (can be an indicator of respiratory problems)
– nasal drainage
– evidence of inhaled objects
Abdomen (belly rubs!):
Some animals are easier to evaluate than others due to differences in body shape (ie. differing breeds), body weight (ie. amount of fat) and species (cats are WAY easier to palpate than dogs). For this reason, we can’t always detect problems inside the abdomen just by feeling for them, but if something is severe enough, we have a chance to catch it during examination.
What we’re checking for:
– abdominal pain, bloating
– masses in the abdomen
– enlarged organs (liver, kidneys, spleen, bladder, etc.)
– GI foreign bodies
Nervous System:
We don’t always do a full neurological examination unless we detect abnormalities. Much of our exam of the nervous system is through passive observation while we check the rest of the body.
What we’re checking for:
– abnormal mentation
– seizures
– gait abnormalities (ie. stumbling)
– non-moving ears, eyes, mouth, etc. (indicating possible nerve damage)
– muscle wasting (indicating possible nerve damage)
Muscular and Skeletal System:
Similarly to the nervous system, our initial exam of bones and muscles might be brief unless there’s an area of concern.
What we’re checking for:
– gait abnormalities (ie. limping)
– muscle wasting (indicating possible underlying arthritis or injury)
– pain with manipulation of joints or limbs
– spinal/neck/back pain
– arthritis
– hard masses (possible associated with bone)
Genitals:
Another brief exam unless there’s reason to explore further.
What we’re checking for:
– abnormal drainage (indicating infection)
– skin irritation
– heat cycles in non-spayed females
Rectal Exam:
Depending on the patient, we don’t always perform a rectal exam.
What we’re checking for:
– anal gland infections
– rectal or anal tumors
– prostatic cancer or infection
– enlargement of surrounding lymph nodes
– urethral stones (can be felt through rectum)
