The Physical Exam – Why is it so Important?

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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?

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 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

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

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)

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)

Internet Searches

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When you want more information regarding your pet’s health, your best resource is your Blue Sky veterinarian.

Our New Website includes a wonderful Pet Health Library that you can use to search specific topics!

However, if you can’t resist the temptation to surf the web, follow these tips to steer you in the right direction and make sure you’re getting accurate info.…/77a35ab4-534f-…/Googlehandout.pdf…


🐾The Truth Behind Grain-Free Diets…Don’t Believe The Hype!!🐾

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Are you feeding a grain-free diet to your pet?

🌾Grain-free diets are one of the largest growing segments of the pet food market right now. More and more pet owners are reaching for these diets, which are billed as more natural for pets and less likely to cause health problems and allergies.

‼️It all sounds great…except that it’s NOT true!‼️

📌There is no reliable evidence that suggests that it is harmful to feed grains as a group to dogs or cats. Whole grains, rather than being “fillers”, can contribute valuable nutrients including vitamins, minerals, essential fatty acids, and fiber to diets. Some grain products even provide protein that is easier for your pet to digest than some protein from meat. Even refined grains such as white rice can be beneficial for health depending on the type of diet and the pet. The vast majority of dogs (and cats!) are very efficient (>90%) at digesting and utilizing nutrients from grains in amounts typically found in pet foods.

📌While food allergies in pets are uncommon, allergies to grains are even rarer. The small numbers of pets that do have allergies are most likely to be allergic to animal proteins such as chicken🐓, beef🐂, and dairy🥛 (which reflects how common these ingredients have traditionally been in commercial diets rather than an increased tendency to cause allergies). Gluten intolerance is also exceedingly RARE in pets, with gastrointestinal signs from consuming gluten having been confirmed only in one inbred family of Irish Setters.

📌It is important to keep in mind that grain-free diets can vary widely in terms of their nutritional profiles including protein, fat, calories, and other nutrients. Some grain-free diets are lower in carbohydrates, which means that they can be quite high in both fat and calories. Other grain-free diets merely substitute similar amounts of highly refined starches such as those from potatoes or tapioca (cassava) in place of grains. These ingredients may provide fewer nutrients and less fiber than whole grains, while costing more. Other companies use ingredients such as peas, beans, or lentils in place of the grains to provide carbohydrates, but these ingredients are not necessarily any better for your pet than grains and may cause digestive upset in some pets.

📌The bottom line is that “grain-free” is a marketing concept designed to sell pet food, not a health solution to help your pet live a long, healthy life. Don’t believe the hype!

Post authored by the Clinical Nutrition Service team of Cummings Veterinary Medical Center at Tufts University—Dr. Lisa M. Freeman, DVM, PhD, DACVN, Dr. Deborah E. Linder, DVM, MS, DACVN, and Dr. Cailin R. Heinze, VMD, MS, DACVN.…/grain-free-diets-big-on-ma…/


The Importance of Heartworm Prevention

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You’ve heard all the Blue Sky veterinarians stress the importance of using year-round heartworm prevention but do you know WHY it’s so important?

First, it’s important to understand the life cycle of the heartworm. “Adult female heartworms living in an infected dog, fox, coyote, or wolf produce microscopic baby worms called microfilaria that circulates in the bloodstream. When a mosquito bites and takes a blood meal from an infected animal, it picks up these baby worms, which develop and mature into “infective stage” larvae over a period of 10 to 14 days. Then, when the infected mosquito bites another dog, cat, or susceptible wild animal, the infective larvae are deposited onto the surface of the animal’s skin and enter the new host through the mosquito’s bite wound. Once inside a new host, it takes approximately 6 months for the larvae to mature into adult heartworms. Once mature, heartworms can live for 5 to 7 years (!!) in dogs and up to 2 or 3 years in cats. Because of the longevity of these worms, each mosquito season can lead to an increasing number of worms in an infected pet.” (American Heartworm Society)

All approved heartworm medications eliminate the heartworm larval stages. Unfortunately, in as little as 51 days, immature heartworm larvae can molt into an adult stage, which cannot be effectively eliminated by preventives. Therefore, it is of extreme importance to use year-round heartworm prevention in order to protect your furry companion!

Remember, heartworm disease is prevalent in ALL 50 STATES!! It only takes ONE mosquito bite to infect your pet and the cost of preventative is so much cheaper than treating the actual (and may we add, DEADLY) disease… heartworm disease treatment can cost at least 15 TIMES the cost of a year’s worth of prevention!

Have questions or concerns? Be sure to ask your Blue Sky vet at your next appointment or call today!