What's in a Wellness Exam?

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Recently, many of the veterinary specialty colleges have started recommending an increased frequency of veterinary checkups for our patients, particularly our senior dogs and cats. At Daniel Island Animal Hospital, we recommend a 6 month wellness check in addition to the more extensive yearly exams where we do heartworm tests, fecal examinations, routine blood work and vaccines as needed. Many people who are used to only doing yearly appointments may be wondering what the value of a 6 month checkup is. To answer that I’d like to go through exactly what it is we are looking for on a physical examination. Although it doesn’t take long, we get a lot of information every time we see your pet, and it helps build a solid medical record so that we can monitor for small changes.

Why every 6 months?

It’s important to remember that our pets age the equivalent of  4-7 years for every calendar year. This means that every 6 month check is about the equivalent of you going to the doctor every 2 – 3 years. This becomes very important for senior pets who may be at risk of developing serious diseases that can show only subtle signs at home. Pets who we may think are just “slowing down” with age may actually have underlying problems that, if undetected, may compromise your pet’s comfort and/or longevity.

What goes into the physical exam?

Every veterinarian has a different approach to physical examination that they are comfortable with, but in general, a thorough physical examination is generally done with the owner and covers the pet from nose to tail.  We like to have the owner present so that you can help to point out things you’ve noticed and we can ask you questions about anything we find (i.e. – have you ever noticed this lump?)

When I start a physical examination, I like to work my way from the front to the back:

  • Eyes – the doorway to the soul? Maybe, but they are also good indicators of discomfort, neurological disease and high blood pressure in addition to any primary problems such as trauma, cataracts, glaucoma, conjunctivitis or tumors of the eye or eyelid. We may use an ophthalmoscope or an indirect light and lens to further examine the structures of the eye for problems. Tests for tear production, corneal ulcers and eye pressure are also common follow-ups when a problem with the eye is observed.
  • Ears – Ears should be fairly clean and pink. If the inside of the ear is red, dirty, swollen, smells funny or if a pet is shaking his/her head frequently, this is where we find out what is going on. We also thoroughly examine the pinna (ear flap), for any injuries or masses. An otoscope is used to examine the deeper ear canals and the tympanum or eardrum.
  • Nose – Noses should be cool, clean and moist. A dry nose doesn’t necessarily mean that a pet is sick, but nasal discharge or abnormal nasal skin can be indicators of allergies, immune mediated disease, infections and some kinds of cancers.
  • Mouth – We check the teeth, gums, tongue, cheeks and back of the throat for dental disease, ulcers, masses or abnormal color. How much information we get depends a lot on how well our patients cooperate, so in some cases we may need to perform a sedated exam to really probe into the areas in the back of the mouth and throat.
  • Lymph nodes – dogs and cats have lymph nodes under the chin, in front of the shoulders, in the armpits (also called axillae), inside of the thighs (the inguinal area) and behind the knees. I usually check all of these at once while doing a good once over of the whole pet by touch to see if I feel any abnormal skin or masses.
  • Heart / lungs – Just like your physician, we listen to the heart and lungs with a stethoscope to detect heart murmurs, arrhythmias and lung crackles or wheezes.  Sometimes in heavily panting dogs or purring cats we may have to close the mouth or adjust the position of the animal to get a good listen. While listening to the heart, I often will feel the femoral pulse, on the inside of the back leg, to make sure the heart beat and the pulse are going at the same time.
  • Abdominal palpation – ideally we like to get a feel of both kidneys, the tip of the liver, the stomach, spleen, intestines and colon, and check for any abnormal masses or areas of discomfort. In overweight or very tense pets we may not be able to be as thorough. A rectal examination is commonly used for intact male dogs to evaluate the prostate, however it may be performed during any physical examination to evaluate the rectum and anal glands for masses. 
  • Musculoskeletal / Nervous system – evaluating the eyes, ears, nose and mouth can tell us a lot about the nervous system, as does watching the pet move around the room.  A full orthopedic examination, including a check of reflexes and range of motion of each joint, is necessary any time lameness appears or if there is concern about possible pain or difficulty moving. We also check closely for pain and normal reflexes in the neck, back and tail.
  • Skin – from head to toe we are evaluating the coat and skin for abnormal color, texture, lumps, bumps, cuts, bruises or smells. This includes between the toes and in the area around the genitals and anus.  

Just like in people, the key to good health is preventative care and early detection of problems. Regular physical examinations help us catch things earlier and give us a better chance of successful treatment! In addition, it gives us a chance to talk with our patient’s owners about anything from behavior training to diet to dental home care and help ensure that we’re doing all we can for your furry companions. It’s what we like to call “good medicine”!