All Pets Veterinary Clinic

COMPLETE HEALTH EXAM

Many pet owners know the importance and value of annual vaccinations for their pets,
however many do not understand the value of a physical exam. Most assume that the
vaccinations are the main reason for a trip to the veterinary clinic each year and that
the physical exam just goes along with those vaccinations. Some veterinarians don't even
perform a physical examination at the time of vaccination. However, the physical
examination should be seen as the cornerstone of your pet's annual trip to the vet.
The vaccinations should be given because the physical exam is favorable (i.e. the pet
is healthy). This article will discuss the importance of a complete health exam (i.e.
physical exam) and what exactly the veterinarian is looking for.


There are three main reasons to have a physical examination conducted at least
annually for your pets (and for yourself!). These reasons are: 1) To evaluate the
overall health of your pet. 2) To identify potential problem areas and recommend
measures to prevent diseases or illnesses from occurring. 3) To identify signs of
diseases or illness and recommend additional diagnostic testing with the goal of halting
progression and ensuring as a high a quality of life as possible for the pet. Each of
these points will be explored below.

The whole purpose of the physical exam is to determine the overall health status of
your pet. A year in the life of a dog is not the same as a year in the life of a human.
Thus, the aging process occurs much faster in animals than in humans. By having a
physical examination performed at least annually for your pet the veterinarian can help
the owner to monitor the aging process. The ultimate goal of this monitoring it to
identify problems early so those problems can be taken care of promptly.

Have you ever heard the saying that an ounce of prevention is worth a pound of cure?
Well, this saying couldn't be truer when it comes to your pet. Many diseases and
illnesses are preventable. This means that with proper care, certain conditions can
be virtually eliminated. For example, consider heartworm disease. Heartworms are 100%
preventable. By successfully giving a monthly heartworm pill, heartworm disease can be
avoided. A physical examination can identify problem areas. Once these areas have been
identified, recommendations for prevention of more serious diseases can be made.

Identification of problems before they are serious is of the utmost importance for
people and for animals. Finding signs of illness early in the course of disease is
essential for proper diagnosis and treatment. In some cases, finding signs of illness
early can be the difference between life and death. For example, consider cancer.
For many types of cancer, early detection, removal, and identification of tissue type
is critical for successful treatment. If treatment is delayed, cancer can progress and
spread to become a virtually unmanageable condition that will likely result in the death
of the pet. A physical examination can help to identify signs of something more serious.
The result can be the recommendation of diagnostic tests and treatment that can help to
improve the life of your pet.

As you can see, a good physical exam is essential to the overall health of your pet.
Annual physical exams are necessary to maintain a high level of health for your pet.
Now that you know why your pet needs a complete physical exam we will discuss the process
of a physical exam as well as what the veterinarian looks for during a routine physical.

During a physical examination, the veterinarian will systematically examine all of the
major organ systems, one at a time. While some of the structures listed below are
easily examined because of their exterior location, others may be more difficult to
examine because of their internal location. More invasive procedures for examination
of these internal structures may or may not be conducted based on the discretion of the
veterinarian. In addition, signs of problems with internal organs may have outward signs.
The veterinarian will look for these. The main organ systems, their components, and
what is examined during a physical are listed below.

Gastrointestinal (GI) system-mouth, including teeth, stomach, small and large
intestines, and rectum.
Examination of the mouth, teeth, and gums paying attention
to odor, color of gums, presence of tartar, calculus, or gingivitis, and presence of
masses or ulcerations. Abdominal palpation (feeling what is inside the abdomen) will
be done, paying attention to size, tenderness/pain, fluid, gas, thickening, masses, etc.
Examination of the rectum noting structure, presence of masses, etc. will be done.

Immune system-bone marrow, spleen, thymus, mucus membranes, and skin. (Skin and
mucus membranes are the exterior lines of defense and are often considered as part of
non-specific immune defenses. The bone marrow, spleen, and thymus are responsible for
production and maintenance of cells involved in the immune system.) Examination of the
skin looking for masses, bruising, lesions, thickening, and presence of parasites (fleas
and lice or signs of mange) will be done.

Neurological system (nervous)-brain, spinal cord, and all associated nerves.
Examination of animal walking paying attention to overall balance, foot placement,
posture, etc. Also, examination of eyes (discussed below) and tongue motions will be done.

Circulatory system-heart and all blood vessels (arteries, veins, and capillaries).
Examination includes looking at jugular veins for enlargement and palpation of pulses of
vessels in the inner thigh area. Listening to the heart for murmurs, irregular rhythms,
etc.

Lymphatic system-lymph nodes. Sometimes considered as part of circulatory system
or immune system. Examination of external lymph nodes for size and symmetry.

Respiratory system-nose (nasal passages) and lungs. Examination of nose for signs
of discharge, symmetrical air flow, etc. Listening to the lungs for consistent airflow
patterns, fluid, harshness, etc.

Special senses-sight (eyes) and hearing (ears). Sometimes considered as part of
neurological system. Examination of the eyes includes looking at pupil size, eyelid
structure, and presence of ocular discharge. Examination of the ears includes looking
for thickness, excessive wax, hair, or debris, signs of parasites (ear mites, ticks),
masses, redness, foul odor, etc.

Musculoskeletal system-muscles and bones. Palpation of all major muscle groups
feeling for symmetry and tone. Palpation of joints for pain, swelling, range of motion,
etc. will be done.

Urinary system (excretory system)-kidneys, bladder, and associated structures.
Abdominal palpation for size and texture of kidneys and bladder as well as presence of
stones within the bladder will be done.

Endocrine system (hormone regulation)-includes all organs that produce hormones such
as the thyroid gland, parathyroid gland, ovaries, testicles, etc.
This can be hard
to evaluate because most are internal. Signs of endocrine problems are often uncovered
by gathering information from the owner and considering overall condition of the animal.
(Testicles covered below.)

Reproductive system-external and internal structures including testicles, penis,
vulva, uterus, and ovaries.
Palpation of testicles for size, symmetry, and masses
will be done. Examination of vulva includes looking for discharge, structure, etc.
Abdominal palpation will be done to detect enlarged uterus.

As you can see, the complete physical exam covers all of the major systems of the body
paying special attention to changes that may or may not indicate illness or disease.
The cost and how you are charged for a physical exam will vary widely by veterinary clinic.
Physical exam cost will typically be billed in one of three ways: 1) The office visit
charge includes the cost of the physical exam, 2) There is a separate physical exam
and office visit charge, or 3) No office visit or physical exam charge but an increased
vaccination fee. Regardless of how it is billed, a physical exam will typically run
anywhere between $10 and $50. Again, this varies by clinic and is often a reflection
of the quality of the exam given and the amount of time spent.


The information provided is for educational purposes only and is not
intended to take the place of your regular veterinarian. Please do not hesitate
to contact your regular veterinarian if you have questions regarding your pet.



Karen Blakeley, DVM, MPH
13 December 2002