In an ongoing series about how different kinds of cases are worked up, today we will look at routine preventive care visits for dogs and cats.
Despite having just used the term “routine,” let me say there is nothing routine about most preventive care visits. Often we hear from pet lovers, “Dr. Randolph, while he’s here…”
Just as likely to occur is that we will find one or more problems the pet owner didn’t even know existed. That’s what a very thorough physical examination is all about.
Indeed, the physical examination is the most important thing that happens in your pet’s visit to his veterinarian.
Vaccinations, heartworm test, stool test for intestinal parasites. By all means, they are extremely important.
But what good does it do to vaccinate a pet if there is a mass in her abdomen? Or an ear infection that causes her so much pain? Or dental disease that works 24/7 to shorten her life? We could go on and on.
A thorough physical examination must be systematic, performed one body part at a time and in the same order every time. Otherwise it’s too easy to miss the growth on the nose of the patient whose complaint is rear-leg limping.
We start with eyes and ears and nose and throat. When we examine the ears we look deep, all the way to the tympanic membrane, or eardrum, with an otoscope and speculum. If we find discharge, parasites, growths or evidence of infection we order additional steps to determine the cause.
When examining the eyes we use an ophthalmoscope which is equipped with a variety of lenses to evaluate all of the inner structures of the eye. We hope to find healthy eyes, but may discover corneal defects, cataracts, glaucoma, detached retina or bleeding in the retina, among hundreds of possible eye diseases.
Next we palpate the front leg joints and lymph nodes. Enlarged lymph nodes may indicate a regional inflammatory process or even cancer. Joints need to be examined for pain, swelling, heat, crepitance, drainage or any other sign of abnormality.
The chest and abdomen are palpated in order. Abdominal organs should all be in their proper location, there should be no masses or tenderness.
We check the spine while we’re in this area. It should be pain-free and flexible.
Rear leg joints and lymph nodes should be evaluated for the same parameters as the front legs. Hip and knee arthritis are very common problems in middle-aged and older dogs and cats. Arthritis is best treated early before joint damage becomes debilitating.
We frequently get a chuckle from pet owners on the next part of the exam, the tail. When I pronounce the tail “good” a response is almost always forthcoming. You would be amazed at how many growths I have removed from tails, sometimes cancerous ones that we caught small before they had the opportunity to invade the rest of the body.
Listening to the heart and lungs is a part of the examination that may detect subtle changes that are truly lifesaving. If your pet has developed a heart murmur or fluid in the lungs, treatment may be needed to prevent further damage. “Dead” or quiet areas in the lungs may indicate space-occupying masses that require a radiograph (X-ray), ultrasound or biopsy.
Dogs need to have a heartworm and stool test at least annually.
Cats should have a stool test at least annually. Cats have heartworm tests only under circumstances in which there is suspicion of infestation. All kitties must be on heartworm preventive, even if they never go outdoors.
So, when you get that postcard or Healthy Pet Magazine reminder in the mail telling you it’s time for Fluffy’s Physical Examination, don’t put it off.
Her examination, the most important part of her visit, could save her life.
See you tomorrow, Dr. Randolph