By Dr. Lara de Courtivron
One of the first things one is taught in vet school is to establish a system when performing a clinical exam on an animal. Each veterinarian has his/her own way of approaching a physical exam but, if the order in which it is performed never varies, fewer things are likely to be missed or overlooked. Your vet relies heavily on your assessment of your pet in order to choose appropriate diagnostics and, ultimately, to guide in treatment. No one knows your dog better than you and, just like in humans, each pet is an individual who does not always read the text books on what “normal” should be. Additionally, there are often breed differences. Following are a few tips to guide you on how to examine your pet at home.
The Hands-on Exam:
1. Nose: Is there any nasal discharge? If so, is it unilateral or bilateral? Is it clear or off color? Take a good look.
2. Mouth: Open your dog’s mouth and get a good look at the teeth, the tongue (including the underside), the cheeks and the gums. Are the teeth clean? Do any teeth seem loose? Is there any bleeding or signs of infection? Are there any tumors? Is the tongue pink? Are there any ulcers or abrasions? Are the gums pink, do they look inflamed? Does the breath smell any worse than usual?
3. Eyes: Is there any discharge? If so, what color is the discharge and is it unilateral or bilateral? Is there any redness or squinting? Are there any light or dark spots on the cornea? Are either of the eyes bulging? Do the eyelids look normal and symmetric? Is the third eyelid (the membrane on the inside corner of the eye) elevated? If you close your dog’s eyelids and gently press back on the eyes, is there any resistance? Are the pupils dilated or constricted? Are the pupils of equal size, symmetric?
4. Ears: Is there any odor? Are the ears being held in the normal position? Are they clean? Is there any debris, abnormal or moist discharge? Is the skin on the inside of the ear thickened or irritated?
5. Throat: Are there any masses or is there any swelling when gently running your hands down the throat? Is it easy to get your dog to cough when feeling the throat?
6. Paws: Are the nails clipped? Are there any ingrown nails growing into the paw pad? Do the paw pads look normal? Be sure to check in between toes for any evidence of redness, odor or fleas and ticks.
7. Joints: Does your dog allow range of motion exercises on every leg? Do any of the joints seem painful or stiff? Is there any heat or swelling around any of the joints?
8. Hindend and tail: Does lifting the tail up seem to cause any pain? Is there any evidence of diarrhea or any other abnormal discharge or odor? Is there anything abnormal adhered to the skin around the anus?
9. Skin, Coat & Muscle mass: Are there any areas of fur loss? Any hyperpigmentation or redness? Are there any wounds or hotspots? Are there any masses/tumors? Is there any muscle wasting anywhere (including the head)? If so, where and is it unilateral or bilateral? Does the coat seem too dry or brittle? Is there dandruff? Any evidence of fleas or ticks? How does your dog smell?
Examination from afar:
1. Gait and overall appearance: Is your dog walking normally? Is there any limping? Does the neck seem stiff or is it held too low? Does your dog’s head and body appear to be proportioned symmetrically?
2. Appetite and Eating habits: Is your dog eating normally? There are often subtle changes that can indicate a problem. For instance, is your dog able to pick up his food normally? Is s/he dropping it on the ground more than usual: Is s/he standing over the bowl seemingly interested but not eating? Is s/he drooling?
3. Intake and Eliminations: Is your dog urinating regularly, less frequently or more frequently? Is there any straining? Is the urine foul smelling or does it appear abnormal in any way? Is there urgency to go outside or abnormal soiling in the house? Does the stool look normal?
4. Behavior and Activity Level: Is your dog less active, not wanting to walk, jump, or play as much? Does your dog seem more irritable or more vocal than normal? Is your dog wanting to be around you more often or is s/he isolating himself? Does your dog breathe more heavily when active or seem exercise intolerant?
5. Respiratory rate and effort: Is there any coughing or sneezing? Is the respiratory rate and effort normal? The best time to assess respiratory rate is when your dog is asleep. A normal respiratory rate varies from 16-40 breaths/minute (count the number of chest excursions in a 15 second period and multiply by 4).
In summary, it is very important for every owner to know his/her own pet’s NORMAL. The best way to do this is by observing your pet frequently and by performing a routine physical exam and overall assessment at home on a regular basis. If any abnormalities are appreciated, or if you are concerned about your pet for any reason, you should schedule an appointment with your family veterinarian. Written logs of specific abnormalities or even video clips are also a good idea since pets do not always act sick or exhibit the abnormal behaviors when taken in to the vet hospital. Additionally, trends are more important than one time occurrences. With owners and veterinarians working together as a team, pets will get the best care that they deserve. Remember, these tips are intended to supplement, not replace your pet’s annual veterinary exam.
Lara de Courtivron, VMD
Dr. Lara de Courtivron of Critical Care & Veterinary Specialists of Sarasota, LLC, received her premedical education at Tufts University and the University of Massachusetts, Boston, and is a graduate of the University of Pennsylvania School of Veterinary Medicine in Philadelphia. Emergency medicine is her passion since it gives her the opportunity to intervene when it really matters.