How to Do a Physical Exam Like Your Vet
You may not have the fancy medical background but learning how to examine your pet is a simple way to help identify changes that may be an early sign of disease.
The aim of this guide is to help you identify problems before your pet gets drastically ill and needs costly emergency medical treatment. I will be referring to dogs and cats mainly, but these skills could be used in any warm blooded species, so go ahead, practice these new skills on all your pets, even your mice.
As a vet I love those owners who are so in tune with their pets that they know something is wrong by very subtle signs. They often mention that Fluffy is just not himself and is perhaps more grumpy or sleeping more than usual. At times they find it hard to articulate exactly what it is their pet is doing that makes them concerned. Having some concrete tools and tips for exactly what to examine and observe can make you a better pet parent. You will know when a subtle change can be an indicator of big problems. And we all know that if your pet gets critically ill, it is always when your vet is shut and you need to take them to that emergency afterhours clinic! Being able to book an appointment when you first suspect a problem saves you the late night drive to the emergency hospital when your pet is very ill.
Our pets have only very limited ways of communicating when something is wrong and in many pets their instinct is to hide any weaknesses. In most animal societies weaker animals are not looked after and helped, in fact quite the opposite. The weaker ones are often isolated or their weakness is used as an opportunity for another animal to gain something whether it be territory, food or resources.
First, heed my warning!
One warning before we start and please promise me you will follow it before we go any further. If you do find something on your examination DO NOT Google it! There are many diseases that present with similar clinical signs and Dr. Google is no replacement for proper medical advice. I would say 99% of the time when a client has diagnosed their pet via the internet they have reached the wrong diagnosis, and usually it is a very scary diagnosis. So you are best off getting some advice and perhaps some tests to work out what really is wrong! OK, let’s begin.
Watch your pet from a distance, are they walking evenly or is there a slight limp. Sometimes a limp will present as an upward hitch at the shoulder, hip or head as the sore leg is placed on the ground. This can be subtle and only more obvious at a faster pace. It may occur at the end of walks, or after resting. You may notice your pet leaning slightly to one side or sitting with the knee pointed outwards. If you still can’t tell which leg is sore, video your dog while a friend walks them on a lead, you can then slow down the video to pick up subtle patterns. Take this video to your vet; they will thank you for being so observant. If you are able to tell your vet which leg is a problem, or perhaps if the lameness is shifting to different legs, it can save you money and time on diagnostics later on.
Also look for areas of hair loss, asymmetries in muscles or joints, turned out toes or feet that are getting flatter than normal. This is also a great chance to check the toenails, if they are starting to curl under or touch the floor, it might be time for a nail trim. Look for a bloated abdomen, or perhaps unusual breathing or posturing. For example a pet who refuses to lie down on his side may be struggling to breathe, or a pet who is sitting upright with his bottom in the air may have a painful abdomen.
Look for discharges from the nose, vulva and prepuce. Check under the tail for signs of diarrhoea such as matted, fecal stained hair.
Touch – The Physical Exam
This is where being a vet is different to being a human doctor. Animals can’t tell us what is wrong, so a vet must rely on touch to identify changes. Run your hands all over your pet, look for areas that are tense and painful, check in the mouth and ears, count breathing and don’t forget to use all your senses, including your sense of smell. Be a pet detective and if you notice anything, ask your vet for advice. For a basic instructional video visit here. If nothing else, it is extremely useful to get your pet used to being handled all over, so use lots of treats and be gentle. If you make it a habit to do this weekly, not only will your pet be accustomed to the process, but you will know exactly what feels normal for your pet.
Some key areas to examine are:
Get used to what they look and smell like. If they all of a sudden start to smell bad or look red with lots of discharge, get your pet to the vet before the infection gets too complicated (and expensive). Some preventative ear cleaning with a pet safe ear cleaner can work wonders for preventing ear infections, particularly if your dog swims. Your vet can show you how to do this and there is a great video here.
Avoid putting vinegar, oil, shampoo, cotton buds or anything else into your dog’s ear. There are some strange remedies on the internet and no one wants to cause or worsen a ruptured ear-drum just to save a few dollars. Do not clean your dog’s ears if they are red, inflamed, itchy or painful, these dogs need a trip to the vet. Only clean them if you notice a change in the amount of ear wax or dirt in the ears, this is a key area where early attention can prevent big problems.
If your pet is squinting or there is redness in the pink conjunctiva or the eye itself it should not be ignored, eyes are very delicate and important! Even a small corneal ulcer can be painful and lead to blindness. Early treatment for all eye problems is the key to recovery and avoiding surgery.
Wipe away any discharge around the eye using cotton wool and cooled boiled water or saline. If there is increased discharge from what is normal for your pet, or it changes into a yellow or greenish discharge get your pet to the vet.
In some cases pets develop a whitish opacity in the lens of the eye, a sign of cataracts or nuclear sclerosis. Cataracts can be caused by many diseases, including diabetes, so should be checked by your vet. Nuclear sclerosis is however a normal aging change and nothing to worry about. To identify the difference your vet will shine a light in your pet’s eyes to look for the brightly coloured tapetum behind the eye.
Pets don’t brush their own teeth. They may be genetically prone to dental disease or be eating a diet that doesn’t require much chewing. If you notice smell, discolouration, damaged teeth or redness along the gumline it is time to implement some preventative dental care, or perhaps even get a dental clean before costly extractions are necessary. Also look for red spots on the gums, lumps in the mouth, ulcers on the tongue and pain on opening the mouth. Make sure you get a good look at the tongue and back teeth. If you identify changes early and start implementing some preventative care you can slow down the progression of dental disease from stage 1 where there is just redness along the gumline to the later stages where tooth extractions are necessary.
Check the skin all over, including the undersides of the feet and between the toes. Feel for sore spots, scabs, new lumps, red patches, itchy areas, dry scaly skin, greasy skin and painful areas. If your cat goes outdoors and gets into fights, sometimes the initial fight wounds are tiny little punctures that quickly heal and the first sign is a soft painful swelling.
Irritated skin can be easily treated if caught early with a medicated wash, but if it develops into a full-blown infection antibiotics may be required. Get used to what is normal and if your dog or cat is prone to allergies or dermatitis, ask your bet for advice on what to do when you first notice the irritation. If your dog does tend to lick or chew at himself, this is a sign of allergies and is rarely behavioural or ‘normal’ grooming behaviour. For most dogs it has been going on for so long their owners assume it is normal.
If you notice any lumps and bumps on your pet, note down where they are and record them on this chart. This will allow you to keep track of when they appeared, when they were sampled by your vet and you can then easily see if new ones appear.
There are glands called lymph nodes at various places in your dog’s body, including at the edge of the jaw, under the arms and behind the knees. These lumps swelling up can be a sign of infection, or in some cases cancer. You vet can show you where they are, but in most cases they are only obvious when they are enlarged.
Check for matts, a drier than usual coat, areas of hair loss, overgrown nails and if your pet needs regular grooming, check they can see from under that fringe. Hair growing over the eyes can be a cause of eye irritation, increased discharge from the eyes, injuries (I once had a dog that broke his jaw after running into something because he couldn’t see!) and sometimes behavioural problems (it is very easy to startle a dog who can’t see). Hair can easily be trimmed at home or by a groomer. This video shows you how to do this safely with clippers or scissors, you don’t necessarily need to use scissors as long and pointy as those in the video!
Note any coughing, increased noise when breathing or increased respiratory rate. If your pet has a heart murmur, your Vet may already be asking you to monitor your pet’s resting respiratory rate. Count how many breaths your pet takes over 1 minute, but make sure your pet is either sleeping or lying down relaxing, to get a true resting respiratory rate. If this increases over 30 breaths per minute, visit your Vet. If your pet coughs, note whether it occurs with rest, excitement, while eating or drinking or when pulling on the lead. Your Vet will also want to know if the cough is dry and harsh like your pet is trying to cough up a bone, or whether it is soft and moist. Also note down how many times a day your pet has been coughing. Breathing difficulties can also be demonstrated with increased movement of the abdomen when breathing, noise, open mouth breathing (normal in dogs, but not in cats!), rapid shallow breathing, or slow deep breathing. It goes without saying that if your pet is having trouble breathing or is coughing more than usual, they should be seen by a Vet.
Appetite and Thirst
Drinking more water and increased or decreased appetite are the things astute pet owners identify as early indicators of disease. Treatment is always simpler, safer and less expensive if a problem is diagnosed before secondary diseases develop. For example an early diagnosis of diabetes can mean the difference between emergency medical treatment to save your pet’s life or a quick consultation, blood tests and treatment as an outpatient. If you are not sure how much your pet is drinking, measure the contents of the water bowl at the start of a 24 hour period and check how much is left at the end. Start with at least 150ml/kg (ie. for a 4 kg dog, start with 600ml) in the bowl to make sure you are getting an accurate idea. Having this information to hand saves your Vet from having to tests to determine if your pet is drinking more (and saves you money).
Weigh your pet regularly and don’t have your head in the sand. Many pet owners are surprised to find out their obviously barrel-shaped pet is in fact overweight. This chart shows an objective scoring system that helps identify pets that are at risk of obesity-related diseases. It is estimated that 30-50% of pets are overweight, so you would not be alone with this problem. Get some help early before your pet ends up rupturing a ligament in their knee and needing $3000 worth of surgery.
Urine and Faeces
Get used to checking out your dog’s toileting habits. Hard faeces, diarrhoea, smelly faeces or urine and problems urinating (small amounts more frequently, straining or increased volumes) can all indicate problems, which if caught early can be treated inexpensively.
If your dog or cat is behaving abnormally, hiding more, sleeping more, grooming more or less, is reluctant to jump, pacing at night or seems to be in some way ‘not himself’, take him to the Vet for examination. If your pet is not as active because they are in pain, best to identify the problem and treat it before they really end up in trouble. Early intervention tactics when it comes to osteoarthritis (which can occur at any age, even in young pets) can give your pet a new lease on life, limit muscle wasting and hopefully slow down the progression of joint degeneration. For cats, behavioural changes such as wailing in the middle of the night, grooming more or less, sleeping less or unusual habits can be a sign of hyperthyroidism, which is very easy to diagnose and treat.
If you notice any changes in your pet, write down when they occurred and also any changes in diet, behaviour or routine and have this information to hand when you visit your vet. Being an observant owner can help you keep your pet healthy and implement early intervention rather than having to spend big dollars at the vet when something goes wrong. Never be concerned that you are worrying about nothing. Ultimately you know your pet better than anyone and your vet is there to help you. We are never happier than when we can diagnose a problem early and save an animal from unnecessarily suffering.
So in summary, look at these key areas, if anything is out of the ordinary, chat to your vet early and avoid that emergency hospital trip! By the way, it is a complete myth that a dog’s nose being wet or dry gives an indicator of health.
- Respiratory signs