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Home Physical Exam

You spend the most time with your pet and know it best. You know what is normal behavior and what is not. With a little extra effort, you can learn to examine your pet in a systematic way. This may help pick up problems early when they are more easily. treated. It also lets you provide your veterinarian with information to help determine when something is an emergency, when it can wait for regular office hours, or perhaps be treated at home.

It is important to use all your senses. Look, listen, touch, and smell. Do not forget the most important sense—common sense.

Stand back and look at your pet. If you do this regularly when your pet is healthy, you will notice the subtle changes that may mark the start of a problem. Look at the haircoat. It should look healthy. The eyes should shine. Look at how your pet holds its head, ears, and tail. Look at how your dog or cat stands and moves. Watch how she or he responds to you. Notice any changes in the way your pet eats and drinks, urinates and defecates.

Listen to the breathing, the heart, and the gurgle of the intestines. You do not need a stethoscope to do this, but if you want to hear better, you can buy an inexpensive stethoscope. Use your sense of touch. Animals love to be petted. Pet your dog or cat all over. Run your hand over the legs and feet. Gently massage the muscles and think about what you are feeling. You will be able to pick up lumps and bumps, changes in the skin and hair coat, and places that hurt.

Pay attention to anything that smells differently and try to figure out the source of any bad smells. Common sources include the mouth, the folds in the lips, ears, skin, and anal area.


Examination—The Vital Signs

The most important values to help your veterinarian evaluate your pet over the telephone are temperature, pulse, respiration, color of the gums, and capillary refill time (CRT). Practice getting these when your pet is healthy. That way you will be ready in an emergency when you need to be calm and you will know what is normal for comparison.

Take the temperature with a rectal thermometer for humans. You can buy one in any pharmacy. Lubricate the tip with petroleum jelly, a water-soluble lubricant, or water and gently insert it in the rectum. It should go in 1/2 to 1 inch. If it does not go in immediately, continue to push gently, but do not try to force it. Many pets do not like this procedure at first and you may need help. Most pets will learn to let you take their temperature if you take your time and stay calm. If your pet gets too agitated, it may make sense to skip the temperature and let the veterinarian get it. It is not worth hurting your pet or risking having someone bitten. A warm nose is not a reliable indication of a fever.

The respiratory rate can be measured by counting the breaths either by watching the nostrils or the chest move or by feeling air blow out of the nostrils. Count the number of breaths in 15 seconds, then multiply by 4 to get breaths per minute. If your pet is panting, there is no need to count, just report it as panting. Also notice if the breathing is labored or if your pet had his head stretched forward and elbows rotated away from the body to make breathing easier.

The pulse or heart rate can be measured by listening to the heart with a stethoscope over the left side of the chest behind the elbow. If you are listening to the heart, each beat will have two parts that sound like lub-dub. The pulse may also be felt on the inside of a back leg. Put your hand around the upper part of the leg with your thumb on the outside and your fingers on the inside. Feel the long femur bone that goes from the stifle/knee to the hips. Slide your fingers toward the back of that bone until they fall into the groove behind it. The femoral artery runs in this groove. Press gently but firmly and you should be able to feel the pulse. Count the number in 15 seconds and multiply by four to get the rate per minute. It takes practice, so practice before there is a problem and do not give up.

The color of the gums or mucous membranes in the mouth and CRT give an estimate of how well the heart and lungs are working and if enough oxygen is getting to the cells where it is needed. The gums should be pink except in some breeds such as chows and in animals with dark pigmentation. CRT is determined by pressing on the gums above or behind an upper canine tooth with your finger. Press for a few seconds and then remove your finger. The pressure keeps blood from flowing through the small capillary blood vessels and there should be a pale fingerprint for an instant after you remove your finger. The normal pink color should returns within 2 seconds.


Normal Vital Signs for Dogs and Cats


   Temperatures over 103°F are elevated and may indicate a fever. Fevers are usually an indication of infections but also occur with some types of cancer and immune-mediated diseases such as lupus. Cats with hyperthyroidism may also have elevated temperatures. Temperature is generally elevated after exercise and in very excited or agitated animals. It is also elevated in animals that have been in too hot an environment or are suffering from heat stroke. Call your veterinarian if the temperature is over 103°F. Fevers in dogs and cats may reach 105°F to 106°F. This is not as dangerous as it would be for a human, but it is a sign to contact your veterinarian or emergency clinic as soon as possible.

Body temperatures lower than normal are often due to the thermometer not being inserted correctly. They may also be lower 12 to 24 hours before whelping and in the presence of some health problems such as overexposure to cold, shock, and advanced kidney failure.

Pulse rate normally increases with excitement and exercise. It also increases if there is a fever and in some types of heart disease. Pulses above 200 beats per minute may prevent the heart from filling completely, which reduces the amount of blood pumped with each beat and the overall efficiency. Decreased pulse rate may occur when your pet is asleep, in some types of heart disease, and with some electrolyte imbalances.

The respiratory rate normally increases when the ambient temperature and humidity are high or if the animal feels hot. Panting is very fast breathing and is a way for dogs and cats to lose excess body heat. Nervous or excited animals may pant even when they are not too hot. The respiratory rate is also elevated if a pet has a fever, in some types of electrolyte imbalances, and if not enough oxygen is being carried to the body.

The respiratory rate is decreased in very cold or comatose animals.

Gums become redder with excitement, exercise, certain poisons, or fever. Anemic animals with low levels of red blood cells may have pale or white gums. Animals that do not have enough oxygen due to heart disease or shock may have a bluish tinge to the gums. Yellow gums indicate jaundice and may be a sign of liver disease or anemia due to rapid destruction of red blood cells.

If the CRT is more than 2 seconds, it may indicate a problem with blood circulating to the small blood capillaries. This is a sign of dehydration, shock, and severe heart failure.


Emergency Situations Requiring Immediate Veterinary Care

1. Severe trauma.

2. Heat exhaustion or stroke.

3. Frostbite and exposure to cold.

4. Electric shock.

5. Hemorrhage from the nose, mouth, ears, rectum, urine, or trauma.

6. Very painful eyes with squinting, dilated, or constricted pupils; pupils of uneven size; conjunctivitis; or protruding eyeball.

7. Frequent vomiting, and/or diarrhea with or without blood.

8. Retching or unproductive vomiting particularly if the stomach area looks bloated.

9. Respiratory distress.

10. Collapse or coma.

11. Paralysis or severe neck or back pain.

12. Clusters of seizures within a 24-hour period or a seizure that does not stop after a few minutes.

13. Difficulty in delivering or prolonged labor.

14. Suspected poisonings, insect bite reactions, snake bites, scorpion stings, spider bites, toad poisoning (See Common Household Poisons, Poisonous Plants and Poisonous Pests).

15. Extreme lethargy.

16. Prolapse of the rectum or uterus.

17. Any other condition that you think might be an emergency.


Preventive Health Care for Dogs and Cats

Prevention is the key to health for your pet just as it is for you. There are many facets to preventive health care, including the day to day care and feeding you provide and regular visits with your veterinarian. The general concepts of health care apply to all animals, but specific measures depend on the species, sex, age, and breed of your pet, what your pet does for a living, and the geographic area where you live.

An important part of preventive care is the regularly scheduled visit with your veterinarian. The physical examination may detect health problems while they are still easily treated. The visit gives the veterinarian an opportunity to discuss new health care methods and share ideas and tips with you. It also gives you a chance to discuss your questions and concerns or ask about treatments and products you have heard about from friends or in the press. Routine visits are the best time to administer vaccinations and perform or schedule routine diagnostic testing and treatments.

Vaccines are available to prevent several serious and potentially fatal infectious diseases. Vaccines stimulate the immune system to produce antibodies that target specific viruses, bacteria, or other infectious agents. Most vaccines are injected either into a muscle or under the skin. A few are administered into the nose to stimulate local immunity at the level the infections enter the body. Most vaccines need to be repeated at regular intervals of 2 to 4 weeks when they are first administered to puppies or kittens to assure that the immune system will recognize the infection and respond rapidly if necessary. Your pet is not fully protected until the series is complete, although some protection starts within 7 to 10 days of the first vaccination. Regular boosters after the initial series also help maintain a high level of immunity. The interval may vary depending on the disease, the level of exposure, general health, age, or other variables. Stress, illness, and administration of corticosteroids may decrease the immune response and are reasons to postpone routine vaccination. Some vaccines provide close to 100% protection, but others are not as effective. It is important to avoid exposing your pet to sick animals even after it is vaccinated.

There are quite a few vaccinations available for dogs and cats. The most common diseases dogs are vaccinated against are canine distemper, canine hepatitis, leptospirosis, parainfluenza, and parvovirus. These vaccines are generally combined into a single injection identified by the first letter of each disease (DHLPP). A vaccine against human measles is sometimes used in young puppies. Measles virus is similar to canine distemper and cross-protects puppies that may still have antibodies from their mother that prevent the distemper vaccine from working. Vaccination against Bordetella bronchiseptica is often recommended for dogs exposed to groups of other dogs, for example in boarding kennels, at training classes, or at dog shows and competitions. It is available as a systemic vaccine or in intranasal form. A vaccine to reduce the risk of Lyme disease is also available and may be useful in areas where this disease is prevalent.

The most common diseases that cats are vaccinated against are panleukopenia (feline distemper) and two respiratory infections caused by the rhinotracheitis herpes virus and calici virus. These are generally combined and referred to as FVRCP (feline viral rhinopneumonitis, calici, panleukopenia). Chlamydia is another organism that causes respiratory disease in cats and is sometimes included in the combination vaccine. The vaccine against feline leukemia virus (FeLV) is often recommended, particularly for cats that go outdoors or are exposed to other cats that may harbor the infection. An intranasal vaccine against a disease called feline infectious peritonitis (FIP) has become available recently. FIP is caused by a complex immune reaction to a viral infection and generally requires exposure very early in life. It is not very common except in catteries and other situations where large numbers of cats are housed together. The usefulness of the vaccine remains controversial.

Rabies is the only vaccine that is given to both dogs and cats. Rabies is a uniformly fatal disease in all mammals including dogs, cats, and humans, and occurs in every state in the U.S. except Hawaii. The incidence of rabies in humans and pets decreased rapidly after the rabies vaccine became available and required by law in many states. The natural reservoir is in wild mammals, and widespread vaccination of pets provides a buffer between the disease in wildlife and humans. Currently, most cases occur in wild animals, but a number of unvaccinated pets die every year and expose their owners or other people. Few people die, but many more undergo postexposure vaccination.

Although vaccines prevent many serious diseases and save the lives of countless pets every year, there are also some risks associated with them. Allergic reactions are rare but may be serious. Listlessness, collapse, diarrhea, vomiting, and swelling or itching of the face within the first day of vaccination should be reported to your veterinarian immediately. There is some evidence that immune-mediated diseases may be more common in the weeks immediately after routine vaccination and may be related to vaccination. Lumps frequently occur at the vaccination site and generally disappear within a month. Lumps that get bigger should be checked. Abscesses are a rare complication and should be drained. Some vaccines, particularly those for rabies and FeLV in cats, are associated with fibrosarcoma, a very aggressive tumor.

Parasite control is another important aspect of preventive health care. Intestinal parasites and heartworm are the most common internal parasites, but lung flukes and kidney worms are occasionally seen. The most common intestinal parasites are roundworm, hookworm, whipworm, and tapeworm. Some may be seen in the stool, but most are too small and must be diagnosed by looking at a sample under the microscope. Routine fecal analysis is a good way to diagnose intestinal worms before they produce clinical signs.

Heartworm is a large parasite that lives in the chambers of the heart. It is most common in dogs but may also infect cats. The signs depend on the number of worms and include respiratory distress and heart failure. A simple diagnostic blood test is used to detect infection. The disease may be treated, but is also easily prevented by either daily (see Diethylcarbamazine and Filaribits Plus) or monthly medication (see Ivermectin and Milbemycin). The preventive is often combined with medication for intestinal parasites offering fairly complete internal parasite control.

The most common external parasi