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Physical Exam

Courtesy of Nanette Walker Smith, RVT, CVT & Elizabeth Warren, RVT

1. Adult patients should be thoroughly examined at least once yearly by the veterinarian to help maintain good health and early detection of problems.
2. Geriatric patients should be seen more frequently and may include diagnostics to screen for early disease (i.e. blood work, radiographs, etc.)
3. Immature patients should be seen more frequently to assure proper vaccination, parasite control, growth patterns, feeding, etc.
4. Be sure to briefly report the clients concerns, questions since they are most aware of the patient's everyday behavior.

General Survey - look at the animal from a distance all around; take a complete history from owner

  • Mentation - attentiveness, consciousness, and reaction to surroundings
  • General Appearance - how does the animal look, hair/skin condition, response to commands, temperament
  • Nutritional State - body condition (dogs and cats should have a slight waist and slightly palpable ribs)
  • Symmetry - the body should be the same on both right and left sides
  • Posture and gait - coordination, proprioception, soundness

Physical Examination - physical evaluation of the entire body, keep in mind those items under general survey.

HINTS:

1. Review Anatomy. Every animal that you see is a candidate for a physical exam. The more patients you examine, the more you will learn. Doing this will make it easier for you to distinguish a normal from an abnormal presentation and make you more able to alert the veterinarian to a potential problem that may or may not be obvious to the owners.

2. Repetition. Remember to work from head to toe, or at least in an easily remembered, repeatable pattern for EVERY exam you do. That way you will be sure not to miss anything. For example, start with the head, including eyes, ears, nose, and mouth. Check for dehydration, palpate lymph nodes, and examine the pads/hooves/toes. Listen to the heart, lungs, and abdomen for normal and abnormal sounds. Lift the tail to check the anus/vulva/cloaca, etc. Part the hair or feathers and examine the skin, hair, feathers, or scales closely.

3. Senses. Use as many of your senses as possible to examine (sight, sound (auscultation), smell (smell the ears, breath), touch (your hands should essentially touch every part of the body and down the legs and tail)

4. Record keeping. Always record/note your findings, especially abnormal ones, but normal ones as well (NSL/F = no significant lesions or findings, NAS = No abnormalities seen, etc.

5. Vital Signs:

SpeciesRectal Temperature Fahrenheit
Celsius
Heart/Pulse Rate - bpm (beats per minute)Respiration Rate - rpm (respirations per minute)WeightGestation PeriodLife Span
Cat100.4 103.0F
(38 - 39.5C)
130 - 140 (young)
100 - 120 (adult)
20 - 308.8 13.2 lbs
4-6 kg
63 days12-16 years
Cow99.0 - 102.2F
(37.5 - 39.0C)
100 - 150 (calf)
40 - 60 (adult)
30 - 60 (calf)
12 - 16 (adult)
Variable274 291 days10 years
Dog99.0 - 102.2F
(37.5 - 39.0C)
110 - 120 (young)
80 - 120 (small breed)
60 - 80 (large breed
20 - 25 (young)
14 - 16 (adult)
13.2 77 lbs
6 35 kg
58 67 days12 14 years
Goat101.2 105.0F
(38.5 - 40.5C)
80 - 120 (kid yearling)
70 - 80 (adult)
12 - 20150 lbs
68 kg
150 days7 15 years
Guinea Pig101F
(38C)
28084500-800 grams60 65 days6 years
Hamster99F
(37C)
4507480 110 grams15 18 days2 years
Horse99.0 - 101.2F
(37.5 - 38.5C)
80 - 120 (foal < 2 weeks)
65 - 80 (3 6 months)
50 - 75 (6 12 months)
40 - 60 (1 2 years)
30 - 40 (adult)
14 15 (foal)
9 10 (adult)
Variable323 341 days20 30 years
Mouse99F (37C)Too fast to count163 25 40 grams19 21 days2.5 years
Pig100.4 - 104.0F
(38 - 40C)
58 - 1208 18Variable114 days 
Rabbit101F (38.3C)205511.5 3 lbs
4 6 kg
29 25 days6 years
Rat99F (37C)Too fast to count 350 grams20 22 days3 years
Sheep102.2 - 104.0F
(39 - 40C)
60 - 12012 72 Variable150 days 

Mucous membrane color indicates blood flow to the peripheral tissues.

Membrane colorInterpretationPossible Causes
PinkNormalAdequate blood perfusion and oxygenation of peripheral tissues
Pale Pink
or
Light Pink
Anemia
Poor perfusion
Vasoconstriction
Blood loss
shock
decreased peripheral vessel blood flow
Blue (cyanotic)Inadequate oxygenationHypoxemia
Brick RedIncreased perfusion
Vasodilation
Early shock, sepsis, fever,
systemic inflammatory response syndrome
Yellow (icteric)Bilirubin accumulationHepatic or biliary disorder and/or hemolysis
Brown (coffee)MethemoglobinemiaAcetaminophen toxicity in cats, intravascular hemolysis
Petechiae or
Ecchymoses
Coagulation disorderPlatelet disorder, DIC (disseminated intravascular coagulation), coagulation factor deficiencies

Assessing Dehydration:

Assessing Dehydration: gently tent the skin over the dorsal shoulder/caudal neck, observe eye and mucous membranes
0-5%No abnormalities seen skin immediately returns to normal position after tenting, CRT normal (1-2 seconds), eyes normal, mucous membranes pink and moist
5-8%Slight delay in return of the skin to normal position, slight increase in CRT (2 seconds), eyes slightly sunken in sockets, mucous membranes slightly dry
8-10%Obvious delay in skin returning to normal position, increased CRT (2 2.5 seconds), eyes sunken in sockets, mucous membranes dry, slightly tacky
10-12%Skin remains tented, CRT increased dramatically (3+ seconds), eyes very sunken in sockets, dry mucous membranes, may see signs of shock such as cool extremities, rapid/weak pulse, tachycardia
12-15%State of shock, death is probable

Courtesy of Nanette Walker Smith, RVT, CVT & Elizabeth Warren, RVT

The Nerd Book
The VSPN Nerdbook was created by veterinary technicians and veterinary support staff for their colleagues. The Nerdbook provides information that veterinary technicians and support staff need in practice, but is not meant to contain everything. Procedures and policies vary among practices, so feel free to modify your Nerdbook fit your facility.
Volume One
Contributors
Introduction
Clinical Pathology
Critical Care - Triage
Emergency-Receptionist tips
Medical Calculations
Medical Records
Medical Terminology
Pharmacology
You are herePhysical Exam
Preventative Health
Radiology

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