Anatomy of a Vet Visit (part two)

History-taking is always followed by a physical exam of the pet, unless your pet refuses this part of the process. During the exam, we engage all of our senses (except taste, if we can avoid it) to find out what we can about the problem that brought you to the clinic. Occasionally, we’ll have a partial or complete diagnosis for you after the exam and history are put together. If not, we’ll still have a good idea of what to do next.

The physical exam is really why you traveled to the clinic with your pet. If doctoring could be done without touching the patient, veterinarians would never have to leave the comfort of their own home computers. Physical exams are a hands-on process, and they aren’t always comfortable for either party. For example, none of my patients seem to enjoy having me pry open their jaw to have a look inside, yet that’s where some very nasty cancers can be found. Most pets aren’t crazy about having a little plastic cone inserted into the ear canal, but that’s how we determine which ear medications are safe. We don’t even need to get into prostate exams and anal gland checks. If you want to get to the bottom of things, we have to get real personal.

A patient that visits the clinic for pain in the leg, back, neck, or... anywhere... will need a complete exam of that body part to extract the necessary information for treatment. We need to pinpoint the exact source of pain by pressing and bending it this way and that until the patient reacts in some way. Sometimes that’s just a pause in the breathing pattern or a slight change in posture. Other times, it’s an enthusiastic attack launched at the veterinarian. Not knowing which to expect (and never blaming the patient, regardless of what he has in store for us), a muzzle is almost always employed when pain is the subject of our investigation. I hope you won’t interpret this as an indictment of your pet’s character; it’s just a tool that’s used to help us end his discomfort more quickly. If you don’t want to witness this part of the exam, spare yourself. Ask for it to be done in another part of the building. I hate knowing that I’ve come into the room to inflict pain, but I also know that we won’t get an answer if I don’t.

Now, what if your pet is too aggressive with the veterinary staff for a complete physical? Anesthesia increases safety and diminishes patient stress, but a significant amount of information is lost. He can not hear, see, keep his balance, blink, cough, or demonstrate his normal breathing pattern while under anesthesia. He can no longer sense pain; thus, we can not determine where his pain is coming from. If the patient needs to be anesthetized in lieu of a full physical, or if nothing important was found on the physical exam, then we’ll need to dig deeper with some laboratory testing.

Dr. M.S. Regan