Every interaction you have with an animal should be used as an opportunity to assess her physical condition. With experience, this can be done quickly and easily. A thorough examination should be completed at intake before the animal is vaccinated or admitted for surgery. Any significant abnormalities should be brought to the attention of a veterinarian before the animal is admitted.

Examine the animal from head to tail, and be sure to check everything in between. Develop a consistent method and use it every time. Using the same method every time is the best way to ensure that you do not miss anything. Avoid the temptation to immediately focus on the most obvious complaint. The dog who comes in limping might also have a head injury that could be life-threatening. Perform a complete exam regardless of the presenting complaint.

Record all results of your examination. Normal findings can be abbreviated NSF (no significant findings) or WNL (within normal limits). Remember to sign the exam record so that the next person working with the animal can ask follow-up questions if necessary.

Don’t forget to back up and examine the animal from a distance. Note how he or she walks, sits, breathes, etc.

You can’t restrain and examine an animal at the same time. Be sure to have an assistant restrain her for a thorough exam. Remember, however, that sometimes the best restraint is light or moderate restraint, which decreases the amount of stress on the animal.

The more animals you examine, the more skilled you will become. Make a commitment to yourself to learn something new from every animal you examine.

The signalment is a complete description of the animal. It includes the species, breed, colors, sex, age and any other distinguishing characteristics. Some of this information is best obtained as part of the animal's history, but it is wise to double-check the owner's opinion on such things as the animal's gender and age.

Body condition can be an important indicator of health. Using a consistent system of evaluating and recording body condition will help to prevent inconsistent evaluations. Using a scale of emaciated>thin>normal>heavy>obese is often helpful.

The animal is too thin of his ribs are easily seen, normal if they are readily felt without a layer of fat lying over them and obese if it is difficult to feel them at all. Bones that seem to "stick out" mean that an animal is too thin. A cushion of fat that covers the edges of the ribs and gives a smooth wavy feel to the chest means that the dog or cat is obese. Most breeds should have an hourglass shape when viewed from above; there should be some indentation behind the rib cage. Light fleshiness over the hips and a trim form stomach also indicate good body condition.

Body temperature can be an indicator of the health status of an animal and may be abnormally elevated (hyperthermia), or abnormally lowered (hypothermia). Either abnormality has multiple causes and should be carefully considered. Normal body temperature for cats/kittens and dogs/puppies is 100.5 F to 102.5 F. Any significant deviation warrants alerting a veterinarian.

Hyperthermia may be the result of exercise, high environmental temperature (as is the case when an animal suffers from heatstroke), or may be due to stress and anxiety. A true fever is a type of hyperthermia that is caused by a disease process and is accompanied by additional symptoms of disease. Any animal with an elevated body temperature should be carefully monitored and isolated from other animals for further observation and evaluation.

Hypothermia may be the result of exposure to cold and/or wet conditions. Factors such as age; body condition, illness, injury and drug administration affect an animal's ability to maintain a normal body temperature. Small animals have a greater amount of body surface area; they are more highly susceptible to hypothermia. In any size of animal, hypothermia is a cause for concern and warrants further evaluation.

The "skin temperature" of an animal, as determined by handling the animals or by feeling its nose or ears, may not be a true indicator of actual body temperature. The true body temperature of a dog or cat is most accurately determined by the use of a rectal thermometer. A thermometer designed for oral use in humans, either a glass mercury thermometer or plastic digital thermometer with a liquid crystal display, is appropriate for rectal use in animals.

At the time the temperature is being taken, the examiner may also determine whether the rectal area is matted or stained with diarrhea and note the consistency, color and odor of any feces that remain on the thermometer after removal. Distended, inflamed or painful anal sacs may be apparent; this is sometimes the case in animals that resist having their temperature taken. The presence of tapeworm segments may also be observed at this time.

The first sign of dehydration is a loss of the elasticity of the skin (skin turgor), resulting in visible dryness and wrinkling of the skin and giving the body and face a shrunken appearance. Eyes recede into the sockets (enophthalmos). The skin of a dehydrated animal subsides slowly after being picked up into a fold (tenting of the skin). Check the skin of the upper eyelid and the neck. Dehydration is often expressed as a percentage of body weight.

To assess hydration status: Gently tent the skin over the dorsal shoulder/caudal neck, observe eyes and mucous membranes.

Symptoms of dehydration are more difficult to see in some animals. Skin may "tent" more in emaciated animals and certain breeds (such as Bassett Hound or a Chinese Sharpei). Obese animals may not have skin tenting even when they are dehydrated.

Auscultation of the chest is performed to determine the heart rate and rhythm and to check for the presence of abnormal heart or lung sounds. Each heart beat should make a clear "lub-dub" sound. Auscultation of the heart should be performed on both the right and left sides of the chest. It is possible for the animal to have a heart murmur that will go undetected unless each valve is ausculated independently.

The heart rate is generally calculated by counting the beats for 15 seconds and multiplying by 4 to obtain the beats per minute. The normal range of heart rates for adult dogs is 60 to 160 beats per minute, up to 180 beats per minute in toy breeds and 220 beats per minute in puppies. The normal range in cats is 110 to 240 beats per minute. The rhythm in both dogs and cats should be reasonably regular, although it is common for the heart rate to increase slightly during inspiration and decrease with expiration (sinus arrhythmia). Sinus arrhythmia is more common in the dog than in the cat.

The animal's pulse can be palpated in any artery located close to the surface of the body. It is most commonly felt in the femoral artery, which is close to the inner surface of the rear leg near the body. Palpation of the femoral pulse requires practice and can be difficult in a trembling patient or in a patient with short, heavily muscled legs. Other pulse sites that may be palpated include the metatarsal and metacarpal arteries. Palpation of the pulse gives some indication of systolic blood pressure: a weak or absent pulse may indicate hypotension.

It is also important to compare the heart rate with the pulse rate. If the pulse rate and heart rate are taken at the same time, and the pulse rate is lower, this is called a pulse deficit. It occurs when the heart beats, but is unable to actually pump blood through the circulatory system.

If you have any doubts about an animal's cardiovascular status consult a veterinarian.

The stress of handling an animal may cause the heart rate to increase. Try to measure heart and respiratory rates before more invasive procedures such as inserting a thermometer or collecting a blood sample.

Auscultation of the lungs is best performed by listening to at least four different areas of the chest, including the right and left anteroventral lung fields and the right and left dorsal lung fields.

Respiration involves 2 phases: inspiration and expiration. To determine respiratory rate, count either inspirations or expirations, but not both. As with the heart rate, count the breaths for 15 seconds and multiply by 4. The normal respiratory rate for a dog is 15 to 30 breaths per minute and for a cat is 20 to 40 breaths per minute.

Auscult all lung field and note any abnormalities in respiratory sounds. Each breath should produce a gentle, breezy sound.

Any abnormal lung sounds should be further evaluated by a veterinarian.

Clinical signs of respiratory distress (dyspnea) will change as disease progresses. The first change will be a change in respiratory rate. Next will be a change in respiratory rhythm and character (depth). Posturing is a very late sign of respiratory disease. The animal may be standing or sitting up with back arched, neck extended, and elbows out and will be reluctant to lie down. Other signs include exaggerated chest or abdominal movements on inspiration, open-mouth breathing and flared nostrils. In extreme cases the animal may become cyanotic (blue mucous membranes).

Dyspneic animals should be evaluated by a veterinarian immediately.

The mucous membranes line the body's openings, including the mouth, nostrils, eyes, anus and vulva. They also line all parts of the penis and the inside of the prepuce. The color of the mucous membranes can be used as an indication of the blood flow to peripheral tissues. The mucous membranes of normal, healthy animals are pink; they may have pigmented areas, such as the black coloration seen on the lips and tongue of many Chinese Chow Chow-type dogs. Any observation of abnormal mucous membrane color should be noted and brought to the attentions of a veterinarian.

Early shock, sepsis, fever,

Petechiae

Capillaries are the tiny vessels that connect arteries to veins. They lay close to the surface at the mucous membranes, providing the pink color seen in a normal, healthy animal. The capillary refill time reflects the blood perfusion of peripheral tissues and serves as a rough assessment of cardiovascular function.

WSW 10/03 5

To check the CRT, press on an area of mucous membrane (usually the gums above one of the upper canine teeth). The gums will "blanch" white as they are pressed and become pink again when pressure is released. The normal amount of time for the color to return is less than 2 seconds. A prolonged CRT (longer than 2 seconds) may indicate that the animal's circulation is compromised due to cold, shock, cardiovascular disease, anemia or other causes and should be further evaluated prior to admitting the animal for surgery.

Run your hands through the coat and examine the skin in several places. Describe any hair loss (alopecia), redness, or scaling of the skin. Include identification of fleas, ticks, or lice in the coat. Examine the condition of the coat. Any matting or excessive oiliness should be documented. A cat who is not grooming may be stressed or ill. Given the high incidence of mange infestation in most of the communities, any animal exhibiting clinical signs of sarcoptic mange (generalized alopecia, intense pruritis) should be treated with ivermectin according to the appropriate protocols.

Skin remains tented for 2-3 secs or more.

Smooth pink, moist

Steady, even sinus rhythm,

no murmur

K9 60-160 bpm

Clear

K9 15-30 bpm