One of the most common areas of practice that clients question is the need for physical examination of pets by the veterinarian. I feel that there’s a lot of misunderstood reasoning on both sides of the question. I’d like to try to offer some clear, straight talk about why examinations are important and why they happen when they do.
There are legal requirements that come into play first. According to Michigan’s veterinary practice law, vets have to know a patient well enough to make a diagnosis and/or a plan for treatment and health care. Michigan does not state how often that has to be done. Nationally, veterinarians generally feel that a yearly exam is the minimum to satisfy this requirement. The knowledge of a patient’s medical status is called the “Veterinarian-Client-Patient Relationship.” The VCPR has to be current for veterinarians to legally prescribe medications of any kind or treatments.
We can now focus on the reasons pets need examinations. One of my professors in veterinary school said, “Nothing compares to the value of a good physical exam.” What he meant was that a ton of important information is gained from a thorough examination.
Our pets rely on us to know when something is wrong. They can’t talk, and instinct tells them to hide their illnesses. Pets can seem normal when they’re actually very sick. We have only history and examination to get us started on a path to healing.
A thorough physical exam will check an animal over from nose to tail. We evaluate eyes, ears, mouth, skin, body condition, heart, lungs, internal organs, muscles and bones, general attitude, hydration status, lymph nodes, and pain score. (Our clients have the exact list on the yellow carbon copy of the exam sheet. It’s the little numbered list on the right hand side.)
It’s common for us to find something out of the normal range. It might be body weight, or yucky ears, or bad teeth. We can find tumors in the belly, arthritis, cataracts, skin growths, heart problems, or fleas. I’ve found completely unnoticed problems that were very important to the health of the pet. Good physical exams let us identify problems when they are small and easier to fix. We can really make a difference when we know what’s happening with our patients BEFORE a crisis.
By far the hottest area of contention is the need to examine pets before vaccinating them. Most people understand the need for sick pet physical examinations, but when apparently healthy pets come in ‘for their shots’ it’s tougher to understand.
For way, way too long, veterinarians depended on vaccines to be the reason pets were brought to the hospital. The true reason was to be able to examine the pet, but we didn’t explain it that way. We now understand that vaccines shouldn’t be taken lightly, and the exams are more important than vaccines. Vaccines, like all medications or treatments, have potential side effects. These risks may be higher if a patient has another problem that the owner or the vet are unaware of.
This summer, I saw a patient for vaccines that was generally fine according to the owner. I found that all of her lymph nodes were enlarged on the physical exam, and that turned out to be cancer. It would have been wrong and potentially harmful to vaccinate that dog, and if I hadn’t examined her I wouldn’t have known that. It’s an extreme example, but it holds up.
Any pet with an infection (ears, dental, skin) may not be healthy enough for vaccines. Giving vaccines could cause harm, which violates the oath we took to help our patients. I’ll tell you bluntly: if I gave a vaccine to a sick pet, *my* butt would be on the line for causing harm. I’m not taking that risk, and I won’t play recklessly with your pet’s health. It’s not fair to the pet or clients.
Problems have a starting point. People get colds at random times, or flu, or sick for other reasons. Pets are no different. We know that time moves more quickly for pets, especially as they get older (think ‘dog years’). It’s honestly just bad practice to skip the exam before vaccinating or treating a pet, even if there was an exam recently. We have to make sure that we know what’s happening today before administering vaccines or any other treatment.
Annual or twice-yearly exams are the best way you and your veterinarian have to know your pet’s true health status. The exam is the single most important thing you can have done to help your pet stay healthy and happy for as long as possible.