The Physical Examination: A Systematic Approach
The physical examination is the foundation of veterinary clinical practice. Unlike human medicine, where the patient can articulate symptoms, describe pain location, and report medical history, veterinarians must rely on thorough physical assessment, keen observational skills, and history from the animal's owner. A systematic examination ensures that no body system is overlooked, even when a specific presenting complaint might focus attention on one region.
The physical examination typically follows a consistent anatomical sequence. Observation begins before touching the patient — watching the animal walk (gait assessment), assessing mentation (alert? depressed? anxious?), and noting body condition score (an assessment of fat coverage and muscle mass on a 1–9 scale for dogs and cats, with 4–5 being ideal). Vital signs follow: temperature (normal for dogs 38.3–39.2°C; cats 38.1–39.2°C; horses 37.2–38.6°C), heart rate, respiratory rate, and mucous membrane assessment (color and capillary refill time, which reflect circulatory status — pale mucous membranes suggest anemia or shock; yellow/icteric membranes suggest liver disease or hemolysis; muddy/brick-red membranes suggest septic shock).
Systematic examination proceeds through all body systems: integument (skin and coat quality, ectoparasites, masses), lymph nodes (size, texture, pain), eyes and ears, oral cavity and teeth, neck and thorax (auscultation of heart sounds and lung sounds with stethoscope — identifying murmurs, arrhythmias, crackles, or wheezes), abdomen (palpation for organ size, pain, masses, intestinal gas), musculoskeletal system (joint swelling, muscle atrophy, pain on manipulation), neurological assessment (reflexes, proprioception, cranial nerve assessment), and reproductive/urinary system.
Body condition scoring is a standardized, evidence-based method of assessing nutritional status. A score of 1–3 indicates underweight (poor fat coverage, prominent bony prominences, potentially ill); 4–5 is ideal (ribs easily palpable with slight fat covering, visible waist); 6–7 is overweight; 8–9 is obese. Obesity affects 59% of dogs and 61% of cats in the United States according to the Association for Pet Obesity Prevention — and is a major risk factor for orthopedic disease, diabetes, urinary disease, respiratory compromise, and reduced lifespan.