Clinical Exams
Terms
• Arrhythmia – a fluctuation in the heart rate
• Auscultation – the use of a stethoscope to listen to
sounds produced by the functions of the respiratory,
circulatory, and digestive systems
• Bradycardia – a decreased pulse rate seen most
commonly with electrolyte imbalances or heart disease
• Cyanosis – a bluish discoloration of the skin, resulting
from inadequate oxygen concentrations in the blood
• Dyspnea – difficulty breathing, characterized by
shallow rapid breaths with abdominal effort
• Eupnea – normal breathing
• Gastrointestinal – a term used to describe the stomach and
intestines as one unit
• Murmur – any abnormal heart sounds produced by improper blood
flow through the heart
• Palpation – using touch to determine the character of deeper,
underlying body structures
• Ophthalmoscope – instrument used to examine the interior eye
• Otoscope – instrument used to examine the interior ear
• Tachycardia – an increased pulse rate seen often with fear, pain,
exercise, and certain
• heart diseases
• Tachypnea – rapid breathing
Importance of Physical Exams
Physical exams are also important because
animals that are unhealthy cannot undergo
many general procedures, such as vaccinating
and spaying or neutering.
A healthy animal has the following
characteristics:
1. Clear bright eyes with pink membranes around the
eyes.
2. An appearance of contentment.
3. An alert attitude and interest in surroundings.
4. A good appetite.
5. A sleek, shiny coat with hair that is pliable, not dry and
brittle.
6. Feces and urine that are easily passed and normal in
appearance.
7. Temperature, pulse, and respiration in normal
range.
Taking a Patients History
• A patient history is a written documentation of the
problem(s) the animal is having.
• A history should not be confused with the basic statistics
on an animal such as age, name, breed, sex, etc.
• This information is usually taken by the hospital secretary
and is recorded before the veterinarian looks at the animal.
• When taking a history, be sure to ask questions that cannot
be answered with a yes or no.
– For example, ask, “How much water does Fluffy drink daily?”
rather than “Is Fluffy drinking more water now?”
• Also, keep in mind that certain breeds are predisposed to
certain illnesses and the age or sex of the animal may be a
clue to determining what is wrong.
Equipment Needed for Example
There are several basic pieces of equipment needed
to complete a physical exam.
• Stethoscope – used to auscult (listen to) the
heart, lungs, and gastrointestinal sounds
• Thermometer and petroleum jelly
• Ophthalmoscope
• Otoscope
• Watch with second hand
• Muzzle
Stethscope
Ophthalmoscope
Otoscope
Temperature, Pulse, & Respiration:
• TPR is a basic component of the physical exam.
• TPR is different for every species of animal and
varies with
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–
–
–
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age
Size
environmental temperature
Stress
activity level
most importantly, health.
Average Values
Normal Temp
Pulse/Beat per
min.
Respiration/
Breaths per min.
Cat
101.5
110-130
20-30
Cattle
101.0
60-70
10-30
Chicken
107.0
200-400
15-30
Dog
102.0
70-120
10-30
Goat
102.5
40-60
12-20
Horse
100.0
30-60
8-16
Rabbit
103.0
123-304
30-45
Sheep
102.0
60-90
12-20
Snake
Room Temp
12
1-2
How to Take Temperature
Temperature is taken rectally on the dog and cat and all species of
livestock.
Variations in temperature may occur due to:
• Infection/disease
• Excitement/stress
• Environment
Procedure:
1. Wipe the thermometer with alcohol and shake it down till the
mercury is below 98 degrees.
2. Lubricate the tip with petroleum jelly.
3. Gently insert the thermometer into the rectum and hold it securely
in place for three minutes.
4. Remove the thermometer and wipe with a paper towel.
5. Slowly rotate the thermometer until the mercury is visible and take
the reading.
Pulse
• Pulse is evaluated using the femoral artery on dogs and cats. The femoral
artery is located on the inside hind leg at the top of the thigh.
• Use the maxillary artery for large animals. It is located under the jaw of the
horse and on the outside of jaw on the cow.
• The ventral tail vein and lower jaw (mandibular) are used to take a pulse in
cattle and sheep.
• There are many variations in pulse such as abnormal rhythms, weak, and
bounding pulses. Variations may occur due to:
• Anxiety
• Exercise
• Pain
• Disease
• Shock
An increased pulse is called tachycardia. A pulse that
is slower than normal is called bradycardia.
Pulse Procedure
1. Using your index and middle fingers, gently
roll them over the artery feeling for the
pulse.
2. Count the number of pulses for 15 seconds.
3. Multiply the number of pulses in 15 seconds
by 4 to get beats/minute.
Respiration
Respiration is evaluated by looking at three parameters:
1. Rate of respiration
2. Depth – degree of chest effort needed to take a
breath (deep, shallow)
3. Character – (slow, rapid, normal)
Several terms are commonly used to describe the character of
respiration.
• Eupnea – normal breathing
• Dyspnea – difficulty breathing (shallow, rapid breaths with increased
chest effort)
• Tachypnea – rapid breathing
Respiration
Procedure:
1. Observe the rise and fall of the chest.
2. Count the number of breaths for 15 seconds.
3. Multiply the number of respirations by 4 to
get breaths/minute.
Note – in small or sick animals it may be necessary
to place a hand lightly on the chest or observe the
nostrils for signs of respiration.
The Physical Exam
When examining an animal, it is best to use a
regional approach.
Begin at the head of the animal and progress to
the tail examining thoroughly all the external
areas and all body cavities (eyes, ears, mouth,
etc).
Examination of underlying structures should also
be done at this time.
Palpation
Palpation is used to inspect underlying muscle
and skeletal structure, and locate
abnormalities.
Structures should be gently traced with the
fingertips and not grabbed.
Improper handling is painful to the animal and
could damage internal organs.
Auscultation
Auscultation is the use of a stethoscope to listen
to sounds produced by the respiratory,
circulatory, and digestive systems.
• In large animals, auscultation is used to
evaluate gastrointestinal sounds.
Lungs
Normal lung sounds are louder during
inspiration and like “rustling leaves”.
Two main types of abnormal sounds:
• Crackles – most often heard in connection
with fluid accumulation in the lungs and
pneumonia
• Wheezes – the result of decreased airflow
from an obstruction or asthma
Heart
• Detects fluctuations in the heart rate
(arrhythmia), and abnormal heart sounds
(murmurs).
• Heart sounds are most easily heard on the left
side of the animal due to the placement of the
heart.
• Dogs have a normal arrhythmia where the heart
rate increases on inspiration and decreases on
expiration.
• Murmurs occur due to an abnormal flow of blood
through the heart.
12 Areas to Exam
1.
General appearance – is there a healthy overall appearance? Are
eyes bright and coat shiny? Is animal obese or very thin?
2. Integumentary (skin) – is the coat shiny and
full or is it dull and brittle? Are there any bald patches, rashes, or
flaking skin?
3. Muscoskeletal (muscles and skeletal structure) – is there a history
of lameness or any visible lameness? Broken bones?
4. Circulatory – coughing, fainting, dyspnea, and murmurs are all signs
of circulatory problems.
5. Respiratory – coughing, sneezing, nasal discharge, exercise intolerance,
and cyanosis are signs of possible respiratory problems.
6. Digestive – is the animal eating normally? Have there been diet changes?
Was a toxin (rat poison, antifreeze) ingested? Vomiting and diarrhea are
signs of digestive upset.
7. Genitourinary (genitals and urinary system) – abnormal discharge, smell,
or color as well as swelling and inability or difficulty in urinating and
defecating are signs of a problem.
8. Nervous system – seizures, changes in behavior, difficulty walking,
head tilt.
9. Lymph nodes – enlarged?
10. Ears – discharge, unusual odor, or head shaking?
11. Eyes – is there excessive tearing or discharge? Are there any visual
deficits?
12. Mouth – are gums and teeth healthy? Are mucous membranes
moist and pink? Very red, cyanotic, or pale membranes are
abnormal. A Capillary Refill Time (CRT) is done to check for
circulatory problems.