Dog Tips

Everything Your Vet Should Look for During a Wellness Exam

While an exam by an integrative veterinarian may look a little different from one performed by a conventional vet, the nose-to-tail body part inspection should be similar.

Analysis by Dr. Karen Shaw Becker

May 3, 2024 • 8 min read

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STORY AT-A-GLANCE

Have you ever wondered what, exactly, is involved in your pet’s veterinary wellness checkup?
Knowing what your veterinarian is looking for can help you formulate questions and raise any concerns you may have about your dog’s or cat’s health
Your vet will ask you detailed questions about your pet’s diet, body, and environment and perform an in-depth physical examination from nose to tail, looking for any abnormalities or changes that have occurred since their last exam
She or he will also perform diagnostic tests such as a complete blood count, urinalysis, thyroid screen, and others to get a complete picture of your animal companion’s health on the inside
If your regular veterinarian doesn’t acquire a detailed history about every aspect of your pet’s physical changes since their last exam or complete a comprehensive physical examination (including organ function testing to evaluate internal changes), consider finding a proactive wellness vet to include on your pet’s healthcare team

Editor's Note: This article is a reprint. It was originally published November 23, 2019.

When you take your furry family member for a wellness checkup, chances are you’re not 100% clear on what your veterinarian is doing as she or he gives your pet a thorough going-over. Some vets are better than others at communicating what they’re doing and why, and what they are or aren’t finding as they poke, prod, and palpate your pet.

Pet parents vary as well in their level of interest in knowing the details of their animal companion’s physical exam as it’s happening. If you’re the curious type (which I encourage) and your veterinarian isn’t terribly forthcoming, don’t be shy about asking questions. And if you don’t understand an answer or explanation, by all means ask for clarification.

It’s also a good idea to come prepared with a list of your own observations and/or concerns about your pet’s health or behavior since your last visit, so you can discuss them with your veterinarian during your appointment. Many proactive vets prefer to have pets over the age of 7 evaluated every 6 months.

This is because significant degeneration can occur over half a year, and waiting a full 12 months to discover a medical problem can leave everyone wishing they’d caught the problem earlier.

Over the last 20 years of seeing my older patients every 6 months I can’t tell you the number of conditions I’ve been able to identify and resolve before significant disease set in. That’s because my clients understand the value of not waiting until symptoms appear to visit the doctor.

Whether you opt for comprehensive examinations every 6 months or annually, your vet will either have you fill out a “catching up” form or ask you these questions during your wellness visit:

What has your pet been eating the last 6 months (what brand and protein; if you’re feeding a homemade diet, what recipe are you following)?
How much food is your pet eating a day, and what’s the brand and number of treats?
What type/brand of chew toys, recreational toys or bones do you provide and how often?
What’s your pet’s daily exercise routine?
Have you noticed a change in your pet’s activity or energy level?
Any limping or stiffness noticed?
Have you noticed any changes in your pet’s urination or defecation habits? Any potty accidents in the house? And change in stool consistency or vomiting?
Have you noticed a change in your pet’s appetite or food intake or a weight gain or loss?
Have you noticed a change in your pet’s breathing or is she coughing?
Is your pet drinking any more than usual?
How often are you brushing your pet’s teeth? Have you noticed mouth odor?
Do you think your pet’s vision has changed in the last 6 months?
How well do you think your pet can hear?
Have you removed any ticks or other parasites off your pet since your last visit?
Is your pet licking or scratching more than normal?
What household and yard chemicals are your pet exposed to on a regular basis?
Is your pet sleeping through the night? Any restlessness, vocalizing or personality changes?
Any behavior changes, or changes in interaction with you/your family?
Any major household changes since your last visit (new house, new job/schedule, new baby, etc.)?
Has your pet been to the ER for an unexpected problem since your last visit?
Any unexpected slips, trips or falls?
What medications and supplements are you giving your pet?
Have you noticed anything new or different that is concerning to you in the last 6 months?

These questions generate important conversation about what you’ve noticed since your last wellness exam and help guide your veterinarian’s physical exam, suggestions and advice. If your vet doesn’t ask you any of these questions during your wellness exam, he or she is very likely not a wellness-oriented doctor and I would consider adding a proactive vet to your pet’s healthcare team.

Nose-to-Tail Body Part Inspection

The physical exam is a critically important part your pet’s wellness checkup. All body systems should be assessed to check for any abnormalities.

During the physical exam I also check a pet's weight, muscle tone and mass, and joint range of motion, and measure the animal's current status against past exam findings as well as norms for the breed, age, and gender. The following chart may help you better prepare for your next veterinary wellness visit with your dog or cat.

Integrative and holistic veterinarians will also palpate the vertebrae down the spinal column, assess joint range of motion and health, assess the body according to TCM (traditional Chinese medicine), ayurvedic or homeopathic principles, and assess pain or guarding behaviors as well as areas of tension, heat or cold. A neurologic assessment will also be performed.

Diagnostic Tests Commonly Performed During Wellness Exams

“She looked great and was acting fine, we had no idea her liver enzymes were 4 times higher than normal,” (or similar statements) are something veterinarians hear all the time from people who are resistant to spending money to make sure their pet’s organ systems are functioning optimally.

The only way to know if your pet’s kidneys, liver, gallbladder, pancreas, thyroid and bone marrow are functioning normally is to check, and preferably before disease is end-stage. The earlier we can identify changes in your pet’s internal organs, the sooner we can address them. Here are common tests wellness veterinarians run to assess your pet’s internal wellbeing:

Complete blood count (CBC) and serum chemistry panel — The CBC gives information on hydration status, anemia, infection, the blood's clotting ability, and the ability of your pet's immune system to respond. It provides a detailed look at the blood itself and reveals problems such as anemia or the presence of infection.

A serum chemistry panel evaluates your pet’s protein levels, cholesterol, liver, kidney, pancreatic and gallbladder enzymes, and gives insights as to how your pet’s adrenal glands, electrolytes and minerals are being regulated. A BNP blood test to detect heart problems is often added on.
Urinalysis — The urinalysis is used to assess the overall health of your pet's urinary tract, including the kidneys and bladder, and to check for other health indicators such as glucose regulation and liver function.

A complete urinalysis measures the function of the nephrons in the kidneys and gives information about your pet's metabolic and fluid status. The test is also used to evaluate substances in the urine that might indicate an underlying disease process.
Blood pressure measurement — This test checks your pet for hypertension (high blood pressure). Like humans, pets with hypertension are at significantly increased risk for kidney problems, heart disease, blindness, and other complications. Cats are especially prone to high blood pressure.
Thyroid screen — The thyroid screen helps diagnose thyroid disease, which is an especially common ailment in older cats and dogs. T4 (thyroxine) is a thyroid hormone. Decreased levels of thyroid hormones often signal hypothyroidism in dogs, while high levels indicate hyperthyroidism, commonly diagnosed in cats. Performing a complete thyroid panel is important, as measuring just a T4 may not reveal an underlying thyroid problem.
Glaucoma screen — Glaucoma testing measures the pressure in each of your pet's eyes quickly and painlessly. This is an important test because undetected glaucoma can lead to permanent blindness.
Retinal exam — This eye test is used to check for evidence of problems deep in the eyes by viewing the structures beyond the lens, through the pupil. The retinas should be healthy and there should be no signs of bleeding, degeneration, inflammation, or detachment.
X-rays — Digital radiographs (x-rays), if indicated, can also be helpful as part of a pet wellness checkup. If your vet finds abnormalities on physical examination, digital x-rays may be needed to identify the underlying problem. Chest x-rays, for example, can reveal certain things about the heart and lungs.

Abdominal x-rays can be used to assess the liver and kidneys. X-rays best define problems within the skeletal system, such as arthritis and bone tumors.

Since some veterinary clinics don't have digital x-ray equipment and their x-rays still involve substantial radiation, I don't typically order them unless the results of other tests indicate a potential problem requiring further investigation. Ultrasound is another noninvasive option to evaluate your pet’s abdomen if abnormalities are discovered on physical examination.
SNAP 4Dx Plus or Accuplex4 (dogs) — These tests check for tick-borne illnesses, including heartworm, Lyme disease, ehrlichiosis, and anaplasmosis. They should be done once or even twice a year for dogs living in areas where ticks are a problem.
FeLV/FIV testing (cats) — When it makes sense (for example, if you’ve just rescued a kitty or your cat has never been tested), these tests are run to check for the presence of the feline leukemia and feline immunodeficiency viruses. These viruses can suppress the immune system and lead to secondary infections, anemia, and even cancer. Early identification of a viral positive cat gives you the best chance of managing infections optimally.
Fecal examination — An internal parasite analysis, via microscopic fecal examination, is important for ruling out common parasites your pet can acquire from walking through his environment (without protective footwear!)

Partnering with your proactive veterinarian in the care of your dog or cat should always be the goal. While it’s true your vet is the degreed professional in the partnership, you know your pet better than anyone, and are therefore the primary advocate for your animal companion.

As an involved, hands-on guardian, you are in the best position to make informed decisions for your pet — decisions that may not always agree 100% with the recommendations of your veterinarian, which is why finding a vet that aligns with your beliefs about the level of proactive wellness you’re looking for is important.

If your regular veterinarian doesn’t take a detailed history on every aspect of your pet’s physical changes since their last exam or complete a comprehensive physical examination (including organ function testing to evaluate internal changes), consider finding a proactive wellness vet to include on your pet’s healthcare team. Prevention is always the best medicine, but you have to find a doctor that agrees with that philosophy.