Posts Tagged ‘limping’

A Truly Hands-On Physical Examination

March 24, 2011

Have you ever gone to the doctor and realized after the visit that those healing hands never actually touched your body? C’mon now, that’s not okay!  Nor is it okay for your veterinarian to skimp when it comes to examining your pet.  In veterinary school, we are taught to perform a thorough physical examination on each and every patient.  It would be a travesty to miss a new heart murmur or enlarged lymph node on a patient that presented for limping.  The sooner abnormalities are detected the more likely we are to gain an upper hand.

 

Listed below are the elements of a thorough physical examination for your dog or cat.  Bear in mind, it takes no more than a minute or two for a seasoned vet to competently complete the following (by the way, it helps if you are not talking when the stethoscope is being used!):

  • Assessment of overall alertness and appearance
  • Evaluation of gait
  • Evaluation of the skin and haircoat
  • Measurement of body weight, temperature, heart rate, respiratory rate, and capillary refill time (the time it takes for the gum line to become pink after it has been blanched by finger pressure)
  • Examination of the eyes, ears, nose, and oral cavity
  • Palpation of lymph nodes
  • Palpation of the thyroid gland (specific for cats)
  • Auscultation of the heart and lungs (listening with a stethoscope) on both sides of the chest
  • Palpation of the abdomen
  • Rectal examination (specific for dogs that are middle aged and older)

Vets perform physical exams differently in terms of order of events.  No matter in the least as long as everything is included. And please remember, such thorough exams are not to be reserved for only the annual office visit. If your kitty is vomiting or your dog has an ear infection, you should expect the whole shebang (although your dog or cat would probably prefer a mini-exam).

Is your veterinarian “hands-on” and doing one heck of a thorough job when it comes to the physical exam?  Please share your experiences.

Best wishes for good health,  

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook  

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Videotaping for Your Vet

February 1, 2011

Rarely am I bothered by client misbehavior, but when a client answers their cell phone while we are in the midst of discussion, I admit to feeling a bit peeved. So why in the world would I invite my clients to whip out their cell phones during the course of an office visit? Because I want to see video of my patients’ symptoms! Unless you are like me- still using a cell phone that my daughter considers prehistoric- your cell phone allows you to have instant access to shooting video. And if I can watch videotape of your pet’s confusing symptom or odd behavior, I’m more likely to figure out the underlying issue, more so than with just your verbal description (no offense intended). And when I have a better sense of the underlying issue, I can more expediently, and often less expensively, guide you towards rational diagnostics and/or therapy.

Unless the odd behavior or new symptom is occurring round the clock, the likelihood of it happening in my exam room is slim to none. You’d be surprised what symptoms fully resolve when animals are under the influence of adrenaline. So, if your dog or cat is doing something bizarre that you think will be difficult to accurately describe to your vet, I encourage you to grab your cell phone and shoot a video (feel free to include some Jacques Cousteau narration if you like). By all means, nix the video if you sense you are observing something that is life threatening, and get to the nearest veterinary hospital ASAP.

Here’s a classic example of how videotaping a medical problem can be wonderfully helpful. A common symptom in dogs is referred to as “reverse sneezing.” It occurs when a dog feels a tickling sensation in the back of their throat. It is somewhat equivalent to a person clearing their throat. However, when dogs reverse sneeze, the symptoms appear ridiculously overly dramatic. They assume a stiff posture with head and neck rigidly extended forward. This is accompanied by forceful, noisy inhalation and exhalation that can last for several seconds, even minutes. Check out the example of reverse sneezing in the video below.

For the uninitiated, reverse sneezing is a scary thing to watch- clients commonly report that they think their dog is having an “asthma attack.” Show your vet a video of reverse sneezing and he or she will be able to recommend what to do about it as well as provide plenty of reassurance that, no matter how dramatic the symptoms appear, they are not causing any oxygen deprivation. As much as video is helpful in this situation, I must admit I will miss watching my clients trying to imitate reverse sneezing (oops- I just revealed one of this veterinarian’s dirty little secrets)!

Here are some examples of other behaviors/symptoms that should prompt you to grab your cell phone and shoot some video (if you can think of others, please let me know):

1. Weakness
2. Trembling
3. Incoordination
4. Falling down/collapse
5. Episodes of pain
6. Symptoms associated with passing urine or stool
7. Making odd noises (in this situation audio taping is a must along with video)
8. Coughing (again, adding audio is great)
9. Labored breathing
10. Limping/lameness
11. Odd behavior

Have you ever shared video with your vet? If so, did it prove to be beneficial in making decisions about how to proceed?

Best wishes,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.