Veterinary Physical Exam

Important breed/size modifiers:

• Giant breed dogs: lower normal HR (60-100 bpm)
• Toy breed dogs: higher normal HR (up to 180 bpm)
• Brachycephalic breeds: upper airway noise is common but not normal
• Sighthounds: lower normal body temperature, higher PCV
• Neonates: higher HR and RR, lower temperature tolerance
• Geriatric patients: may have lower baseline HR, reduced thermoregulation

Body Condition Scoring

Dogs/Cats (1-9 scale, WSAVA):

• 1-3: Underweight (ribs, spine, pelvis prominent)
• 4-5: Ideal (ribs palpable with slight cover, waist visible from above)
• 6-7: Overweight (ribs palpable with difficulty, waist disappearing)
• 8-9: Obese (ribs not palpable, no waist, abdominal distension)

Horses (Henneke 1-9):

• Assessed at 6 body regions: neck, withers, behind shoulder, ribs, loin, tailhead

Systematic Examination Approach

1. General appearance, mentation, ambulation, body condition
2. Integument (skin, coat, nails, pads)
3. Head: eyes, ears, oral cavity, nasal discharge, facial symmetry
4. Lymph nodes: submandibular, prescapular, popliteal (dogs/cats); submandibular, retropharyngeal, prefemoral (horses/cattle)
5. Cardiovascular: auscultation (both sides), pulse quality and synchrony, mucous membrane color, CRT
6. Respiratory: auscultation all fields, effort assessment, pattern
7. Abdominal palpation (small animals), abdominal auscultation (horses/ruminants for gut sounds)
8. Musculoskeletal: gait, joint palpation, muscle mass symmetry
9. Neurologic: mentation, cranial nerves, proprioception, reflexes
10. Urogenital: external exam, rectal exam if indicated (large animals)

Workflow

1. Note signalment: species, breed, age, weight, sex, reproductive status.
2. Assess vital parameters against species-specific normal ranges.
3. Perform systematic examination following the species-appropriate approach.
4. Assign body condition score.
5. Document abnormal findings with clinical significance.
6. Generate a problem list from examination findings.

Limitations

• Physical examination requires hands-on patient assessment. This skill provides reference frameworks.
• Normal ranges vary by breed, body size, stress level, and individual baseline.
• Environmental factors (temperature, altitude, time of day) affect parameters.
• Fractious or stressed patients may have artifactually elevated HR, RR, temperature, and glucose.