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Feline Fundamentals: The Routine Physical Exam

I’ll be the first to admit that it’s not fun going to the doctor. My stomach is flipflopping just thinking about it…and that is as a rational healthcare professional. 

As such, I’m very sympathetic to the plight of my patients, unaware of the reasoning behind the madness of the bright lights, chilly stethoscopes, and needle pricks. I’m also aware that it can be equally (if not more) nervewracking for their owners, who don’t want to see their pets in distress. Cats are thought to be even more sensitive than dogs in this respect and tend to see the vet less frequently as a result. While initimidating, I’d like to demonstrate the value of a thorough physical exam and why a routine annual visit (biannual in a senior kitty) is so highly recommended.

Every exam starts with getting your cat’s history, including past diseases, diet, environment, and fellow pets, all of which play a large part in assessing their general health. We then observe your cat overall: How bright and alert is he? Is she moving around okay? Does his body seem symmetrically and appropriately proportioned? What is her disposition like? How can I best approach him to make this a stress-free visit?

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My exam then moves from head to tail. I start with the eyes, looking for discharge, inflammation, asymmetry, opacities, and normal vision. The nose is also checked for discharge, swellings, and normal sounds. Ears are peeked into to look for clean canals, free of dirt, wax, and parasites. The mouth should have pink moist gums, free of inflammation and ulcers, and clean healthy teeth. It’s not as common for cats to have periodontal disease like dogs do, so when we see gingivitis and/or dental calculus, it’s important for us to discuss at-home care and ultrasonic dental cleanings to ensure your cat gets to eat pain-free for a good long time.

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We feel your cat’s lymph nodes along the length of his/her body to make sure they are symmetrical and soft. One or two enlarged nodes can indicate underlying nearby diseases, while enlargement of all lymph nodes can indicate lymphoma or other widespread issues. In older cats, we also try to feel for a thyroid slip, or enlargement of the thyroids to hint at hyperthyroidism. 

The heart should be free of murmurs and have a nice regular rhythm. Your cat’s pulse is palpated at the same time to make sure it’s strong and matches up with the heartbeats. We listen to the lungs to check for increases or decreases in sounds, either from within or around the lungs, or even coming up above from the nose and throat. We make sure your cat is able to breathe steadily and comfortably.

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The abdomen is palpated for abnormal sizes and consistencies in their organs, including the liver, kidneys, and intestines; these organs may feel larger and firmer with inflammation, infection, and cancer. Kidneys can feel small and round with chronic disease. Unusual stools (ranging from liquid to rock hard) may be felt in the bowels. Bladders may be unusually large or completely empty. Sometimes we feel masses, foreign objects, or extra fluid in the belly. Sometimes our palpation causes your cat pain, and we become suspicious of something serious like peritonitis, pancreatitis, etc.

The skin and coat are checked for any lesions like tumors, scabs, inflammation, hair loss, wounds, parasites, or self-trauma from scratching/licking. The underlying muscles are felt at the same time to make sure your cat stays nice and strong, and is not losing any muscle mass from endocrine diseases like hyperthyroidism, musculoskeletal issues like arthritis, or even degenerative neurologic processes. Body condition is assessed as well, determining whether your cat could lose or add a little extra padding.

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In special cases, we may do a rectal exam as needed; I generally do a visual check for parasites and appropriate anal tone, but if cats are scooting or having gastrointestinal issues, we can check for masses, strictures, and normal anal glands. 

At any point during an exam, feel free to talk to us about things you have observed in your cat, questions you have regarding their behavior and environment, or even share stories about that cute thing Pumpkin did last week. When your cat gets a routine physical exam, it’s not only an opportunity to detect diseases early and receive appropriate care…It’s a chance to improve your relationship with your cat, such as fixing inappropriate habits, figuring out ways to enrich a bored indoor cat’s life, or even how to safely introduce a new cat into your lives.

…Speaking of which, Swiss is an adult spayed female tuxedo cat who kindly posed for the above pictures. She loves to quietly explore her surroundings, but is always up for a good long snuggle. As you can see, the WVG staff adore her! If you are interested in potentially adopting Swiss, please visit her at the Westminster Adoption Group and Services (WAGS)!

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