| Wellness Exams and Health Screening Brenda G. Mills, DVM |
The American Veterinary Medical Association (AVMA) and Fort Dodge Animal Health have teamed up to promote
October as National Pet Wellness Month. Their catch phrase is “Twice a Year for Life,” and their goal is to educate
the public about the importance of well-check examinations and health screens in monitoring and assessing the
health of our pets.
A good well-check starts with a physical examination. A good physical examination goes beyond simply looking at the
pet’s body and using a stethoscope. A veterinarian’s physical examination should be a dialogue with the patient. In
the world of human medicine, a doctor may ask the patient a series of questions verbally to gain information. The
veterinarian can ask such questions of the owner, but the ability of an owner to really know how his or her pet is
feeling varies greatly depending upon their relationship with the pet, the amount of time they spend with the animal,
their individual skills of observation, and their intuition. A lot of information must be gleaned directly from the pet, and
a good clinician will ask questions with their hands and read the answers in changes in body posture, pattern of
respiration, and vocalization. These changes are often subtle enough to be missed by the owner, who is watching
the examination as it is performed from only a few feet away.
In order to be able to assess a sick patient effectively, the veterinarian must have knowledge of the pet when it is
healthy. What is his demeanor normally like? Tense and anxious, or calm and relaxed? Crazed or hysterical? How
does the animal normally breathe, and what is his usual respiratory rate and pattern? Some dogs will pant
hysterically and have a high heart rate, others will be panting hysterically with a heart rate of 60 or 70. A high heart
rate in a dog which usually has a low heart rate when excited is a big clue that something is wrong. Is the pet usually
tense when its abdomen is palpated? If not, tenseness can indicate belly pain. Does the animal usually flip out about
having his feet or his back touched? If not, we again have a major indicator of pain. Other things, such as pigment
spots on the iris of the eye or on the skin, a crooked toe, or physical asymmetry, may be noted on examinations which
may be normal for the pet but may be erroneously perceived as significant if the veterinarian caring for the pet when
it falls ill is unfamiliar with the animal. We usually use the term “baseline” in reference to laboratory values to indicate
a set of data that represent what is “normal” for an individual, but the well-check physical exam provides a baseline as
well. That baseline will have more value if it is repeated on a regular basis, at least once every year, but ideally once
every six months.
The concept of health screening laboratory work has long been embraced by the veterinary community. We know
that animals are inconveniently adept at hiding illness, and that the best way to identify early disease in older pets is
to run lab work every six to twelve months. However, we are seeing diseases,previously believed to be “geriatric”
problems, in younger animals more frequently now. This may be due to changes in our environment and our pet’s
lifestyles, or because we are becoming more aware and are looking at younger animals more closely than we were
fifteen years ago. In either case, a good argument can be made for routine laboratory screening starting well before
the age of six years. Not only does this allow us to check for errors in the function of the organs most likely to fail, but
it also allows us to build our baseline data on the patient.
The ideal, of course, would be to run a full blood panel with a complete chemistry profile, thyroid check, and blood
count, and a urinalysis once every 6 months starting at the age of one year. This is, however, slightly overkill for the
average young pet. A “mini profile” checking the major liver enzymes, BUN and creatinine for kidney function, blood
protein levels, and a complete blood count done once a year will screen for the major problems likely to arise in a
younger pet. Depending on the pet’s physical condition, a thyroid test might be recommended. Heartworm testing
can be added at a minimal cost, and is recommended with annual bloodwork even for pets who are on heartworm
prevention. A urinalysis can screen for diabetes, urinary tract infection (which can be present without the pet showing
symptoms), urinary crystal formation, and numerous other problems with minimal cost. We recommend running a
urinalysis on each pet once every six months.
Our senior pets (age 6 and up for some dog breeds, seven and up for other dogs and for cats) merit somewhat more
detailed health screens. As we age, more things can go wrong within our bodies. This holds true for dogs and cats
as much as it does for humans. A complete chemistry profile including electrolyte values in addition to slightly more
comprehensive enzymes than are included in the “mini panel”, a thyroid check, heartworm test (for cats and dogs),
and complete blood count are recommended for all pets annually. A urine protein:creatinine ratio helps screen for
inflammation or kidney disease not otherwise apparent in a urinalysis, and should be added to the urinalysis once a
year. Urinalyses are recommended once every six months, and various “mini panels” or full panels may be
recommended for your pet at its six month well-check, depending upon what medications your pet is receiving or what
values were abnormal the last time bloodwork was run.
Dogs and cats can develop high blood pressure. This is usually the result of some underlying disease process, but
sometimes occurs on its own. Checking your pets blood pressure is a relatively fast and simple process using the
Doppler blood pressure monitor, and a blood pressure check has been included in our senior well-check packages at
both the annual and the six month exam.
Some breeds of dog and cat are more prone to heart disease than others. Screening with an electrocardiogram can
help identify arrythmias and heart enlargement. Animals with murmurs or animals that are considered to be “at risk”
for developing heart disease may benefit from routine ECG screening. Screening takes 15 minutes or less, and the
ECG is transmitted by phone to Cardiopet, where it is interpreted by a cardiologist. We can have results back the
same day. Screening may be recommended annually for younger animals, and twice yearly for senior pets.
Chest radiographs are useful in monitoring heart disease for progression, as well as for checking for tumors in the
chest. Radiographs may be recommended every six months or more often to monitor some conditions. Screening
radiographs are offered in some of our well-check packages.
The Center for Disease Control (CDC) in Atlanta is currently recommending that all dogs and cats be dewormed with
a broad spectrum dewormer at least once every 6 months, to help prevent environmental contamination with and the
transmission of zoonotic parasites to people. We deworm with Drontal and Drontal Plus.
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