Administering vaccinations is only one small part of the annual or bi-annual visit from your veterinarian. It is our belief that the importance of the physical examination is often undervalued but should be the major focus of your healthcare investment.
The ability to perform a thorough physical exam is one of the most important things learned in veterinary school, which we continue to fine-tune in practice. The physical exam is the evaluation of a horse using our senses (eyes, ears, touch, even smell) to assess the horse for problems, ideally before they cause “disease”. A classic example would be detecting dental disease before the horse has started to lose weight or drop feed, or detecting thrush or white line disease before a horse has become lame. In an unhealthy horse, the physical exam is combined with diagnostic tools to establish a diagnosis and treatment plan. Completion of the physical examination also establishes the proper Veterinarian-Client-Patient-Relationship (VCPR) now viewed as legally needed in order for your veterinarian to prescribe medication, sign health related documents or provide consultation over the phone during the course of the year if needed.
The parts of your horse that we evaluate in our exam are as follows and will be summarized in an Examination Report that will be provided at completion of the visit.
This is the “description” of the horse, meaning name, age, breed, gender. These basic descriptors are important as some breeds, ages and genders are predisposed to different problems. An example of signalment is “Sunny, an 18 year old Quarter Horse gelding.”
- BASIC ASSESSMENT FROM AFAR:
We note if your horse is bright, quiet, alert, responsive, dull, unresponsive, nervous etc. This tells us about mental state, general wellness, and personality.
- BODY CONDITION SCORE (BCS):
A BCS is very helpful for veterinarians and owners to assess the overall condition of their horse. BCS is evaluated on a scale of 1 to 9, and takes into consideration factors such as prominence of hips and ribs, and location of fat deposits, to determine if the horse is at an appropriate weight, or if not, if the horse is overweight, underweight, and by how much. A BCS of 5/9 is about perfect for most horses. Since horses will vary in what is a healthy weight in pounds for a particular frame size, height or type, BCS is a better way to tell when your horse is at an optimal condition.
- WEIGHT TAPE:
Applying a weight tape to the girth area of the horse to estimate weight is a great way to establish a baseline weight for the horse, so that changes in weight can be monitored. It is also helpful for calculating doses, should a medication need to be prescribed.
Sometimes veterinarians take a rectal temperature even in the examination of a healthy horse, to make sure it is within the normal range of 99 – 101.5 degrees. An increased temperature can indicate infection, and a decreased temperature can indicate shock or illness.
- COAT CONDITION:
We observe how shiny the coat is, how even the coat is, how well the horse sheds out, as indicators of several diseases and deficiencies.
- HEART RATE, RHYTHM, and SOUNDS:
We listen to the heart with a stethoscope to check for murmurs, arrhythmias (irregular rhythm), and rate. Normal horses have no murmurs on either side of the body, a heart rate of 36-44, and a regular rhythm.
- LUNG SOUNDS and RESPIRATORY RATE:
The lungs are evaluated using a stethoscope on both sides of the horse, listening for wheezes, crackling sounds, and making sure the rate is low and regular. Abnormalities in the lungs are often found with conditions such as heaves and pneumonia. Pain can result in an increased respiratory rate.
- GUT SOUNDS:
All four quadrants of the abdomen (lower left and right, upper left and right) are listened to with the stethoscope, to make sure characteristic sounds are heard in each. For example, in the upper right quadrant, we expect to hear cecal “flushes”, and in the lower left quadrant, we might hear high pitched sounds of small intestine. Increased or decreased gut sounds in any of the quadrants can indicate an intestinal ailment.
- LEGS and FEET:
There are endless amounts that can be assessed in evaluation of the legs of the horse, but to be brief, most veterinarians check the horse for digital pulses in the leg and heat in the the hoof (indicating inflammation taking place in the feet, such as with laminitis or a hoof abscess), founder lines in the hoof, and check for range of motion, pain, swelling, crackling of the joints (crepitus), and sole diseases such as thrush and white line disease. The importance of foot health cannot be overstated.
The eyes are assessed for vision, constriction of pupils, discomfort, inflammation, swelling, issues with the cornea, detection of cataracts, discharge, and normal structure within the eye.
We check the nose for discharge, and assess air flow from both nostrils.
This is a very important part of the physical exam. As horses age, their teeth are ground down by chewing, and continuously emerge from the skull. Through the chewing and grinding, the teeth form “points” on their surfaces (outside of the upper teeth, inside of the lower teeth) and “hooks” on the front molar and back molars. I strongly believe that the teeth should be evaluated every year, even with just a quick peek, to ensure that the horse is able to grind its feed properly and comfortably, as the ability to grind is essential for adequate absorption of nutrients from the food. This may involve the veterinarian taking a quick peek in the awake horse, by holding the tongue and checking with a headlamp, OR if indicated, an in-depth dental evaluation can be performed.
While the in-depth dental exam is NOT part of a routine physical, it is requested by some clients and encouraged for certain patients. Dental exams are most commonly done if abnormalities are detected on the basic dental exam, OR if the horse is observed to be underweight or dropping feed. In the full dental exam, we utilize sedation, a dental speculum, and a variety of tools just like a human dentist including a pick, probe, and dental mirror, to evaluate the teeth. We can check for broken teeth, large infundibula (spaces between the teeth were feed can pack and cause infection), and other problems that can develop over time, even cavities! Only a veterinarian has the equipment and training to perform a full dental evaluation, which requires sedation to be performed correctly and safely.
The gait is evaluated as part of a basic physical exam, which can be evaluated more in depth on a lunge line, with a rider on the horse, with flexion tests, etc. The degree to which gait is evaluated usually depends on other issues detected during the physical exam or concerns on the part of the owner, recent lameness, etc.