05- The Comprehensive Physical Examination
A thorough physical examination is critically important both for preventive care and for the diagnosis of illness. For sick cats, the examination findings along with the medical history should provide the basis for a list of problems and differential diagnoses, which may then be refined through diagnostic testing.
At a minimum, every cat should be examined at least once yearly. After 8 years of age, twice yearly examinations are recommended as changes may occur more quickly and age-associated disease is more common.
Key points for the feline physical examination include:
- Observe the cat’s behaviour and temperament before and during handling as well as the cat’s interactions with the client
- If the cat will safely move around the exam room, be sure to note problems such as stiffness, reluctance to jump onto or down from chairs or tables, hesitation in movement, lameness, etc.
- Use the cat’s name and refer to its sex correctly. Handle the cat in a respectful and appropriate manner to minimize stress and anxiety for both the cat and the client
- In addition to weighing the cat at every visit (even if the visit is for a non-medical reason such as nail trimming), always determine the body condition score and the muscle condition score. Calculate and record the percentage of weight change. Note whether the cat is at ideal body weight and if not, plan to address the problem with the client
- A complete physical examination should be performed and recorded in the medical record using a systematic checklist. During the examination, positioning the cat facing away from you may be less threatening for the patient
- Be sure to score pain – you can use a simple scale of 0-10, with 0 being no pain and 10 being the most severe pain
- Always assess the cat’s hydration status using skin elasticity (bearing in mind it may be inaccurate in the very young and the very old), mucous membrane moisture, and knowledge of stool consistency
- Be sure to include thyroid palpation and an oral examination (including looking under the tongue) for every cat. Blood pressure should be assessed in any cat over 6 years and any ill patient. (see Preventive Care and Disease Screening)
- If possible, any diagnostic or medical procedures should be completed before the cat is safely back in its carrier so that the stress of unnecessary repeat visits is minimized as much as possible
Photo courtesy of Bayer
AAFP/ISFM Feline-Friendly Handling Guidelines: