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Your pet’s wellness exam starts before the doctor ever touches your pet, when they walk into the exam, they observe your pet. Some of the things they are looking at include:
- Body condition / State of nutrition: Is your pet at a good weight?
- Mentation / Level of consciousness – Is your pet attentive and interactive?
- Posture and gait - Look for limping, incoordination or unsteadiness and abnormal limb placement.
- Hydration status - Does the pet appear well hydrated?
- VITAL SIGNS –Body Weight, Temperature, Heart/Pulse, Respiratory Rate, Mucous membrane color, Capillary refill time.
Because your pet cannot talk to us, the veterinarian depends on the observations of the owner at home to help determine whether the pet is having any signs of illness at home. Signs can be very subtle, and sometimes seemingly insignificant changes may be exactly the clue the veterinarian needs to identify an issue. Your veterinarian will ask you multiple questions about your pet and their behavior at home. This information, combined with the physical exam and observation of your pet in the exam room, will become the basis for the veterinarian’s treatment recommendations.
HEAD TO TOE EXAM:
Once your veterinarian has discussed your pets status at home with you, and observed your pet, they will perform a physical exam. During the exam, your veterinarian will complete a visual and tactile evaluation of your pet’s entire body. Some of the areas evaluated include:
- Head and Neck: Your veterinarian will compare both sides of face and head for symmetry. Assess eyes, Evaluate nose and nares, Examine oral cavity - lips, mucous membranes, teeth, hard and soft palate, tongue, pharynx, tonsils Evaluate carriage and position of ears, thickness of pinnae and cleanliness of ear canals Palpate the submandibular lymph nodes Palpate salivary glands, larynx and thyroid gland, and well as the trachea.
- Trunk and Limbs: Inspect body for symmetry, masses, tenderness, etc. Palpate each limb and joint for swelling or pain, Evaluate muscle mass and tone Examine skin and haircoat, Palpate pelvic region for conformation and symmetry Palpate spine to assess for deviations and pain Palpate peripheral lymph nodes (PLN):
- Thorax/Chest: Observe and palpate the thorax for conformation, symmetry, masses, etc. Cardiac auscultation: Evaluate heart rate (HR) and rhythm, palpate pulses, listen to the the heart in multiple locations on both the right and left sides of the chest. Respiratory auscultation, Respiratory Rate – assess visually or listen and count breaths per minute Depth / Effort – watch degree of chest movement (normal, shallow, deep) Character – note sounds and any difficulty on inspiration and/or expiration
- Abdomen: Inspect for distention, deformity, displacement, symmetry, and bruising Abdominal palpation noting organ size and location and the presence of, fluid, gas, fetuses, masses or feces. Note any pain or guarding of the abdomen. Inspect external reproductive organs, perform rectal exam if indicated.
Because our pets cannot effectively communicate their feelings to us, and because they have a natural tendency to hide outward signs of disease, we must regularly screen for clues that a problem is developing. We recommend a yearly exam for all cats and dogs and may recommend twice annual exam for older or at risk patients. A heart murmur or irregular heart beat may be detected at a regular exam that may signal significant heart disease. An abdominal tumor could be revealed when the abdomen is carefully palpated. We also check your pet for lymph node enlargement and dental disease as well. We frequently see cases involving diseases that have developed to an advanced, untreatable stage before the owner notices that something is wrong. Many times we know that if we had just seen that patient a few months earlier, we would have had a chance to save their life or intervene before the health issue becomes more serious.
Vaccination clinics may save you some money in the short term, but these anonymous clinics don’t know your pet’s history, what is normal for your pet or how your pet compares to previous visits. One little change may be enough to bring to attention potential future issues saving you money in the long run and extending your pet’s wellness in the future. Performing a thorough physical exam and obtaining a comprehensive medical history is imperative in an annual wellness exam. These important aspects of an annual wellness exam often get overlooked in the “assembly line” of a vaccine clinic. The emphasis of an annual wellness exam is the exam; vaccine administration is something that is decided at that time if it is in the best interest of the your pet.
Arizona State law requires veterinarians to have examined a pet at least within the last 12 months before prescribing any medications for that pet.
At TPAH, we understand that there may be times in which your pet's medications may be obtained from alternative sources other than our hospital. We are willing to call in prescriptions to local pharmacies or provide written prescriptions for outside pharmacies but caution you that most manufacturers will guarantee their products when sold directly from a veterinarian but not when sold from an online pharmacy.
Pet owners have many options when choosing where to fill their pet’s prescriptions, Including compounding , traditional and online pharmacies that have begun carrying veterinary drugs recently. We provide written prescriptions to owners who wish to purchase their prescriptions elsewhere, Due to multiple issues with outside pharmacies filling prescriptions incorrectly, or not processing prescriptions in a timely manner, we no longer fax or call in prescriptions to outside pharmacies. Having a written prescription gives the client the ability to deal with the pharmacy directly, and results in improved prescription turn around time.
There have recently been concerns raised about the use of non-veterinary pharmacies in the filling of medications for companion animals when the pharmacy staff have little or no training in veterinary pharmacology. A study was performed by the Oregon Veterinary Medical Association , the results of which can be found here: http://www.petsadviser.com/pet-health/pharmacy-mistakes/. Recently we had a human pharmacist at a major pharmacy chain incorrectly fill a prescription because she did not feel the dose that our veterinarian wrote was correct, her adjustment, while appropriate for a human, would have likely caused renal failure in the dog the medication was intended for.
Please be aware that you pet is required by law to be examined at least once yearly to continue to refill medications.
We accept cash or Debit for payment as well as most major credit cards (Visa, Mastercard, Discover and American Express). We do not offer payment plans but we do accept Care Credit which has several financing options such as interest free and fixed payment plans. You can find more information or apply directly for a Care Credit account at carecredit.com
Because heartworms are transmitted through mosquitoes, dogs in warm weather climates like Phoenix can contract heartworms all year long. Luckily, heartworm disease is easy to diagnose and prevent. We recommend that your dog receive a heartworm blood test every other year as part of its regular wellness exam and that you keep your dog on heartworm preventive medication all year long.
- Valley Fever. Valley fever is caused by a fungus in the soil in the Sonoran Desert. Dogs breathe in the fungus spores while digging in the dirt, sniffing at rodent burrows and from dust storms. While most dogs in Phoenix have had some exposure to valley fever, only a few get sick. Symptoms are quite variable and include fever, coughing, loss of appetite, lameness, seizures and weight loss. Diagnosis is made by blood test, x-rays and physical examination. Valley fever can be treated in most cases, and affected dogs often require long-term anti-fungal medication, which is given by mouth. Cats rarely get valley fever.
- Ehrlichiosis or “Tick Fever.” Ehrlichiosis is spread to pets by ticks and is prevalent in Arizona. It can cause acute symptoms such as fever, listlessness and loss of appetite, or chronic symptoms like lameness, nose bleeds and neurologic disease. Thankfully, ehrlichiosis is easy to diagnose and treat if caught early.
- Toad Poisoning. The Colorado River Toad, commonly found in Arizona, can pose a threat to your pets. Mouthing or ingestion of these toads can cause a mild to severe toxicity in dogs and cats since toads have skin glands that contain toxins. The most common initial presenting clinical signs are mouth irritation and excessive drooling . Affected animals may also develop heart arrhythmias, seizures, weakness, collapse, vomiting and diarrhea. Severe toxicities can quickly lead to death if not treated. Please call to seek veterinary care as soon as possible.
- Rattlesnake Envenomation. Rattlesnakes are a common encounter here in Arizona. There are 13 species of rattlesnakes in Arizona- more than any other state! They don’t hibernate until the nights get close to freezing, so rattlesnake season here generally reaches from April to December. Dog snakes bites are common and usually occur to the face or extremities. If your pet is bitten, you need emergency vet care. The sooner your pet can receive treatment, the better. If your pet does get bitten several outcomes can occur. In most cases there will be sever swelling and pain and the venom can progress to affect the blood stream and then the nervous system. Death may result if not treated promptly. There is a rattlesnake vaccine available for dogs which claims to help if your dog is bitten by a Diamondback rattlesnake. However with 12 other species of rattlesnakes, it may not help if a different species bites your dog due to the different toxins in their venom. The vaccine is said to help reduce the amount of anti-venom that is needed to treat the bite (bottles of anti-venom cost nearly $1000 each!) Please talk to the veterinarian about the possible pros and cons of the vaccine.
- Heat stroke. Heat stroke is a major problem in Arizona for people and pets as well! Heat stroke occurs when pets are exposed to high temperatures and placed under stress. Animals require shade and cool water to help maintain normal body temperature. They rely on two cooling mechanisms (panting and sweating through footpads) as well. One of the most frequent places for heat stroke to occur is in a parked car. With poor ventilation, the temperature rises quickly and your pet is not able to keep cool. Your pet will begin to breath rapidly trying to cool off. The body temperature can rise 5-10 degrees. Vomiting, diarrhea and seizures often follow and death can occur within minutes. If you suspect heat stroke, seek veterinary care immediately.
This reason is why we recommend doing a fecal flotation test as part of your pet’s yearly wellness exam. This fast and simple test will help us spot the eggs of mature parasites that may be living in your pet’s intestines. Then, we can treat the pet with medication, ensuring its health and yours.
- Pre-anesthetic exam
- Pre-anesthetic bloodwork (if required)
- Placement of an intravenous catheter to deliver medications and fluids that support blood pressure and organ function during anesthesia
- Premedication to ease anxiety and to smooth induction of anesthesia
- In addition to the above it gives your pet a chance to acclimate to the hospital environment to make the situation less stressful for him/her as well as a chance for the staff to observe you animal for any concerns