I think I’d know by now if she was sick.” If only that were true. I was endeavoring to examine a frisky 5-month-old pup named Lily, while dodging full-frontal face licks. So far, the only thing for certain was me being canoodled by the little Labradoodle.

“If I’d noticed anything wrong I would’ve brought her in sooner. I’m always checking the internet.”

Lily was one of millions of “pandemic pets” adopted over the past 18 months. Many had first-time dog parents such as Lily’s Gen Z mom, opening their homes to pets in need. Lily’s animal rescue had been clear she needed to be taken to a vet immediately, but somehow two months had slipped by. As healthy as Lily seemed, I was more worried about illnesses that are hard to notice or search on Google.

A dog’s first veterinary exam, no matter the age, is essential to uncover hidden diseases. Some dog parents believe the first visit is merely for vaccinations, but the real value is a thorough physical exam. In fact, if your vet doesn’t make a big deal about a first exam, it’s probably time to find a new one. You’d be shocked at the number of “perfectly fine first-timers” I discovered had heart murmurs, eye anomalies, joint abnormalities, oral disorders and a long list of other unexpected issues. In the majority of cases, these revelations.

It came as a shock to the owner who “hadn’t noticed anything wrong.”

So what are vets looking for? Let’s tour a typical exam to find out.

“Greeting” your dog

At first glance, it may appear your vet is simply greeting your dog. What they’re actually doing is carefully evaluating your pet’s overall health. They’re assessing behavioral issues such as anxiety, fear or aggression, general joint health and mobility, cognitive function and training, neurological status, hearing and vision, skin and coat, and overall energy and vitality. Many times when I meet a dog, decades of experience will warn that “something isn’t right,” prompting me to investigate further.

Body condition score (BCS)

If this is a new dog or puppy, establishing a current weight and body condition score (BCS) allows your vet to spot weight gain before obesity occurs or unexpected weight loss advances. For puppies, ask your vet to document your pup’s size on the validated canine growth curves to make sure she is growing at a healthy rate.

Coat, skin, eyes and ears

The skin is your dog’s largest organ, earning it priority on the first checkup. Studying your dog’s skin, coat, eyes and ears provides insight into parasitism, allergies, nutrition, hygiene and a variety of infections or hereditary conditions, including growths and tumors. A luminous, lustrous coat is the first indicator of good health, while bright, shiny and attentive eyes signal appropriate mental awareness. Dry, flaky, oily or dirty skin and ears are obvious symptoms to investigate further.

Not enough dog parents regularly check inside the ears, under the tail or the axilla (armpits), potentially missing important health clues. Make a habit of checking your dog’s skin and coat for any irregularities, and report any lumps or bumps immediately.

Mouth, nose and throat

An estimated 80% of all dogs over the age of 3 have periodontal disease, making the oral exam an important part of any wellness check. Many congenital diseases involve the oral cavity, and a puppy’s age may be estimated by tooth eruption patterns. Nasal discharge, especially if cloudy or discolored, is often associated with infections or allergies. It’s crucial to check a new dog’s mouth and throat, nasal passages and lymph nodes for any anomalies.

Heart and lungs

A thorough chest auscultation (listening with a stethoscope) is probably the most “doctor-y” part of a pet exam. It’s also one of the most fundamental. Heart murmurs, respiratory infections or conditions and proper anatomical development can all be evaluated with focused listening.

The tummy

There are more organs and vital tissues per square inch in your dog’s belly than anywhere in her body. That’s why a slow and methodical abdominal palpation (feeling with the hands) is indispensable during a post-adoption wellness check. Liver, spleen, kidneys, stomach, intestinal tract, bladder and more are all accessed by gently pushing and probing your dog’s tummy. I can’t tell you how many times I’ve felt a “knot,” “hard spot” or “something’s not right” in a newly adopted dog’s abdomen that led to an early diagnosis and successful outcome.

Spine and joints

The hips, knees, elbows, shoulders and spine need to be extended and flexed, checking for discomfort or impaired range of motion. This is particularly important in larger dogs and breeds at risk for dysplasia, spinal injuries or other inherited musculoskeletal conditions.

As I explained each step of Lily’s exam to her mom, I could see her understand the urgency of the post-adoption wellness check. Other than signs of a few flea bites and roundworm infections, Lily was a perfectly healthy pup. We started her on year-round monthly heartworm preventive and scheduled her spay surgery. We discussed the best diet and supplements for Lily, proper shampooing and ear cleaning and ways to help with training.

“I’m glad I brought her in today, even if it was a little later than it should’ve been. Also, it turns out I really didn’t know what to look for in the first place. Being a new dog mom means I need to learn a lot more about being a dog mom, not just watching internet videos.”

With that, Lily joined millions of “pandemic pups” who found a fabulous furever home. And I felt even better about the next generation of pet parents.

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