Life Stage–Based Approach to the Consultation and Physical Exam
We can’t overemphasize the importance of a thorough individualized consultation and physical exam at every visit using the entire practice team. Life stage information contained in the Canine Life Stage Checklist can guide the practice team through the relevant components of the visit. The length of the visit should be based on the life stage of the dog. For example, a first puppy exam and a senior exam could require an extended period of time. The physical exam should include the five vital assessments (temperature, pulse, respiration, pain, and nutrition) as well as items listed in the Canine Life Stage Checklist. Reproductive status, pain score, thoracic auscultation, gait analysis, and body mapping should also be included in the exam. Results should be recorded using a standardized scoring system (e.g., for pain evaluation, osteoarthritis staging, pruritus scores) to aid in communication, trend surveillance, and continuity of care.15
Puppies will have frequent visits based on their origin (shelter vs. breeder), reproductive consultation, client education needs, preventive care, and as recommended in the AAHA Canine Vaccination Guidelines, AAHA/American Veterinary Medical Association (AVMA) Preventive Healthcare Guidelines, AAHA Canine and Feline Behavior Management Guidelines, and AVMA/AAHA position statements (these publications are cited in their respective sections of these guidelines). Encourage a consultation and physical exam for young adults semiannually to annually and working dogs semiannually. Use open-ended questions to explore lifestyle-social changes that will affect individual care. Mature adults should have semiannual-to-annual exams, annual minimum database (Table 4), and exploration of biomedical as well as lifestylesocial changes using open-ended questions to aid in early disease detection. The senior dog should have at least semiannual exams and minimum database (Table 4) including similar information gathering as the mature adult with additional importance placed on empathizing with the pet owner and exploring their concerns and goals for their pet. Early detection of disease at the mature adult and senior life stage can be achieved through eliciting the pet owner’s concerns and perspective, thorough physical examination, and observing trends in vital assessments. 16 This approach allows for earlier intervention in otherwise healthy-appearing dogs as well as increased lifespan and pet owner satisfaction.12,13,16
Working and service dogs may require more frequent visits as a result of their high-performance nature and genetics.17 These animals not only provide companionship but also fill important service roles. Working and service dogs must maintain optimum health and specific physical abilities to be available to perform their special roles. Pet owners with these high-performing dogs may opt for more frequent evaluations or specific preventive care protocols.