All humane, successful health care plans do have at least one thing in common, however a physical examination of every animal as soon as possible following intake. Shelters should examine all new arrivals for signs of infectious disease, injuries, or medical conditions that could require immediate attention.

For many shelters, health evaluations that lead to prompt isolation of sick animals may be the leading factor in maintaining a healthy animal population. Examination upon entry also allows for compliance with guidelines that recommend vaccination as soon as the animal enters the shelter, before exposure to disease.

The shelter should have a written policy that provides for timely treatment of and pain relief for sick and injured animals. The policy should also allow for humane euthanasia when necessary to prevent suffering and the spread of disease.

Animal health technicians, shelter staff, and volunteers should be trained by a veterinarian or licensed/certified veterinary technician to recognize the signs of infectious disease and identify medical emergencies. That way, appropriate care decisions can be made quickly when a veterinarian is not present.

Doing it Right: The Universals

Staff should keep these tips in mind when developing protocols and conducting exams:

• Develop a system and stick to it, whether it is to work your way from head to tail or vice versa.
• Practice on as many normal, healthy animals as possible so it becomes easier to recognize abnormalities.
• Do not focus only on the obvious problems; it is very easy to miss other significant abnormalities.
• Use the senses of touch, smell, vision, and hearing during the examination.
• Maintain good medical records that contain a complete description of the animal, including his or her sexual status, estimates of age, identifying characteristics, and veterinary history (regarding vaccinations, deworming, and other treatments).
• Recognize that stress and travel may affect the results of the physical examination. Stressed animals may show a variety of medical and behavioral problems, such as vomiting, diarrhea, drooling, depression, or aggression. (Ideally, an evaluation of temperament and behavior to determine adoptability should not be undertaken until the animal has had two to three days to adjust to the new surroundings.)

While these guidelines deal with an actual physical exam, the examination process truly begins as soon as the animal enters the shelter or is picked up by a field officer. A first assessment of the ani­mal's overall condition should be made by evaluating his general appearance, gait, and demeanor. A healthy animal should be bright, alert, and responsive to his surroundings, and his gait should show a normal range of motion and flexibility.

Find a Quiet, Clean Space

Staff should examine animals in a quiet, well-lit area with minimal distractions. They should wash their hands frequently and wear disposable gloves to avoid contracting or transmitting disease; they should also use appropriate restraint equipment, including tranquilizers (when necessary) for aggressive or frightened animals. For safety and efficiency, a staff member trained in handling ani­mals should assist during the exam, and the exam table should be cleaned with a disinfectant after each examination.

Determine the "TPR"

Temperature, pulse, and respiratory rate (TPR) are general indicators of overall health, but in many shelters, only temperature is routinely measured. Staff should be trained to also measure the heart and respiratory rates, especially in injured and diseased animals; these can provide additional information about the severity of an animal's condition.

The temperature is usually taken first. While infection can explain a higher temperature, increased body warmth can also occur when an animal is excited or when the room itself is warm; a single reading may not always be useful. Do not evaluate the temperature by feeling the nose! The normal temperature range for healthy dogs and cats is 37.5 to 39 degrees Celsius.

The normal heart rate for adult dogs ranges from 60 to 180 beats per minute, but it can sometimes go as high as 220 in puppies. The normal heart rate in cats can range from 110 to 220 beats per minute. One of the easiest ways to check the pulse is by palpating (feeling) the femoral artery, which is found midway on the animal's inner thigh.

To determine the respiratory rate, the examiner should count the breaths per minute when the animal is at rest and unexcited. An inspiration and expiration is counted as one breath. The normal respiratory rate in dogs is 10 to 30 breaths per minute. The normal respiratory rate in cats is 20 to 42 breaths per minute.

Evaluate the heart and lungs

Trained staff should evaluate the heart and lungs with a stethoscope to detect abnormal lung sounds and heart murmurs. The heart can be best heard by placing the stethoscope midway on the left side of the chest between the fourth and sixth rib. Detecting abnormalities is a skill that is best developed by listening to as many normal animals as possible.

Measure hydration status with the skin turgor test

Dehydration is a non-specific sign of many medical conditions. Evaluate the animal's hydration status by lifting the skin between the shoulder blades, twisting slightly, and releasing it. The skin snaps back to its normal position in well-hydrated animals almost immediately. If the skin stands, some degree of dehydration is present.

Run down the health care checklist. You can develop your own checklist based on the following criteria:

• The eyes should be bilaterally symmetrical (same size), clear and bright, with no squinting or purulent (pussy) discharges. Note any discoloration in the sclera ("whites" of the eyes).
• The ears should be clean and free of inflammation, swellings, odors, or discharges. (Normal ear wax is light brown.) Deafness can be difficult to assess. Reactions to noise must be evaluated in a manner that doesn't allow for the influence of other senses; for example, if you test a dog's hearing by clapping, don't do it where she can see you.
• The nose should be clean without any discharges. (Remember that some animals will lick the discharges away, unless they are very sick or the discharge is thick and crusty.)
• The teeth should be evaluated for dental disease; staff should keep in mind that severe dental disease in older animals with bad breath may also be a sign of kidney disease. When looking at the teeth, remember that age can sometimes be estimated by the wear pattern or "eruption date," which refers to the time when the deciduous (baby) or permanent teeth first appear in the gums. (It can be difficult to accurately determine the age of animals older than 5 years by their teeth.)
• The gums should be pink and healthy in appearance.
• The trachea should be pressed on gently in dogs to see if it elicits a continuous or harsh cough that may be indicative of infectious tracheobronchitis (kennel cough). A collapsed trachea may cause similar signs in some small dog breeds.
• The general body condition and weight should be evaluated. The ribs should be palpated to detect emaciation in animals with thick hair coats. Check for lumps, bumps, and swellings by running hands over the entire body from head to tail, the sides, top (dorsum) and underneath (ventrum). Be certain to feel the umbilicus (navel) and groin area for swellings that may be hernias, which are ruptures in the body wall that allow the protrusion of internal tissues. Check the mammary glands for normal lactation, tumors (small hard lumps), or infection (gland is often painful, warm, swollen, and emitting a foul discharge).
• The skin should be evaluated for fleas and ticks, dry skin, hair loss, itching, scabs, cuts, lumps, bumps, and other issues. Luster of the fur is a sign of overall good health even in dirty animals.
• The abdomen should be palpated for abnormal masses or pain by gently squeezing between the hind legs. This is a skill that requires practice to learn. If the abdomen is grossly enlarged, avoid palpation. Female animals should be checked for a spay scar - this is not always easy to find, but clipping the fur and examining the abdomen under a bright light will often reveal it.
• The external genitalia should be examined. Verify the animal's sexual status by checking for testicles, which, if present, should be the same size and consistency. The vulva in females should be pink in color. Note any swelling or discharges. Lacerations or foreign bodies in the vulva and vagina may be indicative of sexual abuse.
• The feet, nails, and digital pads should be examined for foreign bodies, infection, cuts, ingrown nails, etc. Animals can become severely lame from a minor injury to the digital pad.
• The anus and perineal area should be examined for cleanliness, swellings, pain, and prolapses (protruding tissue).

In addition to initial hands-on physical examinations of each animal, ongoing observation during daily rounds is critical to identifying conditions that may arise later. This should be mandatory and should include visual assessment of animals as well as examination of cages for evidence of vomit, diarrhea, blood, uneaten food, and sneeze droplets on cage fronts. All staff and volunteers should be encouraged to alert management or the medical team whenever they observe any abnormalities. A library with basic veterinary texts or animal care manuals should be available for their use. Training and written guidelines will increase the likelihood of the animal care program's success.

Possible signs of infectious disease include:

·         ocular or nasal discharge

·         vomiting and/or diarrhea, especially with blood

·         coughing and/or sneezing

·         fever

·         depression; loss of appetite

·         enlarged lymph nodes

·         reddened eyes (conjunctivitis)

·         ulcers in the mouth

·         circling, "star gazing," or seizures (indicating a potential neurological problem)

·         patchy or circular hair loss

Conditions that call for immediate medical attention include:

·         labored or open-mouthed

·         breathing

·         bleeding from open wounds or extensive easy bruising

·         fractures, especially with exposed bones

·         temperature over 41 degrees or below 36 degrees Celsius

·         seizures

·         blue, very pale, or brick red gums

·         history of recent hit by car or other severe trauma

·         evidence of physical abuse

·         suddenly swollen abdomen

·         inability to urinate, evidenced by a hard, enlarged bladder (seen in cats)

·         labor or difficulty giving birth

·         altered consciousness, such as depression or lethargy

Source: BY LILA MILLER, D.V.M.