10.3PHYSICAL EXAMINATION 10.3 PHYSICAL EXAMINATION

Many older animals will have concomitant disease and so it is important to perform a full clinical examination and not just focus on the problem(s) raised by the animal owner. In particular evidence should be sought for the presence of cardiac, respiratory, hepatic or renal dysfunction which are all common in advancing age, and for external evidence of internal disease. Dermatologists frequenfly refer to the skin as an indicator of general health and this can certainly be true in older animals (see Table 10.2).

Greying of the hair - particularly around the face and muzzle is common with advancing age. Neoplasia of the skin is also common in older animals (see Chapter 6).

A full neurological examination is necessary to identify signs of primary or secondary neurological deficit or increased neurological responsiveness. Both the peripheral and central nervous systems should be examined. See Chapter 3 and Wheeler (1989) for further details.

Ophthalmoscopic examination may reveal evidence of increased tortuosity of retinal blood vessels or even of subclinical retinal haemorrhages typical of hypertensive patients. Sudden onset blindness due to retinal detachment (often bilateral) is a more severe manifestation of hypertenand is seen in the presence of renal failure.

Blood and urinalysis should form part of a comprehensive screening programme because quite simple and inexpensive tests can provide invaluable information to assist the clinician. However there are many pitfalls in taking laboratory samples and in interpreting laboratory results and the reader is advised to consult an authoritative text on the subject such as that by Bush (1991).