When a dog, cat or rabbit presents as lame, it can sometimes be quite a challenge to work out exactly what is wrong. Just trying to identify which leg is affected can sometimes be difficult. In this article we give a few top tips on how to ensure you are confident with your examination to ensure you make the right diagnosis.
Posted: 25 June 2020
1. Let them relax – if the patient knows you’re about to check them over, they’ll probably become nervous and may not show signs of pain. You might find some of our previous articles useful.
2. Be patient – it doesn’t help to rush, so take your time and watch everything. There’s no doubt that the first few moments of the clinical examination needs to be done with patience and from the other side of the room. The worst thing you could do is rush to pick up the animal and start feeling all the joints. Take your time and watch the animal’s behaviour first.
3. History – ask lots of questions and find out as much as you can first. A long and detailed history covering as much as possible is worth a lot. Find out when the lameness started; how it happened; what are the signs; does it wax and wane; does anything help; and so on.
4. Use the corner of your eye – whilst chatting with your clients, try to be aware of what the patient is doing. By watching the patient without focusing on it, he/she will be more relaxed and give you more clues. You need to get some answers to all of these;
5. Make friends – the examination room should always be used in a way that keeps the patient relaxed. You need them to think of you as a friend and not a threat. With most animals it can help if you get down to their level. Crouch down and let them approach you first. It often helps if you avoid too much eye contact, and keep the conversation going with the owner with a calm, relaxed tone of voice. The more your patient trusts you, the more natural signals they will give back to you. Some suggestions include;
6. Safe environment – as far as possible make the examination room safe and comfortable for your patient. If they’re relaxed, they’ll be much easier to examine. This is best achieved by;
7. Client confidence - if the owner is new to your surgery and unfamiliar with your vets, nurses and procedures, it may take a bit of time to gain their confidence and trust. However, this is necessary if you are going to be able to help. A cold, distant and overly clinical approach may make it harder, so try to show empathy, care and a love of animals. You can do this by;
8. The Examination
It’s usually best to examine the patient when it’s standing, as you’ll find it easier to make a good comparison of symmetry. Work from behind, using both hands at the same time to simultaneously palpate both;
By doing this you’ll be able to detect even small amounts of swelling, effusion or warmth. Once you’ve compared the symmetry, move on to feeling each limb in turn, checking for ease of movement and any resistance or pain.
9. Look for a reaction
The most effective way to assess the animal’s response to palpation and manipulation is when it’s relaxed and comfortable. This can be made possible if the consulting room is free of other distractions such as phones, other pets and unnecessary people moving about. The subtle clues to look out for are;
If you see any of these signs, repeat the manoeuvre or palpation and see if it’s repeatable.
10) Don’t make these mistakes
Apart from all of the above, there are also some important things to avoid. Our list includes;