I love being a veterinarian. One of the best parts of my job is how diverse the medicine can be. In an age of increasing specialization in medicine, the veterinarian still needs to be an expert of many fields.

In a given week I may be a surgeon, an internist, an ophthalmologist, behaviorist, a dermatologist or many others. The key to being able to practice such a wide variety of medicine in multiple species is to be able to perform a high quality physical exam.

The physical exam is without a doubt the most useful and important tool in the veterinarian's kit. In vet school I was told over and over again that "you miss more by not looking than by not knowing," and I have found this to be true on many occasions. The more you check, the less you miss!

A good physical exam is a whole body nose to tail visual and tactile evaluation. I look at every surface of the pet, and I feel every surface. I check the eyes and ears. I feel the abdomen. I listen to the heart and lungs.

There are literally hundreds of subtle checkpoints on each evaluation. Every time I do an exam, I run through a long string of internal questions: "Are the lymph nodes normal size, what is the gum color, do the gums look moist, how much tartar is there, are the lenses of the eyes clear, are the facial muscles symmetrical, does the pet turn its ears in response to sound...?"

In addition to these concrete findings, I also try to get a feel for intangible aspects as well, such as attitude, energy and demeanor. By the time I run my hand off the tip of the pet's tail, I have accumulated a wealth of information on its health status.

I have had clients comment to me at times that I performed a more thorough check on their pet than they get on their own physical exam. I explain to them that I have to be as thorough as I can because their cat or dog or rabbit is never going to say to them, "You know, I should really get that lump checked out." It's up to us to do that for them.

One of the most important reasons to do a good physical exam every time we see a pet is to make sure that we don't miss a new development that has escaped the pet owner's eyes. There have been countless occasions where I have had a an animal in for a routine checkup or vaccines and we have picked up on a new issue.

Some diseases announce themselves loudly to us in the form of coughing, vomiting, wounds, etc. Some disease are sneakier, like lumps that can be felt but not seen, heart murmurs, changes in the abdomen, subtle changes in the eyes, etc.

Though I never like to tell my clients that their apparently healthy pet has a problem, I am always delighted to catch diseases early in their course. By performing routine physical exams we can often add years to our pets' lives with early intervention.

Another reasons a physical exam is so important is to evaluate the nature and severity of a known problem. Take the example of the dog that comes in for "coughing." Many of these cases are fairly straight forward kennel cough. This is a disease that is limited mostly to the upper airways and clears up well with minimal intervention like a cold in humans.

However, sometimes a dog that is coughing has a very severe disease such as heart failure or pneumonia. By listening carefully to the heart and lungs and evaluating the pet in detail, we can start to narrow in on a diagnosis and a treatment plan before we even begin our diagnostic testing.

At the end of the day, I can't overstate the importance of the physical exam. Our pets age much faster than we do, and they can't communicate subtle changes to us as well as we might like.

In this day and age we have amazing medicine available for our pets. We have board certified specialists in numerous fields who are doing cutting edge treatments for our patients (brain surgery, cardiac catheters, etc.). In our general practices we have excellent screening tests available (radiographs, bloodwork, etc.), and we have great preventative medicine like vaccines, heartworm medicine and special diets.

However, no matter if you are the kind of owner who will pursue a multi-thousand dollar specialist knee surgery for their dog, or one who needs to get by on a tight budget, getting your pet in for a regular physical exam is the most important thing you can do for their health.

Lyssa Alexander, DVM treats small and exotic animals and pocket pets at All Creatures Animal Clinic.