Cat at Vet
In a much-discussed New York Times article titled "Let’s (Not) Get Physicals," a physician reporter named Elisabeth Rosenthal argued that annual physical examinations for human patients are pointless. She cited a Canadian government task force recommendation to abandon annual physical examinations because they are “nonspecific,” “inefficient” and “potentially harmful” (in that they may lead to unnecessary tests). The task force said examinations should be replaced with intermittent screening tests for age- and risk-specific conditions (mammograms, Pap tests, etc.). Dr. Rosenthal argued that this logic is sound in the United States as well.

Scrutiny of annual physical examinations for people does not come as a surprise. Health care costs are soaring, and research consistently shows annual physicals don’t save lives. Most treatment is started because a patient feels sick and comes to the doctor — not because of findings in a routine examination.

So, do these human-side rumblings mean that we should re-evaluate the annual or biannual examinations that veterinarians recommend for pets? Are those trips to the vet with seemingly happy, healthy pets really worth the stress and effort for all involved? I’ve asked myself those questions repeatedly. Here are the key points I always return to.

Patient Risks and Lifestyles Change

The strongest argument I have heard for continuing annual physical examinations on the human side of medicine has nothing to do with taking temperatures, running lab tests, listening to chests or asking patients to turn their heads and cough. The single most important reason for a physical examination is making time to review patients’ medical histories and to discuss health risks associated with their individual lifestyles and activities.

Likewise, these discussions in regard to pets have great benefit, I believe. Vaccination decisions, food choices, exercise routines, parasite control products and behavioral training measures should all be based on each pet’s lifestyle. The activities that your pet participates in, the environment where he or she lives and his or her specific health risks all change over time and with age. These issues need to be reviewed with a veterinarian on a regular basis to help ensure long-term wellness.

History Is Important

Understanding what is “normal” for a pet is of great importance when veterinarians are faced with potentially abnormal findings. When I treat patients who have not been to a veterinarian for extended periods of time, I find myself wondering things like “Is this pet losing weight? If so, how much?” and “Are these blood chemistry levels increasing?” The unfortunate truth is that if no one has investigated or recorded these values previously, I don’t have any basis for comparison. That makes finding meaningful health trends more difficult. Having routine examinations helps establish a normal baseline for each pet, making it much more obvious when something happens that is abnormal.

Pets Age Quickly

I have seen a variety of tables and calculators that convert the age of pets to a comparable age in human years. They all say essentially the same thing: Time passes more quickly for pets than it does for us. While small dogs generally have longer life spans than large dogs, I have found the old adage about one year for people being seven years for dogs and cats to be a fairly useful, if imprecise, estimate.

Even if we decide that annual physical examinations for people do not justify their costs, having a physical examination every three and a half or seven years hardly seems like wasted time. When we examine pets every six or 12 months, this is essentially what we are doing. We like to pretend that our pets will live forever (because this is a wonderful idea), but the truth is that their lives pass quickly. As a result, what seem like “frequent” visits to the veterinarian to us are not for them.

Pets Can’t Talk

While it’s rare for a doctor treating people to find a surprise illness, it’s not for me. I often hear phrases like “An ear infection? I guess she has been shaking her head recently” and “He has lost two pounds? That’s a quarter of his weight!” These are not admissions of  “bad” pet owners. They are statements from normal, busy, distracted people who have stoic, secretive or (in the case of weight loss) very hairy pets.

Pets don’t tell us when they feel sick. Their instincts are often to hide pain and discomfort so as not to appear weak to others. During physical examinations, I have found skin, thyroid, oral, gastrointestinal and prostate cancer, just to name a few. In just the last month, I have seen owners of young, “healthy” pets surprised by internal parasites, periodontal disease, fleas, yeast infections, weight loss, weight gain and ingrown toenails.

Without physical examinations, countless cases of dental disease, skin infections, allergies and arthritis would go undiagnosed and untreated. Serious medical issues like thyroid disease, renal failure and diabetes would be detected much later in the disease process, leading to lower odds of survival.

Until our pets learn to speak up, getting them examined by a veterinarian regularly makes way too much sense to stop.

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