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Very often the veterinary exam goes from head to tail, starting with the mouth (in fact, it's sometimes called a "teeth-to-tail" exam). She will check your dog's gums, teeth, tongue, palate and throat, making note of gum color, tooth occlusion and whether the baby teeth are being properly replaced by permanent teeth (if your puppy is the appropriate age for that). She'll move on to the ears, possibly peering inside the canal with an otoscope, looking for debris and discharge that may indicate mites or an ear infection in puppies. She'll look at the eyes, making note of discharge and staining, redness or lid abnormalities.
The veterinarian will then move on to the body, perhaps tenting the skin to check for dehydration. She'll look at the hair and skin, parting the hair to look for signs of parasites or skin disease. Then she'll feel along the body and palpate the abdomen, feeling for abnormalities in internal organs. She'll check the penis and vulva for abnormal discharge or conformation, and the anus for evidence of prolonged diarrhea.
One of the most important things the veterinarian will do is listen to the heart with a stethoscope. Some puppies have congenital heart defects that can cause a murmur. But not all murmurs in puppies indicate a heart defect; many times puppies grow out of these. Your veterinarian will want to recheck this on subsequent visits.
Based upon your puppy's vaccination history and age, the veterinarian will then administer the proper vaccines. She may also give deworming medicine. Depending on age, she may have you start the puppy on heartworm prevention. And she may suggest a flea and tick preventive as well. She may talk to you about feeding, behavior, and your plans for spaying or neutering.
Before leaving, make sure you understand the veterinarian's instructions. When you check out, these may also be given to you in written form; if not, write them down. You'll probably be instructed to return in three weeks for follow-up vaccinations. The timing of these vaccinations is important; don't put off coming back for them. At each subsequent visit for vaccinations, the veterinarian will probably give your puppy a repeat exam.
Be sure your puppy gets to meet the staff, who will often coo over him and give him treats. It's important for him to enjoy his visits. In fact, many clinics encourage you to bring your puppy just to visit occasionally so he looks forward to seeing his friends. This sets the stage for fear-free visits for the rest of his life — and a healthy future!
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