Usually this time of year clients call to schedule coggins and vaccinations. We always ask, "Would you like me to do an exam on your horse?" Sometimes owners say, "No, I already know they are healthy." What the owner means is that the horse is eating well, acting normally, and holding its weight, which is great! But when we offer to do an exam, we do so because there is so much more to health than that. To help you understand my point, I will walk you through my version of a physical exam. (There are a lot of ways to do a physical exam; I'm not saying this is the only way).
I start at the head. I look at the horse's expression, facial muscle symmetry, and motion of the ears. I even look in the ears because aural plaques are so common. I look at the eyes, and very commonly find cataracts. Once in awhile I find very small cancers that the owners weren't aware of. I often see sarcoids (skin tumors) on the face that the owners had mistaken for rub marks or bites. I look at the color of the gums and estimate hydration. I look at the incisors and canine teeth. The incisors often have irregularities reflecting symmetrical chewing due to problems further back in the mouth. If the horse lets me, I try to get a look in the back of the mouth, but it's really hard to see back there without sedation and specialized equipment. Sometimes I can see major problems indicating we need to do a more thorough exam and corrections.
Then I move to the horse's left side. I look at skin, feel lymph nodes, check hydration, look at muscle mass for symmetry. I run my hand down each leg to check joints, tendons, and splint bones. I find a lot of arthritic knees and popped splits this way. I pick up a couple of the feet. The most common problems in feet I see that the owner wasn't aware of are underrun, sheared heels. I feel the lower belly for edema (fluid) and hernias. I feel back in the sheath area of geldings because tumors back there are common. I check under the tail because tumors are common there too, and often take the horse's temperature. I look for evidence of diarrhea on the legs or urine dribbling from mares. I feel the back leg muscles for scarring.
I listen to the heart's sounds, heart rate, and rhythm. I hear unusual sounds (murmurs) all the time, and sometimes some problematic arrhythmias. I listen to the lungs for clarity, good air movement, and the respiratory rate and effort. I can hear evidence of lung inflammation this way such as heaves. I listen to gut sounds to get an idea of the horse's digestion. I hear sand in there frequently, and we can start treatment before the horse ever loses weight, gets diarrhea, or colics from it. (By the way, when I'm using the stethoscope, I can hear better if you aren't talking to me at the same time :) ).
The exam of the horse's right side is similar to the left. I feel the withers and back for pain, and compare muscle mass to the other side. I consider the haircoat (and hoof quality) because it goes hand in hand with nutrition and the metabolic status of the horse.
I keep my eye on the horse to see how it is walking around before or after the exam. There are a lot of horses that are lame unbeknownst to the owner.
I explain any findings to the owner and see what questions they have or what else they want to discuss. I enjoy talking about the horse's deworming plan, vaccinations, hoof care, and nutrition.
I could have gone on much longer about all the hundreds of issues that turn up on physical exams, but you get the idea :). We love doing exams, even when the owner already knows "it's healthy." :)
I was doing a physical exam on this healthy little mare and noticed she walked oddly. I picked up a hind leg and could do this, which means a specific ligament was ruptured, but there was no history of injury. The right hind leg did the exact same thing. I assume she was born with these ligaments absent in both hind legs. The owners didn't know they owned a medical anomaly!