In this episode of the Disease Du Jour podcast, AAEP President Tracy Turner, DVM, MS, DACVS, DACVSMR, joined us to talk about physical examinations. He discussed everything from why thorough physical exams are important, what they can tell you about a patient before you send them for imaging, and how you can improve your examination skills.
Why Are Thorough Physical Exams Important?
Turner said the physical examination is one of the most important parts of the veterinarian’s job. “There are different types of examinations we’re going to do depending on what the presenting complaint may be, but if you do a thorough examination of that body system, you should learn everything you need to know,” he said.
He said many veterinarians jump straight to laboratory work, radiographs, and ultrasounds when making a diagnosis, which might not provide a complete picture.
“Here’s a philosophical thing: I think [the physical examination] is so important, it should be the biggest thing we’re paid for, but we actually get paid for doing other things,” Turner said.
Equine Physical Examination Process
When performing a musculoskeletal exam, Turner has an assistant handle the horse so he can talk with the owner while making his assessment. He evaluates how the horse stands, walks, trots, and moves in general. He assesses the horse’s movement on the longe. He asks the owner questions about what’s normal for the horse and starts piecing together the puzzle.
“Then we get to the absolute examination, and for me it’s nose to the toes,” he said. “Literally anything in this horse’s body can affect their gait.” He puts pressure on different points to see if they cause a reaction. He runs his hands across where the bridle would sit. He plays with the horse’s gums. Then, he palpates every part of the horse from poll to hooves, all while continuing to ask the owner questions.
“You’re going to go through everything with a stepwise examination that you’ve done again and again and again,” he said. “It’s easy, it’s quick, and you’re getting lots of information from it.”
Turner likes to collect as much information about the horse as possible before recommending diagnostic imaging. Otherwise, the imaging results might only leave you with more questions.
“We don’t know exactly what normal is with some of those [horses],” he said. “I know what a normal MR is supposed to look like, but I don’t know what a normal MR would look like on a horse that’s been competing at the elite levels for 10 years, right?” He said it’s normal to expect adaptive changes in these horses, “and if I don’t know what the adaptive changes are, it makes them more difficult to interpret.”
How to Improve Your Equine Physical Examination Skills
For veterinarians hoping to improve their physical examination skills, Turner said the easiest thing to do is go look at normal horses. One way to do this is by offering to perform physical exams on horses at a local rescue and start keeping data on them. “So you help out somebody that you know needs help, and you’re going to be learning the whole time,” he said.
He also recommends going on a trip with the Equitarian Initiative, which provides philanthropic veterinary care for horses in developing countries. On these trips, you’ll see a lot of horses in a short period, and you’ll have to rely on your physical examination skills because you won’t have any other diagnostic modalities available.
“I think seeing the most normal animals you can, or close to normal, is the best way to hone these skills,” he said.
About Dr. Tracy Turner
Tracy Turner, DVM, MS, DACVS, DACVSMR, is a partner in Turner Wilson Equine Consulting in Stillwater, Minnesota. He retired from private practice in December 2023 after concentrating exclusively on equine sports medicine, lameness, and surgery at his Turner Equine Sports Medicine and Surgery.
Turner received his veterinary degree from Colorado State University in 1978 and served on the faculties at the University of Illinois, University of Florida, and University of Minnesota. He volunteers with Equitarian Initiative, serves as an FEI Examining Veterinarian for show jumping, and has consulted for U.S. Equestrian Federation and USDA APHIS Horse Protection Program for Tennessee Walking Horse welfare.
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