You may think your pet needs to visit the veterinarian once a year for "shots," but just as in human medicine, the annual health examination in veterinary medicine is much more. It's the best way to save money and heartache by promoting wellness and catching problems early.

Dr. Steven Marks, veterinary internist and chief of small animal medicine at the University of Illinois Veterinary Teaching Hospital in Urbana, explains, "We teach the physical examination to our veterinary students with a thorough nose-to-tail approach."

Pet owners may not realize that the medical exam begins before the veterinarian touches a pet. Often, before you see the veterinarian, a veterinary assistant will ask you questions to form a history of care, habits, and events that affect your pet's health. Then, as soon as the veterinarian enters the exam room, she observes how your pet behaves, interacts, and walks and watches the animal's respiration from a distance.

With a "nose-to-tail" exam, the veterinarian will look, listen, and palpate (or touch) to examine for abnormalities. The veterinarian starts with the nose and mouth, performing a dental exam, and then looks closely at the face, eyes, and ears, examining neurological function of the cranial nerves and looking at the skin for signs of allergy or infection. Along the neck she will palpate for abnormalities associated with the thyroid gland and lymph nodes. There are many lymph nodes in the neck, shoulder, and armpit areas, and swelling of these can indicate a nearby infection or other disease.

Throughout the examination your veterinarian will also palpate muscles and bones and squeeze joints, especially of the legs, looking for abnormalities and testing for reflexes and pain. When she gets to the chest area, she will listen to the heart and take a pulse in one of the hind legs. Often heart problems such as murmurs or irregular beats can be heard through a stethoscope. Your veterinarian will also listen to the lungs for any abnormal sounds or breathing patterns.

Your veterinarian will palpate abdominal organs such as kidneys, liver, and intestines for lumps or other abnormalities, and will watch for signs of pain or tenderness, which could also indicate a problem.

Both male and female dogs should also get rectal exams, to rule out prostate disease in males and rectal disease in both sexes. Rectal examinations and temperature readings may not be performed in front of the pet owner, but they are essential components of the annual exam.

Following the physical exam, your veterinarian may order a laboratory evaluation, which may include tests such as a fecal exam, urinalysis, a complete blood cell count, and biochemical blood tests that can indicate how organs such as the liver and kidneys are functioning.

If your veterinarian finds abnormalities or signs of disease, she may investigate further using diagnostic tests such as X-rays and specific blood tests, or if the condition is serious or very specific, she may refer you to a veterinary specialist such as a dermatologist, internist, ophthalmologist, or cardiologist. (More than 20 areas of veterinary specialty are recognized by the American Veterinary Medical Association, and veterinary specialty clinics are becoming more common.)

In addition to the annual rabies shot required by many jurisdictions, your veterinarian may also recommend vaccines for other infectious diseases based on the possible risks associated with your geographical area and your pet's outdoor and social habits. However, "shots" are merely one facet of your pet's wellness. Visits with the veterinarian are important to prevent disease, to catch disease early, and to educate you, the pet owner, on current veterinary knowledge to promote healthy habits. Scheduling annual examinations and following your veterinarian's advice can save money and grief in the long run by catching disease early.

In addition to annual examinations, Dr. Marks also recommends consulting your veterinarian whenever your pet is injured or when your pet is not acting like itself. "Since pet owners are very attuned to their pets, they are the first to notice when their pets are 'off.' They should go with that instinct and consult a veterinarian," he says.