A dog wellness exam is a nose-to-tail physical evaluation combined with diagnostic screening tests designed to catch health problems before symptoms appear. Most visits last 30 to 60 minutes and cover everything from heart and lung function to joint health, dental condition, and parasite screening. Here’s what actually happens during each part of the visit.
The Physical Examination
The hands-on portion follows a systematic path through your dog’s body. Your vet will listen to the heart and lungs with a stethoscope, checking for murmurs, irregular rhythms, or abnormal breathing sounds. They’ll look into your dog’s eyes, ears, and mouth, and feel along the body for anything unusual.
Lymph node checks are a key part of this process. The vet palpates lymph nodes under the jaw, near the shoulders, and behind the knees, feeling for changes in size or shape that could signal infection or, in some cases, cancer. They’ll also work through each limb, feeling the muscles, joints, and long bones for heat, swelling, or pain. This is especially important for breeds prone to hip dysplasia or ligament injuries.
The abdominal exam involves pressing gently from front to back and top to bottom, feeling for organ enlargement, masses, or tenderness. Your vet is checking the size and position of the liver, spleen, kidneys, and bladder. A rectal exam may also be performed, particularly in older dogs, to check for masses or enlarged lymph nodes in the pelvic area.
Body Condition Scoring
Your vet will assess your dog’s weight using a 9-point body condition score (BCS) rather than relying on the number on the scale alone. This scoring system is based on both visual observation and touch. The vet feels for fat coverage over the ribs, spine, and hip bones, then looks at your dog from above and from the side to evaluate whether a visible waist and abdominal tuck are present.
A score of 4 or 5 is considered ideal: ribs with a slight fat covering and a clearly defined waist. Scores of 1 to 3 indicate an underweight dog with easily visible bones and little fat. Scores of 6 to 9 reflect increasing levels of excess weight, with heavy fat covering the ribs, no visible waist, and an obviously rounded abdomen. Your vet may also measure chest and abdominal girth to track changes over time. Based on the score, you’ll get specific feeding and exercise recommendations.
Bloodwork and What It Reveals
Most wellness exams include blood tests, particularly for adult and senior dogs. The two standard panels are a complete blood count (CBC) and a blood chemistry panel.
The CBC measures three main cell types. Red blood cells carry oxygen and reflect your dog’s energy levels and hydration. White blood cells drive the immune response and spike when the body is fighting infection or parasites. Platelets control blood clotting. Abnormal numbers in any of these categories point the vet toward specific problems worth investigating further.
The chemistry panel is more detailed. It evaluates how well individual organs are functioning. Liver enzymes reveal whether the liver and bile ducts are working properly. Kidney markers like BUN and creatinine show how effectively the kidneys are filtering waste. Pancreatic enzymes flag potential inflammation. The panel also measures electrolytes (sodium, potassium, chloride), minerals (calcium, phosphorus), and blood sugar. A thyroid hormone level may be included, especially if your dog has unexplained weight gain, low energy, recurring skin infections, or hair loss on the body and tail.
Bloodwork typically costs $50 to $200 depending on the scope of the panel. Your vet may recommend a baseline panel for younger dogs so there’s a point of comparison as your dog ages.
Parasite Screening
Two types of parasite tests are standard. A heartworm test uses a small blood sample to detect proteins produced by adult heartworms. This is recommended annually even for dogs on preventive medication, because a missed dose or spit-out pill can leave a gap in protection.
A fecal flotation test checks a stool sample for intestinal parasites. The lab processes the sample to float parasite eggs and larvae to the surface for identification under a microscope. This single test can detect a wide range of worm infections as well as protozoan parasites like Giardia and Coccidia. A heartworm test runs about $20 to $75, and a fecal exam costs $25 to $50.
Dental Health Check
Your vet examines the teeth, gums, and oral tissues during every wellness visit. Periodontal disease is graded on a four-stage scale. Stage 1 is gingivitis, with red or swollen gums but no permanent damage. Stage 2 is early periodontal disease with minor loss of the tissue that anchors teeth in place. Stage 3 means moderate tissue loss, and Stage 4 is advanced disease where more than half the supporting structure is gone and teeth may need extraction.
Most dogs over age three have some degree of dental disease, and it often progresses silently. Dogs rarely stop eating because of mouth pain until the problem is severe. Your vet will let you know if a professional dental cleaning under anesthesia is warranted or if at-home care like dental chews or tooth brushing is sufficient for now.
Vaccinations
A wellness visit is when your vet reviews which vaccines are due or overdue. Core vaccines are recommended for every dog regardless of lifestyle. These protect against parvovirus, distemper, adenovirus (infectious hepatitis), rabies, and leptospirosis. Leptospirosis was recently added to the core list because the bacteria can infect dogs even in urban environments, and the disease is potentially fatal.
Non-core vaccines are tailored to your dog’s exposure risk. Factors like whether your dog goes to daycare or boarding, visits dog parks, travels to areas with specific diseases, or spends time in wooded or rural settings all influence which additional vaccines make sense. Common non-core options include Bordetella (kennel cough), canine influenza, and Lyme disease. Each vaccine typically costs $20 to $60.
Behavioral Screening
Increasingly, vets incorporate a behavioral check into the wellness exam. This might be as simple as observing whether your dog accepts treats, plays with a toy, or tolerates gentle handling in the exam room. A dog that refuses a favorite treat despite being hungry, for example, is likely experiencing significant stress or anxiety.
Your vet may also ask about changes in your dog’s daily routine, sleep patterns, house-training reliability, reactivity toward people or other animals, and overall energy level. These questions help screen for anxiety disorders in younger dogs and cognitive dysfunction in older ones. Behavioral changes are sometimes the earliest visible sign of pain or neurological decline, so flagging them early can lead to faster treatment.
Extra Screening for Senior Dogs
Dogs are generally considered senior around age seven, though large breeds age faster and may qualify earlier. Senior wellness exams add several layers of testing. Urinalysis becomes a standard part of the workup because kidney disease is common in older dogs, and urine concentration is one of the first values to change, often before blood markers shift.
Thyroid hormone testing is also routine for seniors. An underactive thyroid slows metabolism body-wide and can cause weight gain, lethargy, and chronic skin problems. If initial screening reveals concerns, your vet may recommend blood pressure measurement, expanded blood panels, or imaging like X-rays or ultrasound to get a clearer picture.
The American Animal Hospital Association recommends senior dogs be seen at least every six months rather than once a year. Because aging-related diseases can progress quickly, that shorter interval gives your vet a better chance of catching problems at a treatable stage.
How Often to Schedule Wellness Visits
Puppies need the most frequent visits: roughly every three to four weeks during their initial vaccine series, which typically wraps up around 16 weeks of age. Young adult and mature adult dogs do well with exams every 6 to 12 months. Senior dogs benefit from visits every six months paired with diagnostic screening.
A basic office visit and physical exam runs $40 to $90. Adding bloodwork, vaccines, parasite testing, and urinalysis can bring the total to several hundred dollars, but many clinics offer bundled wellness packages at a discount. Pet insurance and wellness plans can offset some of these costs, though coverage varies widely. Even without extras, the physical exam alone gives your vet a surprising amount of information about your dog’s health, and catching a problem early almost always costs less than treating it late.