The diagnostic system of Traditional Chinese Veterinary Medicine requires identifying clinical signs (Bian) and the pattern of disease (Zheng). The TCVM physical exam utilizes the four diagnostic methods in order to make an accurate diagnosis and effectively treat the patient. The four diagnostic methods (Si-Zhen) include inspect, hearing and smelling, inquiring, and palpation.


  • Inspection begins with observing the patient’s Shen, or spirit / mental state. An animal with normal Shen will be bright and alert, with clear eyes and responsive to its environment. A patient’s Shen helps determine the severity of disease and can also reflect prognosis. 
  • While evaluating the Shen, the general body condition is also appreciated as well as the quality of the coat and condition of the skin. 
  • Next, the tongue color and appearance is examined. This is a very important part of pattern diagnosis. The tongue’s color, shape, coating, and moisture level is evaluated. A normal tongue is bright pink and moist. Abnormalities in the appearance of the tongue suggest different diagnoses. For example, a pale, wet, swollen tongue indicates a Qi Deficiency. A red, dry tongue, on the other hand, is indicative of Heat.

Hearing and Smelling

  • The quality of the bark or meow is observed. 
  • The heart and lungs are ausculted using a stethoscope. 
  • Odors from the body, breath, and ears are identified. A strong smell is often an indicator of Heat. 


  • This step is comparable to taking the medical history, with some added elements. In addition to the standard questions asked during a physical exam, a TCVM veterinarian will question the owner about temperature preferences, diet, and personality. 


  • A TCVM veterinarian evaluates changes in the pulse to reveal pathological conditions. Pulse diagnosis reflects the state of the internal organs, Qi and Blood. The pulse depth, strength, speed, and character is determined. 
  • Acupuncture points are located along Meridians that course along the body in set paths. These Meridians correspond to body systems. A TCVM examination often involves palpation along the Meridians to identify imbalances with the corresponding internal organs. 
  • Back-Shu association points and front-Mu alarm points are special acupoints where internal organ Qi is distributed. The points are evaluated for sensitivity, depressions, or swelling to identify problems with the corresponding organs. 
  • The rest of the body is palpated to identify moisture content, temperature, and sensitivity. For example, dry, cracked, warm paws indicate Heat. 

A TCVM examination involves careful observation and allows a practitioner to identify subtle changes that may be key factors in identifying disease. An integrative approach utilizes the classic Western physical and the TCVM Si-Zhen for a complete picture of the patient’s health. 

Emily Falk, DVM, CVA