Besides a physical exam, annual check ups include Leptospirosis vaccine and a tri-annual distemper, hepatitis, parvovirus, and parainfluenza vaccine (DH-PP vaccine). You may also consider vaccinating against bordetella & parainfluenza (“kennel cough”), especially if is exposed to many other dogs. Rabies vaccines are given every three years, after your puppy has had a one-year rabies vaccination. Additionally, an intestinal parasite screen should be performed yearly and only requires a small fecal sample. Intestinal parasites can be harmful to your pet, but if detected, they are very treatable. If positive your puppy has a positive screen, bring another fecal sample 2 weeks after worming to ensure all parasites are killed. Heartworm tests are performed every spring using a blood test to ensure is free of heartworms and preventatives are given.