int-Internal Medicine

Internal Medicine

Our internists, Dr. Bryan Harnett and Dr. Amy Cordner are devoted to improving the health and well-being of their patients.  To ensure your pet receives the best care, a certified technician will be dedicated to your pet during their appointment and procedure.  While at BEVS, Dr. Harnett or Dr. Cordner will update your primary veterinarian on your pet’s treatment and progress.  If weekend or overnight hospitalization is necessary, your pet will be monitored by our team of emergency veterinarians and technicians.  Our emergency team will be in regular contact with your pet’s internist when hospitalized during these hours.

Computed Tomography (CT)

Computed Tomography is commonly referred to as a CT scan or CAT scan. Computed tomography (CT) is a noninvasive diagnostic method that uses special x-ray equipment to obtain cross-sectional pictures of the body. The CT computer produces rapid, precise, and clear dimensional images of organs, bones and tissue.

 What happens during a CT?

The patients is placed on the CT table while under anesthesia. The CT table moves through the circular tunnel of the CT scanner (gantry) while an x-ray tube within the CT housing emits x-rays as it encircles the patient within the gantry. A detector array, on the opposite side of the x-ray tube, measures the x-rays that pass through the patient and computer-generated cross-sectional images are constructed from this data.

Why CT? Here are a few of the advantages:

  • CT is fast – Most scans will only require a few minutes of anesthesia time.
  • CT is more affordable and has better availability compared to MRI.
  • Better anesthetic control of critically ill patients.
  • Superior soft tissue contrast resolution vs. radiography.
  • Removal of superimposition
  • Distinction between soft tissue and fluid filled structures
  • Accurate localization of pathologies and structures

Some of the Common Clinical Indications for CT:

  • Nasal disease
  • Seizures or other progressive neurologic disease
  • Elbow disease
  • Thyroid disease
  • Dental disease
  • Liver disease
  • Lung disease
  • Urogenital disorders

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What are Internists?

Small animal internists are specialists who focus on diseases of the internal systems. They have completed basic veterinary education, an internship and residency in their specialty, and passed rigorous testing to achieve board certification from the ACVIM. They have a greater knowledge of complicated, uncommon and rare medical conditions of animals. They are trained in the use of advanced diagnostic and therapeutic equipment.

What is the ACVIM?

The American College of Veterinary Internal Medicine (ACVIM) is the non-profit international certifying organization for veterinary specialists in small animal internal medicine, cardiology, oncology, neurology, and large animal internal medicine. ACVIM has more than 1,800 active members, called ACVIM Diplomates (DACVIM), who are board-certified veterinary specialists. Visit ACVIM.org

When should I see an Internist?

  • Multiple disease conditions that are very difficult to manage.
  • Disorders requiring specialized diagnostics such as ultrasound or endoscopy and treatments such as chemotherapy or radioactive iodine for hyperthyroidism.
  • Complicated endocrine diseases such as Diabetes Mellitus, Hyperthyroidism, or Cushing’s Disease.
  • Unresolved breathing problems
  • Bleeding disorders or anemia
  • Infectious diseases
  • Liver disease
  • Unexplained weight loss
  • Chronic vomiting or diarrhea
  • Kidney and bladder diseases
  • Nutritional support with feeding tube placement or partial parenteral nutrition (PPN).

What to expect during your appointment

Internal Medicine is available  Monday–Friday from 8am–5pm. Upon arrival, you will be asked to complete our Client/Patient Form by one of our front desk staff members. The doctor and his/her nurse will meet with you to discuss your pet’s medical history, condition and evaluate your pet with a thorough exam. At this point, our medical team will have a better idea on how to proceed with diagnostics, treatment plan options and costs. The appointment time is for the consultation and examination. If we recommend a procedure (i.e. ultrasound, endoscopy, etc…), we will make every effort to perform the procedure in a timely manner. However, your pet may need to be admitted to the hospital for the day to allow time for the procedure to occur in the afternoon. In some cases it may be necessary to schedule the procedure for the next possible business day.

Ultrasound & Echocardiography

These diagnostic procedures generate computerized images of internal organs such as the heart, liver, spleen, kidneys, and bladder using noninvasive sound waves. These procedures aid in the diagnosis of conditions such as tumors, obstructions, and fluid accumulation:

  • Echocardiogram
  • Thoracic Ultrasound
  • Abdominal Ultrasound
  • Gastrointestinal Ultrasound
  • Ultrasound-guided fine needle aspirate or biopsy

Endoscopy

This is a minimally invasive procedure using a tiny video camera attached to the end of a flexible or rigid tube.  This special procedure allows direct examination of inside surfaces of hollow organs from which foreign bodies can be found and extracted. Biopsy samples of tumors and other lesions can also be easily collected.

  • Upper GI tract (stomach and upper intestines)
  • Lower GI tract (colonoscopy)
  • Rhinoscopy (nasal passages)
  • Bronchoscopy (lungs)
  • Cystoscopy (bladder)

Laparoscopy

Internal organs in the abdominal cavity can be visualized directly with this minimally invasive method. Biopsy samples of tumors or other abnormalities can also be easily collected.

Thoroscopy

Internal organs in the thoracic cavity can be visualized directly with this minimally invasive method. Biopsy samples of tumors or other abnormalities can also be easily collected. Dr. Harnett and Dr. Cordner can perform a number of procedures with this method including Partial Pericardiectomy.

Chemotherapy

Our chemo patients are very special to us. During the course of your pets treatment a dedicated nurse will work closely with your family to ensure your pets comfort and well-being. Dr. Harnett has been treating animals with cancer for over ten years and is able to treat a variety of cancers with chemotherapy. We commonly treat patients with lymphoma, mast cell tumor, melanoma, osteosarcoma, and other cancers of dogs and cats. Pets generally tolerate cancer chemotherapy better than humans and experience a good quality of life.

Minimally Invasive Diagnostics

Biopsy of certain tissue or fluid samples may require a complicated procedure best done by an internist.

Bone marrow aspiration

To obtain a cytologic sample of bone marrow a bone marrow aspiration is performed. This involves placing a needle through the bone into the marrow cavity and withdrawing cells. In some cases a large sample is needed, in which a bone marrow biopsy is performed. This involves placing a large needle into the bone marrow to obtain a tissue sample. To keep pets comfortable through the procedure a local anesthetic is injected into the marrow site. Some pets may be given sedation with the anesthetic. The illium (part of the pelvis), femur (thigh bone), humerus (upper arm bone), or ribs are sites most commonly aspirated or biopsied.  Samples are submitted to a veterinary pathologist who evaluates all components of the bone marrow and offers an evaluation to assist your veterinarian with a diagnosis. Results typically take about one week to receive.

Blood pressure monitoring

Patients may need to have their blood pressure monitored for a variety of reasons.  Some patients may have underlying disease processes, such as hyperthyroidism or cardiomyopathy, which predispose them to blood pressure abnormalities.  Other pets may get into certain human medications which can negatively affect their blood pressure.  All patients undergoing surgical procedures have their blood pressure monitored closely to ensure they are doing well under anesthesia.  We have two systems to measure your pet’s blood pressure:  Oscillometric and Doppler.  The oscillometric system gathers automated computer generated readings, while the Doppler system uses an ultrasound crystal probe to detect the blood pressure reading by the sound frequency changes heard.  Our nursing staff is skilled in both techniques and are able to provide doctors with timely updates on a patient’s blood pressure changes.

Interventional Radiology

Interventional radiology (IR) refers to advanced imaging techniques including ultrasound, and fluoroscopy (continuous x-ray), and is used to guide the delivery of materials for diagnostic and therapeutic purposes. Examples would include endoscopic placement of tracheal urethral, and esophageal stents. This minimally invasive approach to treatment facilitates shorter hospital stays, decreased pain, and a more rapid return to function.

Advanced laboratory testing

Our in-house diagnostic laboratory allows us to run tests and get immediate results.  Blood tests are used to look for signs of infection, evaluate organ function, and detect effects of some toxins. Our laboratory machines check blood cell counts, metabolic profiles, and clotting times and aid in the diagnosis of diseases and ailments including: feline leukemia, feline heartworm, feline immunodeficiency virus, canine heartworm, Lyme Disease, ehrlichiosis, anaplasmosis, feline hyperthyroidism, canine pancreatitis, canine Addison’s and Cushing’s Disease, as well as portosystemic liver shunts. We can also evaluate urine, fecal and other samples to look for infection, cancer and  evaluate organ function. In some cases it may be necessary to submit samples to outside labs for further diagnostics. These outside laboratories are able to perform a wider range of testing for more complicated cases.