Oncology

Routine behavior problems can frequently be handled by your general practitioner veterinarian. The conditions listed below, however, frequently require the attention of a specialist.
- House soiling or house training problems
- Litter box refusal or rejection
- Destructiveness
- Aggressiveness toward people, including children
- Aggressive conflicts between housemates
- Nipping and unruly puppies or kittens
- Difficulties introducing new pets
- Separation anxiety syndrome
- Fears and phobias
- Compulsive behaviors
- Seizure-related behavior problems
- Geriatric behavior problems in aging cats and dogs
 

Just like a psychiatrist, veterinarians who specialize in veterinary behavior acquire additional, intensive training to become a specialist. Prestigious specialty status is granted by the American College of Veterinary Behaviorists (ACVB). There are only a few dozen veterinary specialists in all of North America. A veterinarian who has received this specialty status will list the initials DACVB (Diplomate of the American College of Veterinary Behaviorists) after his or her veterinary degree. The word -Diplomate- typically means the specialist has achieved the following:
- Obtained a traditional 8-year veterinary degree (four years of college plus four years of veterinary school).
- Usually has completed a one-year internship in small animal medicine and surgery.
- Completed an additional residency in veterinary behavior at a university veterinary hospital.
- Completed the credentialing application process established by the ACVB, which includes publishing credits, case reports, and a resume.
- Passed a rigorous, 20 hour written examination conducted over 2 days.
After completing and passing all of the above, his or her peers recognize the veterinarian as a board certified specialist in veterinary behavior. As you can see, when your pet needs the specialized care of a veterinary behaviorist, the intensive training and additional education will provide you and your pet with the best treatment and the greatest chance of successfully resolving the behavior problem you are trying to overcome. Forming a team with an experienced veterinary behaviorist is the best way to deal with a misbehaving pet.
 

Your veterinary behaviorist will advise your veterinarian of any recommended treatment and your veterinarian will continue to be involved as part of your pet's total veterinary health care team. Your general practitioner veterinarian will still oversee all aspects of your pet's care, but with the added, specialized input of a veterinary behaviorist. For example, if a veterinary behaviorist discovers that your pet has thyroid disease, this clinical diagnosis is relayed immediately to your general practitioner veterinarian, who will treat your pet's thyroid disease. The veterinary behaviorist will also give you a treatment plan to follow that will help to resolve the behavioral problems your pet exhibited that were associated with the discovered medical condition.
 

Veterinary cardiologists are often called upon when a pet is suffering from a suspected heartworm infection. Although there are excellent preventive medications on the market, veterinarians still see cases of this dreaded disease either due to owners forgetting to administer the preventive medication or not realizing that their pet is at risk in a particular region or time of year. The good news is that, at least for dogs, treatment options have improved. There are drugs that can be administered to remove the worms. Cases of heartworm infection in cats, although comparatively more rare, are more difficult to deal with. When a heartworm infection is detected in cats, the treatment is typically limited to close monitoring of the cat and supportive care until the worms die off. In rare cases, surgical removal of the worms may be recommended.
 

The veterinary cardiologist will start with a complete physical exam. Canine or feline heart murmurs can often be heard and detected with a simple stethoscope. The veterinary cardiologist will also check your pet's pulse rate, the color of the mucous membranes, as well as examine him or her for any physical evidence of fluid buildup in the abdomen or extremities. Other diagnostic tests that are useful when attempting to pinpoint or rule out heart disease include:

Chest X-Rays: These pictures allow the veterinary cardiologist to assess your pet's heart and lungs and also provide information that can help tell the doctor whether or not your pet is suffering from congestive heart failure.

Veterinary Electrocardiogram (ECG or EKG): This test records the electrical activity of the heart and can tell whether heartbeats are normal or not. An ECG has a recognizable pattern showing the 'peaks and valleys' of the heart's activity. Each point on the tracing depicts how well each specific part of the heart is doing its job. An ECG can provide valuable information about a suspected arrhythmia.

Cardiac Ultrasound (Echocardiogram): This test allows the visual examination of the interior of the heart, its valves, and its surrounding structures via ultrasonography. It is a sophisticated diagnostic tool which, when combined with other components of a complete cardiac workup'"history, physical examination, cardiac and pulmonary auscultation, ECG, x-rays, and other pertinent tests'"can provide veterinary cardiologists with a complete diagnostic picture of your pet's illness and help outline a treatment course for him or her.

Doppler Echocardiography: A more advanced form of ultrasonography, this sophisticated technology can enhance the diagnostic information gained from standard two-dimensional ultrasounds. In short, sound waves are bounced off of moving red blood cells in order to determine the movement and force of blood flow within the heart. There are three types of Doppler ultrasound: continuous wave, pulsed wave, and color flow. Each type is helpful in diagnosing and/or assessing the severity of different types of heart problems.

Holter Monitor: This is a 24-hour continuous ECG recording that can provide information about heart activity while the pet is at home and engaged in normal activities. The pet wears the monitor in a specially fitted vest.

Blood Pressure Monitoring: Your pet's blood pressure can be checked and monitored in much the same way as is done in people.

 

A veterinarian who has been awarded this specialty status by the ACVIM will list the initials, 'DACVIM (Cardiology),' after his or her DVM degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVIM (cardiology). The word 'Diplomate' typically means the specialist has achieved the following:

• Obtained a traditional veterinary degree (three to four years of college plus four years of veterinary school).
• Complete a one year internship and an additional two to three years of advanced training, including a residency at an approved program where the doctor will have trained with some of the best experts in the field and obtained hands on experience. As part of their training program, veterinary cardiologists receive extensive training in a variety of diagnostic imaging techniques, including veterinary echocardiography and angiography.
• Following this training, the aspiring veterinary cardiologist must pass a series of examinations covering all aspects of general internal medicine and veterinary cardiology.

After completing and passing all of these rigorous requirements, the veterinarian is then recognized by peers as a board certified specialist in veterinary cardiology, and will list the credentials, 'DVM, DACVIM (Cardiology),' after his or her name. When your pet needs the care of a veterinary cardiologist, years of intensive training and additional education will be focused on helping him or her to recover from his or her problem or enjoy the highest quality of life possible.

A heart murmur is a sound caused by turbulence in the cat or dog's blood flow. Murmurs can occur if valves in the heart are leaking, either due to congenital problems or age related changes. Pet heart murmurs are graded according to severity. Mild murmurs, especially in older dogs, may not require treatment.
 

Canine or Feline Heart disease refers to a condition where there is an abnormality of the pet's heart. Canine and Feline Heart failure exists when the heart is no longer able to meet the circulatory needs of the body. Symptoms of canine and feline heart failure include cough, edema, and rapid breathing. Symptoms of heart failure may be more pronounced in active pets as they are more likely to place a demand on their cardiovascular systems whereas the problem may go undetected in more sedentary pets.

The severity of pet heart failure is often staged, using the following guideline:

Asymptomatic: Heart disease may be detectable in the pet but there are no outward signs. A cardiac murmur or arrhythmia may be present.

Mild to moderate heart failure: Clinical signs of heart failure are in evidence at rest or with mild exercise.

Advanced heart failure: Critical clinical signs, such as respiratory distress, ascites (fluid in the body cavity), and profound exercise intolerance, are in evidence. With each advancing stage, the prognosis worsens and the need for treatment of the dog or cat increases.

Chronic Value Disease (CVD), or endocardiosis, is a group of diseases characterized by degeneration and fibrosis of the heart's mitral and/or tricuspid valves. It most commonly affects the mitral valve in dogs, cats, and horses. It is less common in cats, but occurs more commonly in the smaller dog breeds, particularly the miniature poodle, Shetland sheepdog, dachshund, and cocker spaniel.
 

While valve disease is the more common heart ailment in smaller breeds of dogs, larger breeds are more prone to suffer from dilated cardiomyopathy. Dilated cardiomyopathy involves the dilation and thinning of the heart's chambers, which can lead to lowered heart function and, eventually, congestive heart failure.
 

The most common heart disease in cats, hypertrophic cardiomyopathy (HCM) is a heart muscle disease in which the walls of the heart, specifically the left ventricle, become abnormally thickened. As the disease progresses, it alters the structure of the heart and impairs its function. It is a potentially serious
disease that is found in cats of all ages. A cat that seems healthy can suddenly become very ill or even die. There currently is no cure, although there are medications veterinarians and veterinary cardiologists can prescribe to help alleviate the symptoms.
 

This is a buildup of fluid in the membranous sac surrounding the pet's heart. This can be caused by various types of heart tumors although, in many cases, no apparent cause can be found. If a large amount of fluid is present, it can compress the heart and prevent it from working properly. Heart sounds will be muffled and, on x-rays, the heart may appear balloon-like due to the presence of the fluid.
 

Just as your own primary care physician may feel the need to refer you to the care of a specialist from time to time, your general practitioner veterinarian may feel your pet needs a veterinary cardiologist to help diagnose or treat a problem. While your general practitioner veterinarian can handle many aspects of your pet's care, just as in human medicine, there is sometimes a need for the attention of a specialist. You can be assured that a veterinarian who knows when to refer you and your pet for more specialized diagnostic work or treatment is one that is caring and committed to ensuring that your pet receives the highest standard of medical care for his or her condition. While in some cases, your veterinarian may be able to simply consult with a specialist about your pet's care, in other cases it is necessary to actually refer you and your pet to the specialist for more advanced diagnostics and treatment. Board certified veterinary cardiologists also have access to specialized diagnostic or treatment tools that a general practitioner veterinarian may not have.  

The first step is to obtain a doctorate of veterinary medicine at a recognized school. Then the veterinarian must complete a minimum 3 year residency of intense training in emergency, critical care, and surgery through a program approved by the American College of Veterinary Emergency and Critical Care (ACVECC). The resident focuses on the most up to date techniques for diagnosis and treatment of life-threatening disease processes in an emergency and for the critical time the animal is recovering. The resident is supervised by DACVECC mentors and monitored by the ACVECC. Upon completion of these 3 years of comprehensive training, the veterinarian must pass a difficult board certification examination given by the ACVECC. Once successful, the veterinarian is a Diplomate of the American College of Veterinary Emergency and Critical Care, is termed a specialist, and is ‘board certified’. Only those who have gone through this grueling process can hold the title of Board Certified in Veterinary Emergency and Critical Care.

Any pet that is seriously ill might benefit from this type of care. The following is a sampling of the types of patients that routinely benefit from care by an Emergency and Critical Care Specialist.

• Trauma patients, including those who have been hit by a car, bite wounds, bullet wounds, knife or burn injuries.
• Any animal that is having troubles breathing
• Patients who may be in need of assisted breathing/ventilation
• Any patient that is in shock (signs of shock can include weakness, pale mucous membranes in their mouth, cold extremities, and an abnormal heart rate)
• Animals that are having trouble urinating or are not producing urine
• Dogs or cats that need specialized nutritional support because they are unwilling of unable to eat on their own
• Animals in which abnormal heart rhythm is causing problems
• Animals with life threatening neurologic disease such as coma or severe seizures that are not responding to medications
• Patients that have had surgery and are not recovering well from anesthesia or are having trouble in the first few post-operative days.

While the quality of dental care we can now offer to pets is very similar to what humans enjoy, there is one important difference: you can't explain to your pet what is happening and why. For that reason, pets must be anesthetized for anything other than the most cursory of examinations. In order to perform a thorough checkup, your veterinarian or trained veterinary dental technician needs to be able to visualize all your pet's teeth'"even those in the back of his or her mouth'"and be able to access the entire mouth with instruments during the cleaning procedure. For more complicated procedures, such as tooth extractions, oral surgery, and root canal, it is essential.
 

The best answer is with prevention. Starting at the age of one year, your pet should have an annual dental examination and cleaning. While the damage caused by periodontal disease is generally irreversible, it can be stopped and treated with antibiotics and regular cleaning. In between your pet's examination, you should follow your veterinarian's advice regarding home dental care for your pet, including daily tooth cleanings and special dental care diets and treats. There are several stages of periodontal disease. The first stages can be treated with cleanings, medications, and scalings. At the later stages, surgery is necessary to treat the affected teeth.
 

While there is always a slight risk when using anesthesia on a pet, or even a person for that matter, today's veterinary anesthetic agents are extremely safe. To further maximize your pet's safety, your veterinary team will recommend preanesthetic testing to make sure there are no hidden health problems that could compromise your pet's ability to undergo the procedure. In addition, your pet will be monitored while under the anesthesia and during recovery. The risk of disease from dental problems is far greater than any risks presented by the anesthesia. Owners are often especially concerned about anesthetizing older pets. However, many dental problems can be extremely painful as well as contribute to the development of systemic disease. With pets today living longer and longer, owners must weigh, in consultation with their veterinarian, the risks and benefits of allowing an older pet to possibly live years with a painful condition.
 

Veterinarians who want to become board certified in veterinary dentistry must seek additional, intensive training to become a specialist and earn this prestigious credentialing. Specialty status is granted by the American Veterinary Dental College (AVDC). A veterinarian who has received this specialty status will list the initials, 'DAVDC,' after his or her DVM degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the AVDC. The word 'Diplomate' typically means the specialist has achieved the following:
 

Obtained a veterinary degree (three to four years of college plus four years of veterinary school).

Completed at least an additional two years of advanced training, including a residency at an AVDC approved facility or other AVDC approved alternate program. Dental residents must complete a case log of at least 500 cases as well as prepare case reports. Because veterinary dentists must anesthetize pets, take radiographs, and perform surgery, they are also required to complete additional, intensive training in the field of anesthesia, surgery, and radiology.

Completed the credentialing application process established by the AVDC.

Passed a rigorous examination.

After completing all of these requirements, the veterinarian is then recognized by his or her peers as a board certified specialist in veterinary dentistry. When your pet needs the care of a veterinary dentist, years of additional training and education will be focused on helping him or her to recover and enjoy the highest quality of life possible.

The easiest way to introduce a pet to home dental cleanings is to start when it is a puppy or kitten. It is important for youngsters to learn to allow you to examine their mouths, both for dental cleanings and to administer medications if need be. Even if your pet is older, however, it can still be trained to accept a home dental cleaning by being patient and consistent with your efforts.
If your pet does not like to have his or her mouth touched, start with very small steps. Start with touching one tooth at first each day, and then very gradually, over a period of days, weeks, or even months, work toward getting your pet to allow you to brush its entire mouth.
If your pet seems afraid of a pet toothbrush, try using a finger brush or even a piece of gauze wrapped over a finger at first.
Make sure you only use toothpaste made specifically for pets. Pet toothpaste tastes good to pets and, most importantly, will not lead to upset stomachs.
If your pet will not safely tolerate your putting your hands in its mouth, don't risk being bitten. Inform your veterinarian and he or she will schedule more frequent dental cleanings as necessary or provide you with other training advice.
Ask your veterinarian for recommendations regarding special dental care diets and treats that will help you and your pet fight plaque buildup in between cleanings.
And remember, the best homecare tip is to start early while pets are young by making home dental cleanings part of your regular daily grooming routine.

Do you think your pet needs a specialist in veterinary dentistry? Talk to your veterinarian or find a VCA board certified veterinary dentist near you.

 

Broken teeth in pets, especially in dogs, are common, either as a result of chewing on something hard, or from trauma, such as being hit by a car. Broken teeth need to be treated. Just as in people, a broken tooth or one with a fracture exposes the nerves and blood vessels inside the tooth (the pulp) to the outside air and to infection. This can be extremely painful for pets, and leaving a broken tooth in place untreated is not an option because it can lead to chronic infection, abscess formation, and loosening or loss of secondary teeth.

There are two treatment options: extraction, or root canal. Performing a root canal will save what is left of the broken tooth by cleaning out the pulp inside and filling it with an inert material so that it cannot become reinfected'"the same process as in humans. Where root canal is not an option, the tooth should be extracted. In this case, your veterinary team will recommend medications to help reduce pain and maximize healing.
 

Sometimes called cat cavities, neck lesions, or cervical line lesions, these are painful lesions that most commonly affect the lower premolars in a cat's mouth. Cats with FRLs may salivate excessively, bleed from the gums, and have difficulty eating. Keep in mind that a majority of affected cats, however, do not show any outward signs of having one of these painful lesions. When suspected, radiographs are essential to determine if the lesions have entered the pulp chamber of the tooth. In that case, either root canal therapy or extraction would be required.
 

This disease is one of the most common mouth problems of dogs and cats. Periodontal disease is an infection caused by the bacteria found in dental plaque. Unfortunately, bacteria can be present on even healthy looking teeth. Gingivitis, which is another term often mentioned in connection with dental disease, is an inflammation of the gum area that causes reddened and swollen gums. It is a common, visual sign of underlying periodontal disease.

Periodontal disease first occurs when plaque and tartar begin to build up on your pet's teeth. In the beginning, plaque might simply appear to be discoloration or staining on the teeth. Without regular dental examinations and cleanings, however, this plaque builds up and turns into tartar, or calculus. This is the visible material you can sometimes see encrusted on the teeth and along the gum line of a pet's mouth. Tartar can damage the bone in your pet's teeth, as well as the bony socket that holds each tooth in place. It can dig into the gums at the base of your pet's teeth and form pockets, where bacteria can become trapped and cause infections.

This condition is very serious in pets because, if left unchecked, it eventually leads to the destruction of each affected tooth's supporting structures, causing pain, infection, and tooth loss. The infection can also result in bacteria entering the bloodstream and damaging other organs or body systems in your pet, such as the kidney, liver, and heart. It can complicate other underlying diseases, such as diabetes or chronic sinusitis.
 

Dental x-rays are becoming the standard of care for pet dentistry, just as they are in human dentistry. Without radiographs, or x-rays, it is impossible for the veterinary dentist to detect problems below the gum line or within the tooth itself. Radiographs are necessary before deciding on a course of therapy in order to help determine, for example, how extensive a tooth fracture is.
 

A thorough cleaning removes plaque and tartar both above and below the gum line. This is necessary to prevent periodontal disease and all the associated health problems that we have outlined above. While dental cleanings may seem like an added expense, they are actually a very cost effective investment in your pet's continued good health. Caught early, dental problems are easy to treat. Neglected, they can turn into serious and painful problems.
 

Imagine what your mouth and teeth would look and feel like if you never brushed them or visited your dentist. That unappealing picture is the same for your pet. Without proper dental care, your pet will most likely suffer from bad breath, inflamed gums, missing, loose, or broken teeth, and all of the pain and discomfort such problems can cause. In addition, veterinary experts have found that dental disease can also lead to systemic health problems in dogs and cats. The good news, however, is that dental disease is easily prevented by following your veterinarian's recommendations regarding dental examinations, home care, and dental cleanings.
 

It goes without saying that the best way to avoid an emergency is to prevent it in the first place. To reduce the chances that you will experience an emergency situation during the lifetime of your pet, consider the following tips:

• Follow your veterinarian's advice regarding all relevant wellness care, including vaccinations, age appropriate health screenings, and parasite prevention.
• Prevent traumatic injury by keeping pets under your control at all times. Keep cats indoors and dogs fenced. When pets venture outdoors, keep them leashed at all times. If you do allow them off leash, limit this privilege to large enclosed areas away from traffic, other potentially aggressive pets, and wildlife.
• Invest the time in training your pet to obey simple commands, such as Come, Sit, Down, Stay, and No.
• Never leave your pet alone or unattended in a car, even with the windows open.
• Pet proof your home, removing all potential hazards from your pet's reach, much the same as you would do with an infant or toddler.
• Supervise your pet as much as possible. Puppies and kittens, just like human babies, like to explore with their mouths. Supervising them during playtime can prevent their ingesting poisonous substances or choking hazards.
• If your pet is coping with a chronic illness, carefully follow all of your veterinarian's recommendations regarding medication administration and check ups.
   

• Make sure you know ahead of time what your veterinarian's policy is regarding emergency care, both during regular practice hours and after hours. If your veterinarian does not have a referral relationship in place, then make sure you know the location of the closest emergency referral center for your area.
• If your pet has an ongoing medical problem that could result in a sudden emergency, make sure you keep any pertinent medical records in a handy place so that you can quickly locate them and bring them with you to the emergency service or hospital in the event of a crisis.
• Keep your veterinarian's phone number and any emergency phone numbers and directions next to your phone along with all other important emergency information for your family.
• Know basic first aid tips for pets. Ask your veterinarian for these ahead of time during a routine wellness exam

Handle With Care

Pain, fear, and shock can make animals behave differently. When you are faced with a pet emergency, remember that even the most well trained and loving pet can behave differently when feeling ill or in pain. Also realize that even relatively small animals, such as cats or small dogs, are capable of inflicting serious bite and scratch wounds when they are disoriented and in pain. If this occurs, it is important not to take such actions personally, but to realize that it is an expression of the extreme pain or disorientation your pet may be experiencing at the time.

Approach all injured pets with caution. Despite your natural wish to comfort your ill or wounded pet, do not place your face or hands near his or her head until you can assess your pet's condition. If you feel you cannot safely manage the emergency situation, ask your veterinarian for advice on how to handle and transport your pet when you call to report the emergency. Sometimes wrapping small, injured pets in towels (taking care not to cause further injury or pain) or placing larger pets in crates or carriers for transport may be the safest option for both you and your pet.

Radiation oncologists use a linear accelerator, a machine that directs beams of energy, to treat specific areas of your pet's body. Radiation therapy works by sterilizing the targeted tumor cells, making them unable to reproduce and grow and resulting in tumor shrinkage. Your veterinary oncologist or internal medicine specialist will develop a radiation treatment plan in conjunction with the radiation oncologist.
 

Veterinarians who want to become board certified in radiology must seek additional, intensive training to become a specialist and earn this prestigious credentialing. Specialty status is granted by the American College of Veterinary Radiologists (ACVR). A veterinarian who has achieved this specialty status will list the initials, 'DACVR,' after his or her DVM degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVR. The word 'Diplomate' typically means the specialist has achieved the following:
 

Obtained a traditional 8-year veterinary degree (four years of college plus four years of veterinary school).

Completed an additional three years of advanced training, including a residency at a veterinary teaching hospital or approved alternate position where the veterinarian will have trained with some of the best experts in the field and obtained hands on experience.

Completed the credentialing application process established by the ACVR.

Passed a rigorous examination.

Board certified veterinary radiologists may seek additional credentialing in radiation oncology, a recognized affiliate of the ACVR. These veterinarians are specially trained to provide radiation treatments to veterinary cancer patients. After completing and passing all of these rigorous requirements, the veterinarian is then recognized by his or her peers as a board certified specialist in veterinary radiology, with any areas of special emphasis noted. When your pet needs the expertise of a veterinary radiologist, years of intensive training and additional education will be focused on helping to properly diagnose the problem and establish the optimal treatment course
 

The expertise of a board certified veterinary radiologist is helpful in any of the following situations:
 

Surgical cases
Internal medicine cases of all kinds

Trauma cases (when assessing the extent of injury)

Brain, spinal cord, or disc problems

Tumor evaluation Biopsies Cancer treatment (radiation oncology)
 

A contrast agent is a substance that is administered to your pet intravenously that helps determine the amount of blood flow to a particular tissue area. This contrast agent can help the veterinary radiologist determine whether the tissue is normal, inflamed, or cancerous. The agent can also help determine the edges of where abnormal tissue ends and normal tissue begins.

If your pet is in need of a specialist in veterinary radiology, discuss it with your VCA general practitioner vet or find a board certified VCA veterinary radiologist near you.

Some areas of your pet's body are difficult to view with conventional radiographic techniques. Both CT and MRI can sometimes provide more accurate views or additional information that would not be available through routine radiography. All diagnostic imaging techniques'"CT, MRI, radiographs, ultrasound'"are especially helpful to veterinarians as animal patients cannot tell us what is wrong.
 

A veterinarian who has been awarded this specialty status by the ACVIM will list the initials, 'DACVIM (Neurology),' after his or her veterinary degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVIM. The word 'Diplomate' typically means the specialist has achieved the following:

• Obtained a traditional 8 year veterinary degree (four years of college plus four years of veterinary school).
• Completed a one year internship and an additional two to three years of advanced training, including a residency at an approved program where the doctor will have trained with some of the best experts in the field and obtained hands on experience.
• Following this training, the aspiring veterinary neurologist must pass a series of examinations covering all aspects of general internal medicine and neurology.

After completing and passing all of these rigorous requirements, the veterinarian is then recognized by his or her peers as a board certified specialist in veterinary neurology. Many veterinary neurologists are also trained in neurosurgery, while others limit their practice to the medical aspects of the discipline and work with a surgeon on the cases requiring surgery. When your pet needs the care of a veterinary neurologist, years of intensive training and additional education will be focused on helping him or her to recover from his or her problem or enjoy the highest quality of life possible.

• Epilepsy
• Congenital deafness
• Viral infection (canine distemper, feline infectious peritonitis, feline leukemia, rabies)
• Fungal infection (Cryptococcus, Coccidioides)
• Tick-borne infections (Rocky Mountain Spotted Fever, Ehrlichia)
• Granulomatous Meningioencephalitis (GME)
• Myasthenia gravis
  Hypoglycemia
• Hepatoencephalopathy (brain dysfunction due to liver disease)
• Hypothyrodism
• Toxicity due to pesticides, lead, ethylene glycol (antifreeze), certain antibiotics
• Nutritional disorders, such as thiamine or vitamin E deficiency
• Traumatic brain or spinal cord injury
• Degenerative myelopathy
• Cancer

• Behavior changes
• Altered consciousness (e.g., depression, disorientation, coma
• Seizures
• Complete or partial paralysis
• Neck or back pain
• Generalized weakness or weakness in one area of the body
• Incoordination or imbalance
• Gait or stance abnormalities (e.g., straddling or shuffling of rear limbs; crouched position)
• Loss of sensory function (sight or hearing)
• Confusion
• Head tilt
• Tremors
• Fecal or urinary incontinence
• Inappetence

In some cases, your veterinarian may be able to simply consult with the Veterinary Neurologist about your pet's care. In other cases, it is necessary to actually refer you to the specialist. Veterinary Neurologists are trained in state of the art diagnostic techniques and will utilize advanced imaging such as CT or MRI scans to look at the structures of the nervous system. With electrodiagnostic tests, a neurologist can examine the function of the peripheral nervous system, particularly the nerves and muscles. Spinal fluid analysis can provide clues to such infectious diseases as encephalitis or meningitis. Veterinary Neurologists also will be able to make appropriate recommendations for your pet's rehabilitation period, especially after such major procedures as back surgery. Lengthy recuperation times can be necessary, and your pet may be referred to rehabilitation facilities offering such services as water or physical therapy. Pain management will also be addressed.

Depending on the source, the incidence of epilepsy among the general pet population is estimated at between 0.5 and 2.3%. Epilepsy refers to chronic, recurrent seizures and can be inherited or acquired. Thus, epilepsy is a clinical condition, not a specific disease. Idiopathic epilepsy refers to recurrent seizures in which no identifiable cause is found to explain the seizures, such as metabolic disease, toxin exposure, encephalitis, or brain tumors. Seizure diagnosis involves ruling out common causes of seizures. Initially, your veterinary neurologist will likely order a series of blood tests to help rule out metabolic and toxic causes of seizures. Depending on the age of your pet, the course of the seizures, and the results of the neurological examination, the neurologist may recommend an MRI or CT scan of the brain and/or a spinal fluid tap to look for signs of encephalitis or brain cancer.

Idiopathic epilepsy is most common in purebred dogs, with an age of onset between one and five years of age (often before three years). Dogs and cats with idiopathic epilepsy are completely normal between seizures and have a normal neurological examination.

If your pet's first seizure occurs before 1 year of age or after 5 years of age, is not normal between seizures, or if there are any abnormalities on neurological examination, the veterinary neurologist may recommend advanced diagnostics, such as an MRI of the brain, to help determine the cause of the seizure.

• Bloodwork
• X-rays of the chest, spine, etc
• Advanced imaging such as MRI and CT
• CSF tap: Cerebral spinal fluid removed from the spinal cord and analyzed
• Electromyography: Electrical impulses are used to diagnose the function of nerves and muscles
• Imaging techniques such as MRI and CT

Neurological examinations typically proceed from head to tail, with all areas of the body being given systematic attention in that order. In addition, your pet may be videotaped for future reference and to help train other veterinarians.

Mental status: The pet will be observed to determine whether it interacts normally with its owner, other people and animals, and the environment.

Gait and body posture: The veterinary neurologist will watch the animal walk around the room, in the hallway, or up and down stairs. Additionally, the neurologist will make observations regarding the animal's body posture.

Cranial nerve examination: The pet's senses of sight, smell, and hearing will be checked, as well as its ability to chew, swallow, and move its tongue, eye, and facial structures normally. Response to pain will also be checked.

Physical examination: The pet's body will be palpated for any signs of pain or muscle atrophy. The veterinary neurologist will also perform a number of tests with the pet's limbs to check reflexes and reactions, such as turning a pet's paw over to see if the pet will reposition it to the normal stance, and lifting a pet up off the ground and lowering it back down to see how it positions its legs upon contact with the ground.

Reflex testing: Just as in humans, a veterinary neurologist may check a pet's reflexes as part of the examination process.
 

• Seizure
• Complete loss of function of any or all limbs
• Recurrent or intractable pain, specifically of the back and neck
• Head trauma
• Spinal trauma
• Severe depression or inability of the patient to respond to its environment
   

Veterinary neurology is a challenging field in that some diseases are solely neurologic in origin while in other cases, the neurologic problem may be related to an underlying systemic disease. In the first case, the veterinary neurologist may be able to treat the neurologic problem directly. In the second case, resolution of the neurologic problem may hinge on the correct diagnosis and treatment of the underlying disease. For example, certain viral infections may result in neurologic signs.
 

Just as in people, there is no proven way to keep your pet from getting cancer. You can, however, take steps to minimize the risks. Avoid any known predisposing causes, such as not spaying or neutering pets, or leaving pets exposed to sunlight. Also make sure your pet has regularly scheduled checkups and follow your veterinarian's advice regarding any necessary screening tests.
 

Any veterinarian who wants to specialize in oncology must first be certified as an internal medicine specialist. Veterinarians who want to become board certified in internal medicine must seek additional, intensive training to become a specialist and earn this prestigious credentialing. Specialty status is granted by the American College of Veterinary Internal Medicine (ACVIM). A veterinarian who has received this specialty status will list the initials, 'DACVIM,' after his or her DVM degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVIM. The word 'Diplomate' typically means the specialist has achieved the following:

• Obtained a traditional 8 year veterinary degree (four years of college plus four years of veterinary school).
• Completed an additional three to six years of advanced training, including a residency at a veterinary teaching hospital where the veterinarian will have trained with some of the best experts in the field and obtained hands on experience.
• Completed the credentialing application process established by the ACVIM
• Passed a rigorous general examination.

Once a veterinarian is board certified in internal medicine, he or she may seek additional specialty status in veterinary oncology. Internal medicine specialists must obtain additional training in this area and sit for a second, even more intensive examination. These doctors will list their credentials after their boarded status, for example, as 'DAVCIM (Oncology).'

When your pet needs the care of a veterinary internal medicine specialist/veterinary oncologist, years of intensive training and additional education will be focused on helping him or her to recover from the disease and/or enjoy the highest quality of life possible.

The goal of cancer therapy is to destroy abnormal cancer cells while sparing normal cells. An important difference in human vs. animal oncology is that the goal with humans, due to our extended life spans, is to cure the disease. In animals, the goal is more to extend the length of life while still maintaining its
quality. In many cases, a veterinary oncologist will combine some or all of the treatment options outlined below in order to provide the very best outcome for your pet.
 

Surgery

Radiation Treatment

Chemotherapy

Immunotherapy
 

Your veterinary oncologist will give you specific instructions regarding your pet's chemotherapy, but in general, you should be aware that pets typically handle chemotherapy regimens far better than people do. First, as cancer treatment for both humans and small animals has become more sophisticated, the side effects created by chemotherapy regimens have become less severe. Second, chemotherapy administration in animals is less aggressive than it is in humans, so animals typically do not become as sick from the side effects as do people.

Finally, veterinary oncologists have many options at their disposal to help keep your pet comfortable during treatment for his or her disease. From pain management options to special nutritional recommendations to medications that can help lessen the nausea associated with chemotherapy, be assured that veterinary oncologists can keep most pets surprisingly comfortable during treatment. In fact, one of the biggest hurdles to treating pets with cancer is that many owners imagine their pet's treatment will be more difficult than it really is.
 

Veterinarians who want to become board certified in small animal surgery must seek additional, intensive training to become a specialist and earn this prestigious credentialing. Specialty status is granted by the American College of Veterinary Surgeons (ACVS). A veterinarian who has received this specialty status will list the initials, 'DACVS,' after his or her DVM degree. Or, the veterinarian may indicate that he or she is a 'Diplomate' of the ACVS. The word 'Diplomate' typically means the specialist has achieved the following:

• Obtained a degree in veterinary medicine from a university certified by the American Veterinary Medical Association following completion of undergraduate requirements.
• Completed a one year general internship, plus an additional three to four years of advanced training in a residency at a veterinary teaching hospital where the veterinarian will have trained with some of the best surgeons in the field and obtained hands on experience. Surgery residents also have to complete a case log in soft tissue, orthopedic, and neurologic surgery.
• Completed the credentialing application process established by the ACVS, including publication of research results.
• Passed a rigorous examination.
• After completing and passing all of these rigorous requirements, the veterinarian is then recognized by his or her peers as a board certified specialist in veterinary surgery. When your pet needs the care of a veterinary surgeon, years of additional training and education will be focused on helping him or her to recover from injury or illness and enjoy the highest quality of life possible.

• Tumor removal
• Limb amputation
• Cruciate ligament repair (TPLO's and other traditional methods)
• Hip replacement
• Surgical repair of elbow dysplasia
• Spinal problems/herniated discs
• Gastric dilatation/volvulus
• Wound management and skin reconstruction
• Congenital defects
• Urinary obstructions
• Cancer Surgeries

Cancer does appear to be becoming more common in both dogs and cats, most likely because they are simply living longer. However, early detection and specialized care are leading to increased survival and cure rates in almost all the types of cancers that afflict pets. From surgery to chemotherapy to radiation therapy, veterinary cancer specialists can offer your pet the very latest diagnostic and treatment options and the best chance of survival. With optimal treatment, cancer in many cases simply becomes another manageable chronic disease.

Surgery is one of the most common treatment options for pets with cancer, and can lead to enhanced survival times and better quality of life for many affected pets. Your Veterinary Surgeon will work closely with your general practitioner or Veterinary Oncologist to ensure your pet is getting the very best care.

Three orthopedic surgeries that are commonly performed in pets are triple pelvic osteotomy (TPO), total hip replacement (THR), and cruciate ligament repair (TPLO).

In the TPO procedure, the bones of the pelvis are cut apart and rotated to more correct positions. In THR procedures, a dog's diseased hip joints are replaced with prosthetic ones. TPO's and THR's are two commonly used surgical techniques for the treatment of canine hip dysplasia (CHD), an inherited and potentially painful disease that affects the hip joints of millions of dogs. Cruciate ligament disease can occur in both dogs and cats, who usually tear or rupture this ligament while exercising, playing, or simply landing incorrectly after a jump. The ligament will not heal without surgery. Surgery helps to stabilize the pet's knee joint and prevent further wear on the joint and associated structures. An increasingly common surgical technique to correct this situation is called the Tibial Plateau Leveling Osteotomy or TPLO.

Surgery is a major medical procedure and is often associated with pain in both animals and humans. You can be assured that your veterinary team (your pet's family veterinarian, veterinary surgeon, and any other veterinary specialists involved in your pet's care) will prescribe pain management options to help keep your pet as comfortable as possible before, during, and after surgery. If you are concerned about pain management for your pet, simply ask your veterinarian.

Trans-cervical insemination refers to the placement of semen into the uterus by passing a small catheter through the cervix. Placement of the catheter is completed under direct visualization of the cervix using a special scope. Trans-cervical insemination is particularly useful when using frozen semen or when inseminating females that have difficulty conceiving.

In the female dog an ovulated egg must mature for several days before it is capable of being fertilized. The process of ovulation and subsequent maturation are not able to be identified by any external signs in the female such as '˜heat' or stud dog receptivity. Ensuring insemination at the expected time of egg maturation not only improves pregnancy rate but may also increase litter size.
What is a semen evaluation?

A semen evaluation in the dog and tom evaluates the sperm output and quality at a single time point in an individual male. In the dog, semen evaluation is completed as an outpatient procedure using manual stimulation. In the tom, semen evaluation is typically achieved via stimulation under general anesthesia. For both the dog and the tom ejaculate volumes, sperm count, movement and appearance are recorded and compared to species standards.
 

Pre-breeding evaluation of the male and female
Semen evaluation
Ovulation timing
Artificial insemination, both Vaginal and Trans-cervical
Whelping / Queening monitoring
Infertility evaluation
Non-surgical treatment of pyometra
Evaluation and treatment of prostatic disease
Evaluation and treatment of mammary neoplasia
Neonatology