Tidewater Veterinary Internal Medicine / Services

Scroll down to read about common services offered at Tidewater Veterinary Internal Medicine:

Exam & Consultation

A detailed history of your pet's
condition is obtained and any recent records that you bring to the appointment are reviewed. Your pet is then given a full medical exam. This process assures your pet benefits from a second opinion as a routine part of the visit. Procedures and tests are never performed without first obtaining a full medical history and completing a thorough exam of your pet.

Ultrasound

Ultrasound is the most common procedure we perform and enables us to literally look into the body to assess the health of various organs. It is generally far superior to radiographs in evaluating the abdomen. There are limitations to ultrasound - it does not differentiate benign from malignant tumors, and it does not assess actual organ function. In addition, ultrasound has little to no benefit is assessing the esophagus, lungs, and bone. You may view a video clip of an ultrasound evaluation on the "Video" webpage on this website.

Endoscopy

Endoscopy is also a common procedure we perform. We offer endoscopy of the nose (rhinoscopy), lungs (bronchoscopy), upper gastro-intestinal tract (gastroduodenoscopy) and lower intestinal tract (colonoscopy). To perform an endoscopy, the patient must be anesthetized. Biopsies are usually obtained during the procedure and the samples are about the size of a match head. The procedure is performed on an outpatient basis, and there is little to no discomfort to the patient from the procedure. You may view larger video clips of endoscopic procedures on the "Video" webpage on this website.

Gastroscopy video

Rhinoscopy video

Biopsies

We commonly perform needle biopsies and needle aspirates. These are performed under the guidance of ultrasound imaging, so the needle can be placed exactly in the area we wish to sample, as can be seen in the video to the left. This procedure enables us to obtain tissue samples from many different organs within the body, including the liver, spleen, kidneys, lymph nodes, and growths or tumors. This procedure is especially helpful in evaluating for different types of cancer. Check our "Video" webpage for other clips.

Splenic aspirate video

Cardiology

We offer echocardiography
and EKG testing for our patients. An echocardiogram is an ultrasound evaluation of the heart and is considered the gold standard in evaluating heart disease. An EKG traces the electrical activity in the heart and is needed to assess for rhythm disturbances. For those patients with more complicated or severe heart disease, we recommend evaluation by Dr. Merrilee Small, a board-certified veterinary cardiologist. Her phone number is 499-5463.

Chemotherapy

Great strides have been made in treating cancer in pets over the past decade, and chemotherapy is often a very viable treatment option for some pet cancers. There is a great deal of misperception regarding chemotherapy in pets - while side effects are always a concern, most pets tolerate the treatments amazingly well and enjoy an excellent quality of life. Pets do not lose their fur, although they can lose their whiskers (especially cats). A complete web page addressing chemotherapy will soon be available on this website.

Complete Lab Testing

We offer complete laboratory testing. When time is of the essence, we can perform cbc and chemistry analysis and obtain results within an hour. For non-critical patients, or for more extensive testing, we prefer to utilize a commercial laboratory, such as Antech or Idexx Labs. Commercial labs generally have far superior quality control, and the cost of testing is often less to the client.

Biopsy procedures
We commonly obtain tissue samples with a needle during ultrasound procedures. Tissue samples are often needed to confirm a diagnosis, or differentiate a benign tumor from one that is malignant. Two different types of needle procedures are offered. A Needle Aspirate is the most common type of sample with obtain. This procedure uses a thin, hypodermic needle (the same size as those used for vaccinations but longer) to obtain a very small tissue sample. This procedure can often be done without sedation and performed at the same time as the initial ultrasound. Results usually take 1-2 business days. The limitation of this procedure is that the sample is very small, and sometimes the sample size is too small for a diagnosis. The other procedure that can be performed is a Needle Biopsy. This procedure usually requires heavy sedation or anesthesia, because the needle is much larger. Clotting tests are also usually needed prior to performing a needle biopsy to ensure there is no additional risk of bleeding. The advantage to this procedure is that a larger tissue sample is obtained for the lab, but the procedure usually must be scheduled in advance.

Additional Services

Anesthesia: We utilize the safest available anesthetics to provide an extra margin of safety, especially for our older or high-risk patients. Patient's vital signs, including ekg and blood pressure, are continuously monitored during all anesthetic procedures by a licensed veterinary technician. Geriatric and higher risk patients are the norm for our practice, and serious anesthetic complications are rare.


Pharmacy:  We have a limited pharmacy consisting of those medications used most commonly in a specialty practice. We also frequently utilize human pharmacies for unusual medications or drugs that are too expensive to keep in stock (no, you cannot put your pet on your own insurance plan!)  Because of the difficulty administering medications to some pets, particularly cats, many medications can be compounded into flavored forms by select local and national pharmacies. A list of these pharmacies is being developed elsewhere on this website.


Emergency and Critial Care: Patients that require after-hours emergency care or hospitalization will be referred to one of the local emergency practices. We enjoy a close working relationship with Tidewater Veterinary Emergency and Critical Care at 5425 Virginia Beach Blvd, but we are happy to work with any of the other emergency practices in Hampton Roads should your pet require emergency or critical care.