Internal Medicine 

Internal medicine encompasses at least eight sub-disciplines which have in common organs, body systems and disease mechanisms not plainly visible to the outside.  These include cardio-respiratory medicine, endocrinology, gastroenterology, infectious disease, neurology, nephrology, oncology,  and urology.  Dr. David Brummer provides the expertise in these areas to pets from our own practice and for those sent here by their own veterinarian.  Should you wish to have your pet seen by our internist, please request that your veterinarian make a referral to Dr. David Brummer.

CARDIO-RESPIRATORY MEDICINE 

Conditions of the heart, lungs and chest are among the most serious which we diagnose and treat. Often a "cough" is the only sign an owner may see. As a non-specific sign, cough can be a result of heart, lung, upper airway, dental disease and others. The complex anatomical  interrelationships among the structures of the chest and the critical nature of the functions those structures perform combine to make diseases of these systems critically important to health and survival. Complete diagnostic testing is essential to obtain an optimal result. This testing will include blood and urine tests, electrocardiography and diagnostic imaging (X-ray images and often, ultrasonography).
 
CARDIO-RESPIRATORY MEDICINE SERVICES

Detailed history
Physical examination
Auscultation
Laboratory examination
Diagnostic imaging
Overall treatment plan
Client education
Oxygen therapy
Nebulization
Monitoring and follow up
 
 
ENDOCRINOLOGY
   
Endocrine disorders are a diverse group of ailments which include diabetes mellitus, adrenal gland disorders such as Addison's and Cushings diseases and thyroid disorders. Generally, several phases of laboratory testing are required to adequately characterize these illnesses and plan a treatment protocol. While most of these disorders are treatable, few are curable and therefore management for a good quality of life is the goal.  These disorders can have serious health consequences and therefore should not be ignored or regarded lightly. Follow-up evaluation to include regular laboratory monitoring is essential, even in the case of well controlled disease.
 

ENDOCRINOLOGY SERVICES

Detailed history
Physical examination
Initial laboratory examination
Diagnostic imaging
Provocative laboratory testing
Overall treatment plan
Client education
Monitoring and follow up
 
 
GASTROENTEROLOGY
 
After diseases of the skin, disorders and diseases of the digestive organs are extremely common. While most cases are fairly straightforward episodes of vomiting and/or diarrhea, there are enough other diagnostic possibilities to make this area challenging. The history of signs and the physical examination are particularly important to determine the likely severity of the problem. A variety of tests, imaging options and medications exist to allow specific diagnosis and treatment.
 
GASTROENTEROLOGY SERVICES
 
Detailed history
Physical examination
Initial laboratory examination
Diagnostic imaging
Contrast imaging
Endoscopy
Overall treatment plan
Client education
Monitoring and follow up
 
 
INFECTIOUS DISEASE
 
Infectious diseases are as numerous and varied as the types of microorganisms which exist to cause them. Bacteria, fungi, viruses and the recently prominent prions are all capable of causing disease under the right circumstances. They can be contracted from a variety of sources such as from other animals of the same or different species, from parasites such as fleas, flies, mosquitoes and ticks and from the environment. While similar symptoms may occur with many of these diseases, they are not usually specific to one organism. Reaching a conclusive diagnosis frequently requires serial laboratory testing and at times cannot be immediately narrowed down to a single possibility. Therefore, treatment generally begins simultaneously with the diagnostic process. Prognosis is generally good for recovery, however, there are disease-causing agents which cannot be eliminated. Prevention is a superior strategy and methods with which to accomplish that are the elements of Preventive Medicine.
 
INFECTIOUS DISEASE SERVICES
 
Detailed history
Physical examination
Baseline laboratory examination
Supportive care
Specific diagnostic tests
Diagnostic imaging
Overall treatment plan
Client education
Monitoring and follow up
 
 
NEPHROLOGY
 
Disorders of the kidneys are both common and relatively predictable in their signs. Often dysfunctional kidneys will cause an excess of urine production and a compensatory increase in thirst. Early diagnosis and initiation of treatment allows the best opportunity for provision of a good quality of life for the longest period. A strong reliance on laboratory testing for diagnosis and monitoring is essential to properly manage kidney disease.
 
NEPHROLOGY SERVICES
 
Detailed history
Physical examination
Initial laboratory examination
Diagnostic imaging
Overall treatment plan
Diuresis
intermittent Fluid administration
Indwelling catheter maintenance
Client education
Monitoring and follow up
 
 
NEUROLOGY
 
Treatment of neurologic disease is based upon localization of the site of the lesion in the nervous stem. The brain, spinal cord and peripheral nerves are distinct entities which have unique as well as shared disorders. The specialized neurologic examination is geared towards identifying this site and identifying the likely diagnostic possibilities. Following this, appropriate tests can be conducted to further characterize the disease process and guide treatment.
 
NEUROLOGY SERVICES
 
Detailed history
Detailed neurologic history
Physical examination
Neurologic examination
Gait analysis
Initial laboratory examination
Diagnostic imaging
Overall treatment plan
Client education
Monitoring and follow up Specialist referral
 
 
ONCOLOGY
 
A diagnosis of cancer, regardless of severity, is the most feared and misunderstood of all disease categories. Cancer is not just one disease, but is a diverse family of diseases. Only the underlying cause, the unchecked cellular division within a particular body tissue is common to all. We strive to convey to caregivers that quality of life is our primary goal, rather than simply prolonging life. We strive for a cure when possible, but when it is not, we advocate for the pet, the pet's comfort and quality of life. Treatment may involve medications, given orally or by injection ("chemotherapy"), surgery, radiation, cryotherapy (cold) or several of these in combination. Each cancer is managed individually and with due attention to the most current veterinary medical literature.

Thankfully, due to differing treatment goals between people and animals, pets do not suffer the degree or severity of post-chemotherapeutic side effects as do people. In fact, most pets treated with chemotherapy for cancer do very well.  They also don't seem to have the same side effects from treatment as humans do.   Of course, appropriate laboratory monitoring is essential to follow these pets carefully throughout their treatment. In many cases, a durable remission may be achieved and your pet will have an excellent quality of life and may be able to maintain full activity.
 
ONCOLOGY SERVICES

Detailed history
Physical examination
Initial laboratory examination
Cytologic evaluation
Diagnostic imaging
Biopsy specimen acquisition
Histopathology
Overall treatment planning
Chemotherapy planning
Oncologic surgery
Rescue protocol planning
Client education
Monitoring and follow up
End-of-life planning and decision making 
  
 
 
UROLOGY
 
While cooperative in function with the kidneys, the lower urinary tract has its own distinct functions and disorders. Symptoms of lower urinary tract disorders, while specific to the urinary tract, are frequently similar regardless of the underlying cause. Therefore, the history, physical examination, diagnostic test results and imaging studies are essential to reach a diagnosis and initiate definitive therapy.
 
UROLOGY SERVICES

Detailed history
Physical examination
Baseline laboratory examination
intervention supportive care
Specific diagnostic tests
Diagnostic imaging
Contrast imaging
Overall treatment plan
Client education
Medical and surgical management
Monitoring and follow up