If your normal vet has suggested referring your cat or dog to a veterinary internist, then you might want to know a bit more. Many owners have never had to consider this option previously and could be left feeling a bit confused. Here we’ll explore what an internist is and how they might be able to help your pet.
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What‘s a veterinary internist?
A veterinary internist is a vet who specialises in internal medicine. These vets have studied for extra qualifications giving them more in-depth knowledge and skills than a normal vet in general practice may have.
While some specialist vets may focus on very specific areas such as cardiology (the heart) or dermatology (the skin), an internist often needs to look at the animal as a whole. They work out what might be going wrong with your pet, by piecing together various bits of information. This occurs through speaking to you as the owner, examining the animal and performing relevant tests.
What tests do internists do?
As well as having more knowledge in veterinary internal medicine, internists are often able to perform and interpret more complicated tests than a normal GP vet – and more importantly, use them together to solve complex and often intractable medical problems. So, in addition to taking blood samples, they may run some of the following tests (depending on your pet’s condition):
Bone marrow biopsies
Small samples of bone marrow are taken for analysis in pets that have issues with their blood cell counts
Endoscopy
A small camera is used to examine areas inside the body such as the digestive tract or airways (bronchoscopy). Small samples of tissue can be collected for analysis this way too.
Joint taps
Taking samples of joint fluid to look for markers of infection or inflammation
Fine needle aspirates
Inserting a small needle into a suspicious area to take a sample of the cells there (for example a mass or a lymph node)
Biopsies
Taking small pieces of tissue for analysis, from things like tumours or organs in the body.
Ultrasound scans
While many vets in normal practice can perform a basic ultrasound scan, an internist may be able to perform a higher level of scan or have access to an ultrasonographer in their hospital who can.
Radiography and fluoroscopy
X-rays may be taken to help identify many issues. Some of these may require a contrast medium to highlight specific areas in the digestive or urinary tract. Fluoroscopy produces a type of ‘moving x-ray’ which can be particularly useful when looking at swallowing and digestive disorders.
MRI and CT scans
Internists may recommend advanced imaging to look at problem areas. For example, the spinal cord is often examined in more detail via an MRI scan than normal x-rays. This may be performed by a vet who specialises in diagnostic imaging, but the internal medicine expert will use the results to help work out what is going on with your pet.
What sort of conditions do internists regularly see?
Vets that specialise in internal medicine end up seeing a wide variety of cases with some animals even suffering from more than one complaint at a time – which can be confusing at times! But some of the most common conditions that benefit from a specialist include (but are not limited to) –
- Cancer (various types)
- Respiratory conditions like asthma and pneumonia
- Complicated diabetic cases
- Liver disease
- Infectious diseases
- Hypothyroidism and hyperthyroidism
- Blood disorders
- Hyperadrenocorticism (Cushing’s disease) and Hypoadrenocorticism (Addison’s disease)
- Fever of unknown origin
- Kidney disease
Why should my pet see an internist? Can’t my normal vet work out what’s wrong?
While GP vets are excellent problem solvers, some cases are a bit trickier for them to manage. This may be because the animal has multiple medical complaints going on at the same time, or because it is suffering from an uncommon or challenging condition.
Internists have additional qualifications and usually work at a referral hospital, giving them access to other specialists. This allows them to get together and discuss your pet’s case, as well as utilise vets with skills in other areas. Also, it is worth bearing in mind that a normal vet has very limited time for each patient over the course of a day, bouncing from a puppy vaccination at one appointment to a complicated case uncontrolled diabetic case the next – often with the same allocated 15-minute consultation time. A specialist will usually have more time allocated to spend on each patient and will often have time available in the day for group case discussions.
If your vet has suggested that your pet sees an internal medicine specialist, then it is because they have their best interests at heart. They want to get to the bottom of your cat or dog’s issues and would like to get their condition well-managed.
Of course, there are some instances where owner finances may not allow this to happen. If you are unable to afford to see a specialist, then your vet will still look after your pet in the best way they can. Many internists are happy to give GP vets advice over the phone or via email, which can be helpful too.
Summary
A veterinary internist is a vet that enjoys problem-solving! They will spend time with you and your pet, advising on relevant tests, to try and make a diagnosis. If you think your pet would benefit from a referral, then discuss things with your regular veterinary surgeon first. They will be able to help guide you and try to find a suitable specialist to take on your pet’s case.
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