Veterinary Internal Medicine for Dogs and Cats

When your pet has persistent symptoms, an unusual test result, or a condition that affects several parts of the body, finding answers can feel frustrating and overwhelming.

The board-certified veterinary internists at Oakland Veterinary Referral Services specialize in diagnosing and managing complex diseases in dogs and cats. Our team combines advanced training, sophisticated diagnostic tools, and thoughtful investigation to uncover the cause of difficult medical problems.

We work closely with you and your family veterinarian to create a plan that supports your pet’s health, comfort, and quality of life.

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What Does a Veterinary Internist Do?

Veterinary internists focus on diseases that affect the body’s internal systems. They often care for pets with chronic illnesses, unexplained symptoms, abnormal laboratory results, or conditions that require advanced diagnostic testing and long-term management.

After veterinary school, board-certified internists complete extensive additional training in small animal internal medicine and meet the American College of Veterinary Internal Medicine's certification requirements.

This training helps them evaluate complicated cases, recognize connections between symptoms, and manage conditions that affect more than one organ or body system.

When Might Your Pet Need an Internal Medicine Specialist?

Your family veterinarian may refer your pet to OVRS when:

• Symptoms continue despite initial treatment
• Routine testing has not identified the cause of illness
• Bloodwork, imaging, or other test results show unusual changes
• A condition requires advanced diagnostics or specialized procedures
• Several medical problems complicate diagnosis or treatment
• A chronic disease requires ongoing monitoring and adjustment
• Your pet needs coordinated care from multiple specialists
• Your veterinarian would like another perspective on a difficult case

You do not need to know exactly what is wrong before scheduling a consultation. Investigating unexplained symptoms forms an important part of internal medicine.

Conditions Our Internal Medicine Team Treats

Our internists diagnose and manage a wide range of acute and chronic conditions.

Gastrointestinal Disorders

Digestive disease can cause vomiting, diarrhea, weight loss, appetite changes, abdominal discomfort, or difficulty absorbing nutrients. Our internists evaluate conditions involving the stomach, intestines, esophagus, and related digestive organs.

These conditions may include:

• Inflammatory bowel disease and chronic enteropathy
• Persistent vomiting or diarrhea
• Esophageal disease
• Gastrointestinal bleeding
• Protein-losing enteropathy
• Motility disorders
• Malabsorption
• Unexplained weight loss

Liver and Gallbladder Disease

The liver performs many essential functions, including processing nutrients, filtering substances from the blood, and supporting digestion. Liver and gallbladder disorders can cause vague symptoms and may require advanced testing.

Our team evaluates:

• Elevated liver enzymes
• Hepatitis and inflammatory liver disease
• Gallbladder disease
• Bile duct disorders
• Portosystemic shunts
• Copper-associated liver disease
• Jaundice
• Liver masses and structural abnormalities

Kidney and Urinary Tract Disease

Kidney and urinary disorders can affect hydration, blood pressure, appetite, toxin removal, and overall health.

Our internists care for pets with:

• Acute or chronic kidney disease
• Protein loss through the kidneys
• Recurrent urinary tract infections
• Bladder and urethral disorders
• Urinary incontinence
• Kidney or bladder stones
• Abnormal urination
• Congenital urinary abnormalities

Endocrine and Metabolic Disorders

Hormones regulate many of the body’s essential processes. Even a small hormonal imbalance can affect appetite, weight, thirst, urination, skin, energy, and behavior.

Our team manages conditions such as:

• Diabetes mellitus
• Cushing’s disease
• Addison’s disease
• Thyroid disorders
• Calcium disorders
• Adrenal gland disease
• Other hormonal and metabolic conditions

Immune-Mediated and Blood Disorders

The immune system sometimes attacks the body’s own cells or tissues. These disorders can develop quickly and may require intensive treatment and close monitoring.

Our internists evaluate and manage:

• Immune-mediated hemolytic anemia
• Immune-mediated thrombocytopenia
• Disorders involving white or red blood cells
• Bone marrow disease
• Abnormal bleeding or clotting
• Persistent anemia
• Fever of unknown origin
• Systemic inflammatory disease

Respiratory Disease

Coughing, labored breathing, nasal discharge, exercise intolerance, or recurring pneumonia may signal disease within the airways, lungs, or nasal passages.

Our team investigates:

• Chronic coughing
• Asthma and inflammatory airway disease
• Pneumonia
• Tracheal and bronchial disorders
• Nasal disease
• Pulmonary fibrosis
• Recurrent respiratory infections
• Unexplained breathing changes

Infectious Disease

Bacteria, viruses, fungi, parasites, and other organisms can cause illness throughout the body. Some infections prove difficult to identify or require specialized treatment and monitoring.

Our internists combine your pet’s history, examination findings, laboratory testing, and imaging to identify possible infections and choose an appropriate treatment plan.

What to Expect at an Internal Medicine Consultation

Before the appointment, our team will review the records that your family veterinarian provides. These may include examination notes, laboratory results, imaging, medication history, and previous treatment responses.

During the consultation, the internist will:

• Ask detailed questions about your pet’s symptoms and medical history
• Perform a comprehensive physical examination
• Review previous test results and treatments
• Explain the most likely causes of your pet’s symptoms
• Discuss which tests could provide useful answers
• Review treatment options, expected outcomes, and costs
• Learn about your priorities and concerns
• Create an individualized diagnostic or treatment plan

Sometimes the internist can narrow the possibilities during the first visit. More complicated cases may require several stages of testing. Your doctor will explain the purpose of each recommendation and how the result could influence treatment.

You always choose which diagnostic and treatment options to pursue.

Advanced Diagnostic Services at OVRS

Internal medicine often requires more than a single blood test or image. Our internists select tests according to your pet’s symptoms, medical history, and previous results.

Laboratory Testing

Blood, urine, and other laboratory tests can evaluate organ function, hormone levels, immune activity, infection, anemia, clotting, and metabolic changes.

OVRS also offers access to clinical pathology expertise for complex samples and unusual laboratory findings.

Ultrasound

Ultrasound uses sound waves to create real-time images of internal organs. It can help the team evaluate the liver, gallbladder, kidneys, bladder, gastrointestinal tract, pancreas, spleen, adrenal glands, and other abdominal structures.

The internist may also use ultrasound to guide a needle while collecting cells or tissue from an abnormal area.

Digital Radiography

Digital X-rays help evaluate the chest, abdomen, bones, and other structures. They can reveal changes involving the lungs, heart, gastrointestinal tract, urinary system, or skeletal system.

Computed Tomography

CT creates detailed cross-sectional images of the body. It can help the team investigate complex changes in the chest, abdomen, airways, blood vessels, nasal passages, and other areas.

Endoscopy

Endoscopy allows the internist to examine certain areas inside the body with a flexible or rigid camera. Depending on the procedure, the doctor may examine the esophagus, stomach, intestines, airways, nasal passages, or urinary tract.

Endoscopy can also help the internist collect biopsy samples, retrieve some foreign objects, or perform selected treatments without open surgery.

Specialized Procedures

When appropriate, our Internal Medicine team may perform:

• Ultrasound-guided aspirates
• Tru-Cut tissue biopsies
• Gastrostomy tube placement
• Bone marrow aspiration or biopsy
• Joint taps
• Tracheal wash
• Endoscopy
• Urethral hydropropulsion
• CT portography
• Tracheal stent placement

Your internist will explain why a procedure may help, how the team will perform it, what preparation your pet needs, and what risks or recovery considerations you should expect.

Managing Chronic Disease

Many internal medicine conditions require care over months or years. Successful management depends on more than choosing the first medication. It often requires regular monitoring, adjustments, and communication among the pet owner, family veterinarian, and specialist.

Our team helps families manage chronic disease by:

• Tracking symptoms and quality of life
• Monitoring bloodwork, urine testing, or imaging
• Adjusting medications and nutrition plans
• Watching for complications or treatment side effects
• Coordinating follow-up care with the primary veterinarian
• Responding when a pet’s condition changes

We aim to control disease while helping your pet maintain the best daily life possible.

Collaborative Care Under One Roof

Complex cases sometimes involve more than one specialty. A pet with kidney disease may also develop heart concerns. A patient with an immune-mediated condition may need emergency stabilization. Another pet may require advanced imaging, anesthesia, nutritional support, or surgery.

OVRS brings multiple specialty departments, advanced diagnostics, and 24-hour emergency and critical care together in one hospital. Our doctors can consult one another and coordinate care when a case crosses specialty boundaries.

We also keep your family veterinarian informed so everyone understands the diagnostic findings, treatment plan, and follow-up needs.

Will My Pet Need to Stay in the Hospital?

Many pets return home after their consultation or outpatient diagnostic testing. Other pets need hospitalization for procedures, intravenous fluids, medication, monitoring, or stabilization.

Your internist will discuss the expected schedule before you authorize care. If your pet remains in the hospital, our medical team will monitor progress, provide treatment, and update you according to the communication plan established for your pet.

OVRS provides 24-hour hospital care for patients who need continuous observation and support.

Preparing for Your Pet’s Appointment

Before the visit, ask your family veterinarian to send relevant medical records to OVRS, including:

• Recent examination notes
• Blood and urine test results
• Imaging reports and images
• Biopsy or cytology results
• Previous treatment plans
• Medication history
• Records from other veterinary hospitals

Please bring:

• A complete list of medications and supplements
• Medication dosages and schedules
• Details about your pet’s diet
• Notes about changes in appetite, thirst, urination, weight, energy, breathing, digestion, or behavior
• A written list of your questions

Do not stop medications or withhold food unless the OVRS team or your veterinarian instructs you to do so.

Experienced Guidance for Complicated Medical Problems

When your pet feels unwell, and the cause remains unclear, you need more than another test. You need a specialist who can bring the history, symptoms, and results together—and explain what they mean.

The OVRS Internal Medicine team combines advanced expertise with careful investigation and compassionate care. We will work with you and your family veterinarian to pursue answers, manage disease, and protect your pet’s comfort and quality of life.

To request an Internal Medicine consultation, complete our appointment request form or call OVRS at (248) 334‑6877.

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Important Internal Medicine Forms

Drop Off Form Drop Off Form (PDF)

Internal Medicine: Medical History Form

Internal Medicine: Medical History Form (PDF)

Internal Medicine Recheck Form Internal Medicine Recheck Form (PDF)

Consent to Treat Form Consent to Treat Form (PDF)