Internal medicine involves diseases affecting internal organs and systems. We utilise various techniques and equipment to help us reach a diagnosis, including diagnostic imaging, clinical pathology and endoscopy. We also work closely with other services within our hospital, as one of the strengths of Wear Referrals is drawing upon the joint expertise of vets specialising in different disciplines.
We also benefit from a dedicated intensive care unit, which allows high-level care to be delivered around the clock to critically ill patients.
All veterinarians working within our service in County Durham are either training towards, or already possess, specialist status in internal medicine, awarded by the Royal College of Veterinary Surgeons or the European College of Veterinary Internal Medicine. This is the highest level of clinical qualification currently available.
A dedicated team of Registered Veterinary Nurses (RVNs) work alongside the clinicians to afford the best possible standard of care to patients within our service.
In addition to seeing patients referred to us, we are happy to provide free advice to vets in practice on request.
Internal medicine conditions that we investigate and treat:
- Endocrine conditions - hypoadrenocorticism, hyperadrenocorticism, diabetes mellitus, hyperaldosteronism, diabetes insipidus, pheochromocytoma.
- Swallowing disorders, including barium swallow fluoroscopy using our digital fluoroscopy unit, and an inter-disciplinary approach with our neurology team.
- Respiratory disorders - investigations of chronic cough, tachypnoea, dyspnoea, pleural effusions, sneezing, nasal discharge, and epistaxis- often involving the use of CT, bronchoscopy and bronchoalveolar lavage, rhinoscopy and nasopharyngoscopy.
- Hepatobiliary disease - investigation and treatment of jaundice, increased liver enzymes, suspected portosystemic shunts, biliary disorders, hepatic lipidosis. Often using abdominal ultrasound, multi-phase contrast CT studies, and laparoscopic liver biopsies.
- Gastrointestinal conditions, including investigation of chronic diarrhoea, vomiting, regurgitation, weight loss, suspected malabsorption, dyschezia, haematochezia, perianal fistulas.
- Renal and urinary disorders – acute or chronic azotaemia (including intensive management of acute renal failure), dysuria, urinary incontinence, urinary obstruction, urolithiasis, haematuria, recurrent urinary tract infections.
- Pancreatic disease - acute and chronic pancreatitis, pancreatic insufficiency.
- Haematologic and immune-mediated disease – including immune-mediated haemolytic anaemia, thrombocytopenia, or neutropenia; non-regenerative anaemia; immune-mediated polyarthritis, ulcerative or erosive skin or mucosal disease such as lupus and pemphigus-type disease, leukaemias, myasthenia gravis.
- Oncology - diagnosis and treatment of neoplasia or suspected neoplasia, adopting a multi-disciplinary approach. We have a dedicated chemotherapy suite for providing ongoing outpatient care for oncology patients.
- Other clinical signs commonly investigated by the medicine department: polyuria, polydipsia, polyphagia, reduced appetite, weight loss, unexplained weight gain, abdominal distension, abdominal pain, malaise, hypersalivation, pain on opening jaw, muscle-wasting, pyrexia of unknown origin.
A well-equipped in-house laboratory, including endocrine and PCR testing, support all services.
What's new in our Internal Medicine department?
- Our department is getting involved in a multi-centre study regarding immune mediated anaemia and Pancytopenia (low red and white cells in cats)
- Now the UK has access to treatment of FIP in cats, this was previously a fatal condition and now we can offer treatment with promising results. We currently have several cats at Wear Referrals on this therapy.
- We have expanded the medicine team to include a medicine resident and medicine intern, and keen to raise and train our own specialists.
- We have invested in a new gastroscope to allow better visualisation during endoscopy and to aid obtaining minimally invasive biopsy of the stomach and intestines.
- We have invested in a new cystoscope to allow better access and visualization of the urinary tract in dogs. Cystoscopy now allows us to biopsy the bladder and urethra via a minimally invasive approach.
- We offer FreeStyle Libre monitoring for our diabetic patients. Instead of hourly blood glucose samples being taken (which lead to prolonged hospitalisation and increased stress to the pet), we can apply a glucose sensor to the skin which can stay in place for up to 14 days. This also allows the patients to be discharged from the hospital and allows ease of monitoring at home.
- We can offer fluoroscopy which allows real time live visualisation (a live xray is how I explain it to the owner) , this can be performed with or without anaesthesia, which is useful to identify swallowing problems and dynamic airway collapse which can be difficult to diagnose on a static image.
- We offer balloon dilation via endoscopy to dilate any strictures (narrowing of the oesophagus) leading to swallowing problems.