Trinity Internal Medicine Referral Center

10/18/2024

It’s National Veterinary Technician Week!!

What a great opportunity to acknowledge the work that technicians, nurses, assistants do for the community of veterinary medicine. They enable the doctors to do what we do and we couldn’t do our job without them 💜

I specifically want to acknowledge Christine!! She makes the Referral Center happen! From talking to veterinarians, coordinating referrals, talking to owners, plus all the help with ultrasounds and endoscopy and everything in between!! She is intelligent, hard working, often anticipates what I need before I know I need it, incredibly trustworthy, cares for family, and loves animals deeply. I could go on-and-on. The thing I love most about Christine is her love of Jesus and how she lives her life in a stressful, emotional job reflects that. I couldn’t ask for a better partner!

10/17/2024

🐾 Happy Vet Tech Week! 🐾

There is no such thing as a typical day inside a veterinary hospital.

The duties of a veterinary technician will also vary based upon the type of facility/hospital where they are employed.

For a technician, the day often begins with patient rounds. The previous clinical shift will present the current cases in the hospital, their diagnosis, treatment plan, and any other pertinent information.

After rounds, patients are assessed and evaluated, their vitals recorded and reported to the overseeing veterinarian.

After completing patient treatments, it's time for appointments and surgeries to begin. Developing and implementing anesthetic protocols for surgical cases, performing radiographs (x-rays), delivering chemotherapy, polishing and cleaning teeth, placing intravenous catheters (IVC), client education, filling prescriptions, administering medications, and much more fill the hours between patient rounds, when the next shift arrives, or a new day begins.

We could not survive without them!

Thank you for everything you do!

10/16/2024

IT'S NATIONAL VET TECH WEEK!!!

You know our doctors would be LOST without them!

Time to thank them EXTRA for everything they do for your kiddos!

They do it all!
Nurse
Surgical assistant
Dental hygienist
Xray tech
Groomer
Anesthesiologist
Phlebotomist
Pharmacy tech
Lab tech
Educator
Janitor
Anger target.
A shoulder to cry on
A face to lick
And SO much more!

Let's show them some extra love this week!

10/08/2024

Does your feline friend vomit hairballs? Have they "always been a puker"?

Cats normally groom themselves daily and can indeed ingest hair, but there could be an underlying chronic small bowel disease.

CSBD is a common cause of vomiting and early diagnosis can be difficult if the intermittent vomiting is assumed to be "just hairballs".

Some of the more common clinical signs of CSBD are vomiting (more than twice a week) and weight loss. Evidence is mounting that CSBD is a continuum of one disease, meaning it begins with mild inflammation of the small bowel, possibly within the first 2–3 years of life, progresses to severe inflammation known as IBD and may further progress to lymphoma. The pancreas and liver may also be involved.

So when should you be concerned?

If there is an increase in the frequency of vomiting (greater than 2 times a month), unexplained weight loss with or without diarrhea, a change in appetite (increase or decrease), or there is a change in the vomitus (not just hair, but bile or food).

Biopsies of the small intestines are needed to diagnose CSBD. The biopsies can be obtained surgically or less invasively via endoscopy.

Surgical biopsies might be needed if the abnormal areas are further down in the small intestines and/or liver/pancreas biopsies are needed.

Blood work and an abdominal ultrasound can help determine which method is the best for your cat.

If this sounds like your cat, please contact your regular veterinarian. If there is a concern that something more than "hairballs" may be going on, we are happy to work with your veterinarian to discuss if endoscopic biopsies are the next step. Your veterinarian can refer to TIMRC for a consult appointment.

Most of the time, endoscopic procedures can be performed the same day as your appointment.

10/03/2024

Almost everyone has been affected by cancer. Either personally, a loved one, a friend, or co-worker.

Unfortunately, cancer affects our furry friends as well.

Approximately 1 in 4 dogs will develop cancer at some point in their lifetime. The number increases to almost half of dogs over 10 years of age will develop cancer.

Similarly to humans, identifying cancer earlier can in some cases lead to a better outcome. Because of this, the owner should play an active role in monitoring their beloved pet.

It can be as simple as feeling for lumps and bumps while petting them and observing what is normal for their dog or cat, so when there is a change, they can consult with their primary veterinarian.

Other things to look for - Does the pet's abdomen look distended? Are they having a harder time urinating or defecating? Vomiting? Are they having a harder time eating or is there blood-tinged saliva? Are they coughing? Are they limping? Have they suddenly lost weight?

Having a partnership with a veterinarian throughout the animal's life is crucial for preventing disease, as well as for earlier detection of problems that initially can be subtle.

A physical examination when annual vaccines are due allows the veterinarian to check the mouth, lymph nodes, listen to the heart/lungs, feel the abdomen for abnormalities, and monitor for changes in body weight. As the animal ages, additional diagnostics, such as blood work can be added. Having baseline blood work before they get sick can be very helpful.

Recommendations from your veterinarian can also be influenced by the breed of dog as some breeds of dog are more likely to develop certain types of cancer. In those breeds, more frequent and additional testing can be done.

Additional testing can be radiographs (x-rays), abdominal ultrasound, aspiration/biopsies of suspicious areas, and advanced imaging (CT scan).

A recent study in the Journal of Veterinary Internal Medicine (2024 Jul-Aug;38(4):20892098) looked at a large group of cats which were deemed "healthy" by their owner. Within 2 years, 28% of mature adult cats (ages 7-10) and 58% of older cats (> 10 years of age) that were confirmed healthy at inclusion developed new diseases, most commonly early kidney disease, hyperthyroidism, chronic gastrointestinal disease, liver disease or pancreatitis, and cancer in 7%.

Did you catch that? Over half of cats over the age of 10 years had developed a medical condition.

So now what? If you have any concerns regarding your pets health, contact your regular veterinarian and discuss it with them.

If appropriate, your veterinarian can refer to specialists for additional diagnostics.

If your pet has been diagnosed with cancer, consultation with board certified specialists for treatment recommendations may be needed. Information regarding staging, treatment options (chemotherapy, surgery, radiation), and prognosis can be discussed and an informed decision can be made. The website VetSpecialists.com can be used to find specialists in your area.

09/30/2024

I would imagine that most everyone has seen numerous success stories on social media. We have posted them as well, but what about the cases that don't have a good outcome? What about the sweet ones we lose? To be honest, the dogs and cats that end up being referred to us usually have complicated medical conditions and a poor long-term prognosis.

This post is in memory of them and the families they left behind. We see you. We know you hurt. We've experienced the same. We hope you know that by seeing your pet, it has in some way made us better doctors, nurses, and people. It's not just the care and compassion for the pet that drives us, but the human-animal bond. It's this relationship/bond that allows us to go from one difficult case to the next.

In honor of a beloved pet(s), we would love for you to post their name(s) below.

08/26/2024

It’s today! Here are my two! Jonah (5) and Bentley (3) are full brothers and are the bestest boys!!
I would LOVE to see yours!

08/05/2024

We have just opened a new study in collaboration with LEAH Labs for dogs with B cell lymphoma. Visit our website for more information.

08/01/2024

🐾 Reminder: Applications for Class 12 are coming soon! 📅 Available online August 1. Apply to be part of the pack and help make a difference at 🌟

More info ➡️ https://bit.ly/3OoTnFU

08/01/2024

Heidi Sue had a team of veterinarians working to find why she didn't feel good. This quickly escalated to an Addisonian Crisis! Action was taken by Dr. Jill Brunker to initiate emergency protocols and Veterinary Specialty Center of Stillwater cared for her overnight to ensure continued treatment and monitoring. Visit www.trinityveterinaryhospital.com/timrc to learn about Heidi Sue's story and how she is doing now!

TIMRC is an outpatient only referral center that was established to support area veterinarians in complicated or uncommon patient conditions that would benefit from the expertise of an internal medicine specialist.  Our board certified internist is experienced in diagnosing and treating various iss...

04/02/2024

WARNING - ENDOSCOPY VIDEO! Asher was seen for intermittent GI problems (mostly after he gets into something he shouldn't). On his annual wellness bloodwork it showed that he was low in a very important blood protein called albumin! This, along with the intermittent GI problems meant that there was a problem that needed attention! After no significant answers on ultrasound an upper endoscopic procedure was performed. Watch this video to see part of his procedure. Biopsies showed an increase in eosinophils and a hypoallergenic diet is recommended. Stay tuned to see how Asher responds to treatment!

03/30/2024

Please share so more people will find Dr. Brunker!

TIMRC is an outpatient only referral center that was established to support area veterinarians in complicated or uncommon patient conditions that would benefit from the expertise of an internal medicine specialist.  Our board certified internist is experienced in diagnosing and treating various iss...

03/18/2024

⭐️Case Spotlight⭐️

Piper came to see us with a 2-month history of intermittent diarrhea. She was losing weight despite having a great appetite. Also, she seemed to tire easier. The referring veterinarian did a great job of testing and treating for many causes of diarrhea, but Piper’s diarrhea and weight loss persisted. Because of her work as a blue-ribbon winning field trial dog, she was having a harder time doing what she loved. Blood work showed she was not digesting her food normally. On her ultrasound, portions of her small intestines had the appearance of “striations” which is a specific ultrasound finding consistent with lymphangiectasia. Lymphangiectasia is where the lacteals in the intestinal villi become dilated. which disrupts the intestine's ability to take the nutrients from the food. An upper GI endoscopy (gastroduodenoscopy) was used to obtain biopsies of the intestines to determine the underlying cause of the lymphangiectasia. In Piper’s case, endoscopy was preferred over surgery as low protein blood levels can lead to delayed healing with surgical biopsies. Based on the results of Piper’s diagnostic tests, she started treatment which consisted primarily of a high-quality, low-fat diet. Within a few days of treatment, Piper’s diarrhea was completely resolved! She is now able to perform to her fullest ability at what she loves most! Well, other than spending time with her humans! We were blessed to have met Piper and her humans and wish her luck with all of her field trials this season. May she get many more blue ribbons!!

01/27/2024

Day number 2 at OVMA was so much fun! We have met some wonderful referring vets and have had the best time next to our friends Veterinary Specialty Center of Stillwater❤️

We look forward to tomorrow, final day!

01/25/2024

Come see us at OVMA!

01/09/2024

Let's talk about histoplasmosis...

Histoplasma capsulatum is a fungus commonly found in our area (Oklahoma) and can infect our dogs and cats, but typically affects our furry feline friends more so than canines. It exists primarily in soil or dust that has been infected by bird or bat f***s. In susceptible dogs and cats, the fungus enters the body by mouth or by inhalation of the fungal spores and travels through the body to set up a localized infection. Clinical signs of this disease can initially be nonspecific, therefore, it may take a little longer to notice your pet is sick. Some signs can include weight loss, fever, decreased appetite, decreased energy, respiratory signs (coughing, sneezing, increased respiratory rate, etc), diarrhea (if in the gastrointestinal system), and painful joints (lameness). This is one reason why seeking veterinary care when your pet is sick is so very important. Some common ways to diagnose this infection include radiographs (x-rays), urinalysis, bloodwork, cytology, and histopathology. There is a urine test for histoplasmosis that can be used to diagnose and screen for infection in the majority of cases, as well as monitor the treatment.

Humans CAN contract this disease, but only from coming into direct contact with fungus spores, NOT from your pet (you can still cuddle your furry friend if they are infected❤️).

Luckily, this infectious disease can be treated with anti-fungal medications long-term (at least 6 months). Although, once the infection is cleared, there is still a chance of relapse. Continued monitoring will be needed by your veterinarian. Prognosis is good when caught early, although some patients may be further along in the disease process and may not survive.

Picture references:
https://veteriankey.com/histoplasmosis/