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Internal Medicine Frequently Asked Questions

What is a board certified Small Animal Internist or Internal Medicine Specialist?
The American College of Veterinary Internal Medicine (ACVIM) is the international certifying organization for veterinary specialists in large animal internal medicine, small animal internal medicine, cardiology, oncology, and neurology. These specialists are known as ACVIM Diplomates. There are approximately 2000 ACVIM Diplomates worldwide.

A Small Animal Internal Medicine Specialist is a Diplomate of the ACVIM who has completed four years of veterinary school, a postgraduate internship, and a small animal internal medicine residency. The three-year residency program includes general internal medicine specialty training in physiology, infectious disease, pharmacology, and pathology along with species-specific training for diagnosis and care of dogs and cats. Throughout the training program each specialty candidate is evaluated by supervising professors and specialists. Before recognition as a Diplomate of the ACVIM, each candidate must also pass a rigorous two-day examination. In addition, many ACVIM Diplomates complete two to four additional years of graduate school training and research to obtain a Master’s Degree (MS) or Doctorate (PhD).

How is a Board-certified Small Animal Internist different from my family veterinarian?
All veterinarians must complete three to four years of undergraduate training and four years of veterinary school. This training includes numerous topics including anatomy, physiology, pharmacology, infectious disease and preventive medicine, surgery and internal medicine of dogs, cats, horses, livestock and other species.

Board-certified Veterinary Specialists, including ACVIM Diplomates, are similar to their human medical counterparts in that they have completed all the above training plus an internship and residency in their specialized field (an additional 3-5 years training). A Small Animal Internal Medicine Specialist has a greater understanding of internal medicine including lung and thoracic disease, kidney disease, infectious and immune disease, gastrointestinal and abdominal disease. In addition, most Small Animal Internists have cross-training in cardiology, oncology, and neurology and diagnostic imaging (ultrasound and radiology). This training provides the Internal Medicine Specialist with greater knowledge of diagnostic and treatment options especially for unusual, uncommon, or rare conditions in dogs and cats. In addition, a Small Animal Internist has diagnostic equipment not generally used by your family veterinarian.

Why does my animal need to see a Board-certified Small Animal Internist?
Commonly called Internists, these specialists focus on diagnosing and treating diseases of the internal systems. Where the diagnosis is known, an Internist may confirm the diagnosis and treatment, providing piece of mind. If a diagnosis is proving elusive or therapy is not proving effective, the Internist may be better able to refine the diagnosis or adjust treatment plans to get your animal back to health. Examples of conditions for which your family veterinarian might refer your animal to an Internist are:

  • Endocrine disease (adrenal tumors, complicated diabetes, thyroid disorders)
  • Liver and gall bladder inflammation or infection
  • Chronic vomiting or diarrhea
  • Complicated pancreatic disease
  • Coughing and breathing problems
  • Infectious diseases
  • Anemia or other blood disorders
  • Kidney or bladder diseases
  • Unexplained weight loss

What should I expect during a visit with a board certified Small Animal Internist?
The Internist will review information provided by you and your family veterinarian, perform a complete and thorough physical examination of your pet, and based on these initial findings, additional tests and care may be recommended. Depending on your pet’s condition, diagnostic testing or treatments may include:

  • Advanced laboratory testing of various tissue and blood samples
  • Diagnostic Imaging – ultrasound, radiography (x-rays), CT scans, MRIs
  • Biopsies of masses, internal organs, or bone marrow
  • Endoscopic examination – the use of a slender, tubular camera for non-invasive visual examination and sampling of internal organs or body structures
  • Feeding tube placement
  • Nutrition consultations

When should I request a referral to an ACVIM board certified Veterinary Internist?

  • Your pet’s disease is uncommon, complicated, or undiagnosed after standard testing
  • You would like an informed, neutral second opinion of your pet’s condition
  • The outcomes of the current treatments are not going well or as expected
  • Your pet requires a sophisticated procedure that is offered only by a specialty hospital
  • Your pet can benefit from 24-hour monitoring provided by a referral hospital

If you believe your pet would benefit from a visit to a board certified Small Animal Internal Medicine Specialist, you are encouraged to work with your family veterinarian to complete a referral.

Will my family veterinarian still be involved after referral to a Veterinary Internist?
Your veterinarian is an important contributor to your pet’s health, even if help from a board certified Internist is required. The Internist works as part of the team along with you and your family veterinarian to diagnose and treat your pet. Your family veterinarian will continue to supervise your pet’s routine care including vaccinations, parasite control, and annual examinations. In some cases, the Internist may take over all care and diagnostics related to your pet’s medical disease or condition. In most cases, however, your pet will receive coordinated care and diagnostic rechecks from both the Internist and your family veterinarian. Communication among all team members is important so all aspects of care provided by the Internist will be reported to your family veterinarian and you will be included in decisions regarding when and where follow-ups will be completed.