I can perform abdominal, cervical (thyroid and parathyroid) and thoracic (non-cardiac) ultrasound, thoracocentesis, abdominocentesis, fine needle aspirates and cystocentesis. With ultrasounds, I will review the medical record as long as they are provided to me before the ultrasound and give basic medical recommendations to complement the ultrasound findings. The report and images will be given to you prior to my leaving on a reusable USB key. There is an area to upload medical records on the request page. I am also available for internal medicine consultations. This can be done in conjunction with an ultrasound or can be a standalone request. I do not have to be at your practice to perform an internal medicine consult. You can request them through my website. Please provide a complete medical record including clinical notes and test results. I also have some helpful client questionnaires for you to use to help get a more complete history. If there are crucial tests pending, please wait for those results to come in before requesting the consult as this can significantly change my interpretation and recommendations. Internal medicine consults and rechecks will be completed within 24 hours of the request Monday through Thursday. Any request made after Thursday 6 PM will be completed by the following Monday. If you have a challenging case that is stable but needs considerable attention, I can help manage these cases on an ongoing basis. I will do an initial internal medicine consult and also provide interpretation of any tests I recommend in that consult. I can continue to help you manage the patient long-term with recheck exams (one visit to you = one recheck fee). I do not consult directly with clients since I do not have a valid veterinary-client-patient relationship. If you or the client requests it, I can do a teleconference call during the initial consult but do not maintain ongoing primary communication with clients or maintain direct contact with clients about their pets. If I have performed internal medicine consult and recommend a procedure you are not comfortable with, I can perform the procedure at your practice. This would include but is not limited to bone marrow aspirates, arthrocentesis, feeding tube placements, ultrasound-guided biopsies, etc.

Ultrasound: · For AM visits, fast patient after midnight the night before. For PM visits, a small meal at 6am or before is fine. Water is always OK. If you have a patient with special medical needs where fasting is unsafe, advise them appropriately or contact me with questions. · Consider whether or not patients would benefit from a ‘chill’ protocol using gabapentin and/or trazadone. Even the sweetest patient doesn’t always sit still for ultrasound exams. Ask owners if additional sedation is permissible, if needed. · Discuss aspirates with clients if you think they will be needed. Have a recent CBC with normal platelet count less than a month old. · Plan on having patients ready for the exam when I arrive. I will need a staff member to restrain and a quiet dark space to perform the scans. I will call and confirm the appointments in the morning and give an approximate arrival time. I will call again when I am on my way to your practice. · Add-ons are usually easy to accommodate but please let me know in advance. Internal medicine consults: · The majority of internal medicine consults and rechecks are done remotely. · I will need a complete medical record and all test results – if possible, wait until all results are in before submitting. · Direct clients to fill out an internal medicine questionnaire which provides me with a detailed history and saves time for the practice in gathering this information. · Keep in mind that in most cases, I will not have a valid VCPR relationship so my role will mostly be as a consultant. I am happy to talk to clients when the need arises but cannot manage cases primarily.

I am available for abdominal ultrasounds Monday-Thursday. There is occasional availability outside these hours. Please contact me. Internal medicine consults and rechecks are available Monday-Thursday and a complete report will be delivered within 24 hours after receiving a COMPLETE medical record. Any request made after Thursday 6p will be completed by the following Monday.

Click here for the referral form for all my services. I will contact you promptly to schedule if I am not already scheduled to visit your practice.

Click here for consult/recheck request. It is also extremely helpful if your client fills out the internal medicine questionnaire. Click here for the link or direct your client to my web site's "Client Forms" page and fill out the Internal Medicine New Consult questionnaire. There is also a shorter recheck questionnaire that is very useful for the purpose of history and identifying any ongoing concerns by the client.

Payment for ultrasounds is expected at the time of the practice visit by the practice. I do not accept payments directly from clients. Internal medicine requests that are done remotely are invoiced directly to the practice and payment can be made through electronic fund transfer (ACH). Any alternative payment arrangements must be made with me prior to the examination/consultation. For updated pricing, please contact me.