If your pet is a patient at the Cornell University Hospital for Animals, your primary veterinarian may request a consultation with Nutrition Services. If your animal is not a Cornell patient, your primary veterinarian may make a referral to our service. Once we review your animal's medical records, a clinician or technician from our service will call to ask about your animal's nutrition history and any current diet issues.

We will work with you to formulate a diet for your animal that is complete and balanced, and addresses any health conditions or chronic diseases. We may recommend a commercial dog food, supplements or provide recipes for a home prepared diet.

Dale and Debbie Reichard originally brought in their Schnauzer Tobie to CUHA for medical management of his liver shunt. Tobie had been doing well, but at 9 years of age he was diagnosed with another problem, calcium oxalate bladder stones. These are two medical conditions that have separate dietary plans that do not overlap particularly well. Tobie's veterinarian contacted the Nutrition Service to help create a dietary plan that would help prevent further calcium oxalate stones in the bladder and maintain his liver condition.

We created a diet plan for Tobie consisting of shunt friendly protein sources partially restricted in calcium and phosphorus with moderate sodium content and low oxalate that helped to manage his liver and bladder stone problems. Sadly, Tobie died of cancer 3 years later.

Tobie's owners, the Reichard’s, also own a giant Schnauzer named Niko who was recently diagnosed with an inflammatory bowel disorder with excessive protein loss and poor fat absorption leading to excessive weight loss, which requires an expensive hypoallergenic commercial food. Again, they called the Nutrition Service to see if there was a less expensive alternative to feeding their 85-pound companion. We developed a plan that includes an inexpensive novel ingredient diet based on egg and potato that was low in fat and appropriately supplemented. Since starting on his new diet, Niko is doing very well and slowly becoming the vibrant dog they once knew. 

Companion Animal Diet Consultation

Many of the dietary needs of your companion can be obtained by feeding a general over-the-counter or therapeutic commercial diet. However, in many cases, supplementation or increasing specific components in the diet are beneficial to maintaining or optimizing health. We are available to discuss your pet’s nutrition and how it affects the health and longevity of his of her life.

Obesity Consultation

Obesity prevention can help eradicate many medical and surgical problems that we see every day and also improve and extend your pet’s quality of life. Obesity management is achieved through strategies to satiate your companion, attention to calorie intake, and knowing the weekly percentage of weight loss. We can provide a detailed weight loss program for your pet that includes recommendations for therapeutic or over-the-counter calorie-restricted diets and the proper feeding guidelines. With our assistance, your pet can lose weight safely and effectively.

Homemade Diet Formulation

Many clients are interested in cooking for their companions. While we often recommend commercial food products, some disease and client concerns warrant home prepared diets. We provide recipes that are grain-free, gluten-free, or vegetarian for interested clients. We are happy to design a detailed and well-balanced diet to meet your pet’s special needs.

Total Parenteral or Partial Parenteral Nutrition

When animals are critically ill or cannot take in enough calories, intravenous nutrition may be required. Adequate and proper nutrition is very important for pets that are hospitalized, and has a great impact on a pet’s attitude and the healing process. If you feel that your animal needs this service, please ask your primary clinician for a referral to our service.

Equine Forage and Diet Analysis

The feeding of your equine companion can be complex, particularly after diagnosis of certain medical conditions. A complete dietary analysis based on diet history, present supplementation, and forage analysis can help manage medical illnesses and potentially improve athletic performance. Forages and concentrates can be analyzed, providing us with an exact list of the specific nutrients your horse is receiving. All of this information helps us generate a detailed report that will support your feeding plan for your equine companion or entire stable. 

American Academy of Veterinary Nutrition
An international association of veterinarians and animal scientists with a common interest in animal nutrition and animal health.

American College of Veterinary Nutrition
An organization dedicated to advancing the specialty area of veterinary nutrition and increase the competence of those who practice in this field by establishing requirements for certification in veterinary nutrition, encouraging continuing professional education, promoting research, and enhancing the dissemination of new knowledge of veterinary nutrition.

Balance IT
An online software program that provides recipes for balanced, homemade animal diets.

Bill

We had a great experience with Cornell’s emergency and neurology services. We were seen shortly after we arrived and the emergency and critical care veterinarian gave us hope that Bill could get back to almost his full self. We were given options on how it could happen. I can't tell you how scared I was leaving him there. I am sure most people with furry friends feel the same! I was comforted by the calls from Bill's surgeon keeping us informed about the plan each step of the way and also the updates from either the veterinarian or veterinary student before and after surgery. They kept us posted on his progress and we felt we made the best decision for him after having many conversations with the veterinarian. It was also scary bringing him home and trying to adjust to a new way of life for a little bit. The first time he wagged his tail, we all cried tears of joy! Even though the veterinarian told us it would be slow progress, it seemed as though Bill was on his way back to being himself. Three months later he still walks like a drunken sailor all on his own, goes to the bathroom on his own and is pretty much back to his ornery old self. We wouldn't have it any other way. Sincere thanks to the staff for the great care they gave Bill.

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Big John

You guys have been nothing short of amazing! My dog now has a higher quality of life since since all of the unanswered questions that we have had so long about what was causing his issues have been answered.

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Fame

Our Shetland Sheepdog, Fame, has been a patient with Cornell's neurology service for over a decade. She suffered her first seizure when she was about a year and a half old and has been under the care of the neurology staff since that traumatic event. As she approaches her thirteenth year, her seizures are fully controlled. We feel fortunate to have such a caring and professional facility nearby. Fame’s quality of life would not be the same without the Cornell neurology service.

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Shadow

When we first brought Shadow in, it was a very distressing day and the help that we received from the minute we got there was so reassuring. To have to leave your puppy with strangers for four days or more was made so much easier because we knew you would do everything for him. Once we were able to bring him home I knew I could call anytime with questions. We went from three to four visits a year to now just having a yearly check up. He always likes to show the team what a big strong boy he still is.

Chewie

When Chewie, a shih tzu-poodle, began having seizures at the age of two, his owners brought him to the Neurology Service in January 2022. He had started to display seizure behaviors in early 2020, and after receiving medicine and treatment for a year, the family’s primary care veterinarian recommended an MRI at CUHA. Leading up to the appointment, however, Chewie went into status epilepticus (prolonged seizure activity). Status epilepticus is considered a life-threatening condition in dogs when the seizures are not self-limiting. His loving owners flew back from their vacation on the first available flight to get Chewie to Cornell.

The Emergency Service veterinarians and staff were able to stabilize Chewie and transfer his care to the Neurology Service. Upon examination by Dr. Patricia Lawler (second-year Neurology resident) and Dr. Christine Senneca (DACVIM Neurology Locum), Chewie was placed under general anesthesia for both diagnostic and treatment purposes. General anesthesia is sometimes needed in order to stop the seizures and also allows for a brain MRI and cerebrospinal fluid collection to look for any cause(s) that could potentially elicit the seizure events. Since all the tests came back normal, Chewie was diagnosed with idiopathic epilepsy.

Idiopathic epilepsy is a diagnosis of exclusion, implying recurrent and unprovoked seizures without any apparent cause. Seizures can look different from patient to patient. Usually, generalized seizures are when a patient falls down on their side (or it can begin when they are asleep); they may urinate and/or defecate, and they paddle their front and/or hindlimbs. Seizures cannot be interrupted by calling their name, as they are unaware of what is happening. Sometimes certain dogs can exhibit signs that their owners are able to pick up on before having a seizure; for example, a dog may display signs of being clingy, acting different, pacing around the room, etc.

Chewie was hospitalized at Cornell for four days. After being released and returning home, Chewie gained full mobility two weeks later, and is now being managed with long-term oral medications. His owners are happy to report that, after his three-month checkup, Chewie is doing well. “We would like to thank all the staff at Cornell for all your help, support and patience in answering our questions and taking the time to check in on Chewie. You have provided the best service we have ever had. We feel very blessed and thankful.”

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Roscoe

Roscoe, a 13-year-old male neutered Russian Blue feline, was brought to the neurology service at the Cornell University Hospital for Animals (CUHA) in March 2021. He had a wobbly gait (ataxia) and vision abnormalities, and was having trouble navigating and jumping. An MRI of his brain revealed a large mass consistent with a type of tumor called a meningioma (a tumor of the lining of the brain), which was later confirmed from histopathology results. After discussing options with Roscoe’s owner, the large mass was surgically removed from Roscoe’s right forebrain.

Roscoe recovered from surgery and anesthesia as expected and was able to go home three days later. He went home on anti-seizure medication, pain medication and prednisolone. At his one-month recheck appointment, Roscoe showed significant improvement. He was playful, had a good appetite and seemed comfortable. He started taking oral chemotherapy medication to help prevent regrowth of the tumor, and is doing well.

Roscoe’s owner, Sarah Bauer, thanks CUHA and says: “the Cornell neurology department is the BEST and your services saved Roscoe's life. Now he is back to normal, if not better than before. I cannot praise Dr. Rebecca Sandler enough! She realized that our cat isn't just a pet but a family member.”

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Franklin

Franklin, a 2-year old Golden Retriever, first presented to Cornell University Hospital for Animals (CUHA) emergency service in July of 2020. He had been wobbly, losing some control of his movements (ataxic) and lethargic for several days at home. After being transferred from emergency to the neurology service for further examination an MRI of Franklin's brain was recommended. MRI was performed the next day under general anesthesia. The images captured by MRI revealed marked patchy bright areas in his forebrain and cervical spine. While Franklin was still anesthetized, a spinal tap was performed and a sample of cerebrospinal fluid was sent to the Clinical Pathology lab at Cornell's Animal Health Diagnostic Center. Franklin was diagnosed with Menigoencephalitis of unknown etiology (MUE). He was started on steroids and was able to go home the next day. Patients with MUE often experience seizure activity which was true for Franklin. He began receiving monthly cytosar infusions and anti seizure medication. Cytosar is a well-tolerated and effective chemotherapy to control inflammatory central nervous diseases. Franklin responded well to this treatment plan.

During one of Franklin's regularly scheduled cytosar appointments in the fall it was noted that he had been vomiting and having diarrhea at home. He was lethargic on presentation and had a fever. The neurology service facilitated an initial work up to see what might be going on. Radiographs of his chest showed aspiration pneumonia and an abdominal ultrasound showed blood clots throughout his abdominal veins. He was anemic and his white blood cell count changes were consistent with an infection. Franklin was transferred directly to the internal medicine specialists at CUHA. He received 2 blood transfusions and oxygen supplementation. The supportive care and treatment he received had him feeling much better the next day. He was ready to go home again soon after.

Franklin's health conditions are being well managed at home by dedicated owners and at Cornell by the neurology and internal medicine teams.

We wish Franklin a happy life and love to see that he continues to do so well!

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Willow

Willow, a 5-year-old female spayed Himalayan, presented to the Cornell Neurology & Neurosurgery service in November of 2020.  She could move three of her legs but was unable to walk on her own.  The neurologists recommended Willow have imaging of her cervical spine.  Radiographs of her cervical spine showed an abnormal bony growth in her cervical vertebrae.  She went on to have an MRI and CT scan performed that confirmed there was a fluid filled mass at her C3 vertebrae.  Neurosurgery was performed to reduce the bulk of the mass relieving compression on Willow’s spinal cord.  Samples were submitted to Cornell’s Animal Health Diagnostic Center with a resulting diagnosis of osteosarcoma. 

Willow was referred to our colleagues in the Oncology service and began radiation therapy.  Over the last few months Willow has returned for recheck appointments with neurology and oncology. Her follow up radiographs show there are no signs of osteosarcoma regrowth.  Willow has gained the ability to walk around on her own and is getting stronger daily. 

We are so happy to work collaboratively with the oncologists in continued support of Willow’s recovery and care.   

We adopted Sam in the fall of 2010 from a local rescue when he was approximately six months old.  We believe that Sam was a lab/chessie mix. From the minute that we got Sam, we knew that he was not that typical happy go lucky lab. He just seemed off occasionally and was having periodic aggressive episodes that we now believe were partial seizures or linked somehow to his epilepsy.

Sam had his first generalized seizure about a month after his second birthday.  We immediately contacted his vet and we did the standard blood work looking for a reason why he had a seizure.  Nothing remarkable showed up on his blood work so we were hopeful that this seizure was a one off.  I then started researching anything and everything that I could find that might prevent another seizure.  I cleaned up his diet, added supplements and then six months later his seizures reappeared with a vengeance. This is when we began treating him with phenobarbital.  Pheno worked for a while and then it didn’t so his vet added Zonisamide.  At that time, our primary vet sensing that Sam might be a difficult case recommended that we go to Cornell for a consult.

In April of 2013, Sam had his first check up with Cornell’s neurology service.  At this first visit, it was determined that Sam probably had presumptive idiopathic epilepsy. After that visit, I felt a sense of relief that although there was no cure, Sam could lead a normal full life. I also had a sense of security knowing that I would have the assistance of Cornell to help us through this unknown journey.  We visited Cornell once a year throughout his life for his rechecks and in between visits they were always a phone call away when we were struggling.

Sam fought epilepsy for about nine years and later on in his life was also having issues with mobility and a painful vertebrate.  Throughout his life, he had many ups and downs. His epilepsy at times was uncontrolled even though he was on a cocktail of four different anti-seizure medications that made him sleepy and impacted his mobility and stability.  At times, early on he struggled with cluster seizures which were so scary. Last fall he survived a mast cell cancer. Through it all he was a fighter and did not let epilepsy or his other health issues define him.  Sam led a full life.  He earned his Canine Good Citizen Certification, excelled at agility and he loved to travel.  He was an awesome dog who was so loyal and provided so much love to our family.

Sam lost his battle on May 17, 2021 at the age of 11 but not before he took one last beach vacation. He led a full life and he left behind a family that loved him dearly. Having a dog with chronic health issues is challenging and stressful but so rewarding.  They often say, and I agree, that epilepsy is harder on the family than it is on the epileptic dog. In addition to the help from Cornell, I found that the following helped me manage his epilepsy: setting a firm medication schedule, journaling his seizures and trying to find possible triggers, seizure tracker apps, price shopping for meds using drug discount cards and finding a good online canine epilepsy forum.

Our home feels so empty without Sam but I am grateful that he is finally running free with no more pain and no more seizures.

-Beth

If you are looking for support after the loss of a pet, we are here to help.

Pet Loss Support Hotline

American College of Veterinary Internal Medicine
A specialty organization created to enhance animal and human health by advancing veterinary internal medicine through training, education, and discovery.

European College of Veterinary Neurology
The European Society of Veterinary Neurology (ESVN) was founded in 1987 and serves as a forum for persons interested in all aspects of the nervous system of animals, promotes training programs in veterinary neurology and provides an opportunity for collaborative clinical research throughout Europe.

• Arthrocentesis
• Balloon dilatation of esophageal strictures
• Bone marrow aspiration or core biopsy
• Bronchoscopy
• Capsule endoscopy
• Cystoscopy
• Feeding tube placement: esophageal, gastric
• Gastrointestinal endoscopy
• Laparoscopic liver biopsy
• Needle and core biopsy collection w/ultrasound guidance
• Rhinoscopy
• Treatment of nasal/sinus fungal infections

What is hyperthyroidism?

Feline hyperthyroidism is a disorder resulting from excessive thyroid hormone. The disease occurs in middle-age to older cats without sex or breed predilection. Though functional benign enlargement (adenoma) is most common (98%), thyroid carcinoma (cancer) is another cause (2%). About 70% of cats have both lobes of the thyroid gland affected.

• Symptoms: May include weight loss, poor hair coat, rapid heart rate, voracious appetite or thirst, anxiety or nervousness, diarrhea or vomiting, and vocalizing.
• Diagnosis: Lump or mass in the neck detected during a physical exam; elevated levels of thyroid hormone in the blood; isotope imaging that depicts hyper-function as a change in the size, shape, and location of the thyroid glands.
• Treatment: The four options include anti-thyroid medication, surgery, diet, and radioiodine therapy.
• Prognosis: Generally good. Cats with severe disease involving many organ systems may not survive. However, most cats, even teenagers, respond well to treatment.

TREATMENT OPTIONS
WHAT TO EXPECT DURING YOUR APPOINTMENT 
GUIDELINES FOR CAT OWNERS AFTER RADIOIODINE THERAPY
FAQ’s

TREATMENT OPTIONS

Cornell veterinarians are fully qualified to treat cats diagnosed with feline hyperthyroidism. We can suggest the best treatment for your cat and help manage the problem. We have experience with medical, surgical, dietary, and radioiodine treatment, complications, and long term management. We can assist your veterinarian with follow up care. All treatment options carry the potential risk of hypothyroidism.

Medical Treatment:

Anti-thyroid drugs inhibit the production of thyroxine by blocking reactions that produce the hormone. These drugs are usually effective but may be needed lifelong. As with any drug, there can be adverse reactions. These include loss of appetite, vomiting, depression, bleeding, liver problems, facial swelling and itching. Pills are given two times a day. Periodic exams are needed to check hormone levels and adjust the dosage. Long term therapy (years) is discouraged because the thyroid tumor continues to grow and eventually drugs may not work.

Surgical Treatment:

Removal of the thyroid gland is a surgical procedure with a good success rate. General anesthesia is used with attendant risk and older cats may have heart, kidney or other problems that cause complications. Loss of the parathyroid gland can cause problems with calcium metabolism.

Dietary Treatment:

An iodine-restricted diet (Hill's Prescription Diet Y/D) is available commercially. Consumption of this diet by a hyperthyroid cat decreases production of thyroxine by the thyroid gland by limiting the amount of iodine necessary for thyroid hormone production. Cats must eat only this diet lifelong with no supplementation with other foods, treats, or hunting.

Radioiodine Treatment:

GUIDELINES FOR PRE-RADIOIODINE TREATMENT: Consult your referring veterinarian about taking your cat off of Methimazole for 7-10 days and Hills YD 14 days prior to your appointment with us. 
The availability of radioiodine for cats is limited to hospitals with radioisotope permits. We have treated cats with radioiodine at Cornell for more than 25 years. Radioiodine is safe and effective with cure rates approximately 95 - 98% with one treatment. Cats can receive a second treatment, if necessary. Radioiodine treatment avoids surgery, anesthesia, and anti-thyroid drugs. A single injection is given subcutaneously (i.e. under the skin, like a vaccine) and the radioactive iodine is quickly absorbed into the bloodstream. The iodine is taken into the thyroid gland and incorporated into thyroxine. The majority of cats have normal hormone levels within a week or two of treatment. Hospitalization is required under the radioisotope permit issued by New York State to Cornell. You can expect that your cat will remain at the Hospital for 3 to 5 days after injection (about a week total). Additional minor precautions after discharge are needed but they are not difficult and will be thoroughly explained to you. 
 

WHAT TO EXPECT DURING YOUR APPOINTMENT

The Cornell University Hospital for Animals is the teaching hospital for the College of Veterinary Medicine at Cornell. We train veterinary students, interns (recent DVM graduates), and residents (DVM graduates with a year or more of training) as part of our mission. A board-certified expert, experienced faculty member oversees, supervises, and has final responsibility for the diagnosis and treatment of our animal patients. We are nationally and internationally recognized as a premier college of veterinary medicine and teaching facility.

We know that your time is valuable but we ask your patience with the teaching process as students and new doctors learn through experience. You will be greeted by a third or fourth-year veterinary student and will meet both interns and residents during your visit. Faculty may also introduce themselves. Our examination will review past history, physical and laboratory results; we will conduct additional physical and laboratory examinations to confirm the initial diagnosis and make sure that no other problems exist that would complicate treatment. All tests and procedures and the related costs will be explained; you can accept or decline recommendations during these discussions. We strive to be thorough and recommend those procedures that are essential to your cat and avoid unnecessary testing.

If radioiodine is the treatment of choice, we will explain the procedure and keep you informed during hospitalization (3 – 5 days).

GUIDELINES FOR PRE-RADIOIODINE TREATMENT: Consult your referring veterinarian about taking your cat off of Methimazole for 7-10 days and Hills YD 14 days prior to your appointment with us.

GUIDELINES FOR CAT OWNERS AFTER RADIOIODINE THERAPY

Cats treated with radioiodine (I-131) have a low level of radioactivity following discharge from the hospital. This level is sufficiently low that complete isolation of the cat from people is not required. Follow these guidelines for 3 weeks after your cat comes home to eliminate or further reduce human exposure to radiation that is emitted by the cat and by radioiodine that is excreted by the cat in urine and saliva.

---Do not allow your cat to sit on or sleep with anyone after coming home. Spend as little time as possible close to your cat. Casual contact is fine, but prolonged lap sitting and sleeping in your bed should be avoided. You can relax these guidelines for yourself after the second week, but not for young children or women who are pregnant or might become pregnant.

---As an extra safety precaution for the very young and developing fetuses, children under 10-years-old and pregnant woman should avoid contact with your cat, food dishes, toys and litter for the full 3 weeks.

---Keep your cat separate from any other cats in the household in order to reduce the risk of radiation exposure. Please ensure that your other cats do not use the same litter box, as radioiodine is excreted in the urine. Please ensure that your other cats are fed from separate food bowls and water dishes as radioiodine is also excreted in the saliva.

---Wash your hands with soap and water after touching your cat or anything the cat has been in contact (e.g., food dishes, toys, bedding, and especially the litter box). When cats groom themselves saliva contaminates their hair coat, which can then contaminate dishes and other objects.

---If possible, use flushable litter for the next 3 weeks. Otherwise use scoopable litter and collect all waste in a sturdy container lined with two plastic bags (one placed inside the other). Store waste in a well-ventilated space away from your primary living areas, and hold for an additional 2 weeks so natural decay will reduce radioactivity to background levels. Then the litter may be disposed with the normal trash. Landfills do not allow the disposal of low-level radioactive waste and are equipped with sensitive radiation detectors. You may be charged over $1000 if radioactivity is detected in your cat's litter at the landfill.

---Please use extra care when cleaning the litter box to avoid getting soiled litter on your hands. Use disposable plastic gloves and litter box liners to help prevent contamination. Wash with soap and water after cleaning the litter box. All used disposable gloves should be stored with the waste—treat them as if they are contaminated.

---Please keep your cat indoors if the cat uses garden areas as a litter box. Cats may go outside for supervised exercise.

---Do not allow your cat to eat from your plate or walk on counter tops where food is prepared. If the cat does or you are not sure, then put on disposable gloves and thoroughly wash the area with soap and water before preparing food.

---Items that your cat routinely contacts (e.g., bedding, toys) should be thoroughly washed with soap and water prior to handling them without disposable gloves.

---If your cat salivates on hard surfaces, then these areas should be cleaned often with soap and water, or a spray cleaner (e.g., Formula409). For surfaces that are difficult to clean (e.g., couches and upholstered chairs) cover these surfaces with a towel or blanket and replace as necessary. These towels and blankets should be washed separately from your clothing using standard laundry detergents.

---If your cat vomits a hair ball, put on disposable plastic gloves and dispose of the material with the waste litter or flush down the toilet. Next, clean the area with soap and water or spray cleaners.

---If your cat needs emergency care within the first 3 weeks of coming home, then advise the veterinary staff that your cat has recently undergone radioiodine therapy.

---After a month (typically after your first recheck appointment with your veterinarian) you can resume all normal routines and assume that all hazards associated with radioiodine treatment are gone.

                                    

FAQ’s

Q: My cat is on Tapazole, can she still be given radioiodine?
A: Cats should be off anti-thyroid drugs for a week before receiving I-131. This helps with the incorporation of radioiodine into thyroid hormone. If you or your veterinarian are concerned about withdrawing anti-thyroid drugs for a week because of the severity of your cat's hyperthyroidism, please contact us by calling 607-253-3060.

Q: My cat is 17, can she stand the hospitalization?
A: Yes, while disconcerting, cats quickly adjust in the hospital. We have successfully treated cats as old as 21-years-of-age.

Q: Can I visit?
A: No, this is not permitted, but you may leave blankets, toys, or special diets (no fish) for your cat.

Q: Are some cats NOT able to receive radioiodine?
Q: Yes, some cats have too many problems that require intensive nursing and handling to allow radioiodine therapy. Treated cats are housed in a separate ward to minimize exposure to radioiodine.

Q: What happens if my cat becomes critically ill while hospitalized for radioiodine therapy?
A: Full care is given with arrangements made to minimize radiation exposure to our personnel. Needed treatment is never denied.

                         

Immune-mediated Disorders: 

In these conditions, the body attacks its own tissues. These diseases can affect the entire body, but main systems involved are:

Diseases of the Blood System:

In these disorders, the dog or cat abnormally produces antibodies causing rapid destruction of red blood cells and/or platelets (platelets are needed for normal ability to clot blood). In immune mediated hemolytic anemia or IMHA, the antibodies attaching to red blood cells lead to anemia that is often severe and life-endangering. In immune mediated thrombocytopenia or ITP, antibodies attach to platelets causing their loss which impairs normal clotting ability. Thus, patients with ITP often present for abnormal bleeding or bruising (e.g., bleeding from the nose, gums, or under the skin). Bleeding can be so severe that the patient becomes pale, weak, and anemic. Diagnosis of IMHA or ITP is accomplished using blood tests. It is important to survey general health as finding an underlying cause of IMHA or ITP helps guide appropriate treatment (e.g. possible initiating conditions include: infections, cancer, and drug or vaccine reactions).

Treatment may include blood transfusions, medications aimed at controlling adverse immune responses, and management of any underlying conditions. Prognosis for both conditions can be good depending on patient response to medications and underlying causal disorder.

Joints/Arthritis:

In this condition, known as polyarthritis, dogs present with lameness in many different joints but typically the wrist, hock, knee and elbow. Diagnosis is often made by evaluating radiographs of the joints to rule out other conditions, retrieving joint fluid for analysis and culture, and performing blood tests for other diseases that can present in a similar way. Treatment is immunosuppressive medications. Prognosis is excellent.

Liver Disorders:

There are numerous types of liver disease commonly seen in dogs and cats. Several of the more common syndromes are profiled below.

Portosystemic Vascular Anomalies (PSVA, or “portosystemic shunts”) and Microvascular Dysplasia (MVD).

These related congenital genetic disorders are most common in small dog breeds. PSVA are also observed in large breed dogs and less commonly in cats. PSVA differs from MVD in the following way: the PSVA malformation involves one or rarely two large vessels that shunt blood around the liver directly to the heart, whereas the MVD malformation involves microscopic blood vessels within the liver. Both PSVA and MVD are recognized by testing bile acid concentrations in a blood sample. Dogs may be referred for definitive differentiation of PSVA from MVD. Patients with PSVA are often small (runt of litter) with poor growth, and often show neurologic signs (staggering, walking the wall, staring, trembling, seizures), drink excessive amounts of water, and might show signs of urinary irritation (blood in urine, straining) or develop a urinary blockage with stones unique to PSVA (ammonium urate stones). Diagnosis of PSVA is first suspected based on history and routine laboratory assessments or finding unique ammonium biurate crystals in urine. Definitive confirmation of a PSVA may be achieved by ultrasonography or isotope testing (colorectal scintigraphy) or a spiral CT scan. The latter imaging modality is used to definitively identify the anatomy of a PSVA for surgical planning and is more exact than ultrasonography or isotope methods. PSVA may be surgically attenuated, however, some patients respond well to medical intervention (diet and medications). Prognosis can be excellent but specific treatments must be tailored to the patient. MVD is often differentiated from PSVA based on blood tests and if necessary, an isotope study that rules out large grade shunting. Neither tissue biopsy nor serum bile acid tests can differentiate PSVA from MVD. We use a Protein C test to help differentiate PSVA from MVD (PSVA often have values < 70% whereas MVD values are > 70%).

Disorders of Hepatobiliary Structures:

Cholangiohepatitis: 

This condition is characterized by inflammation of bile ducts and adjacent liver, and is the most common form of chronic liver disease in the cat. Typical signs include jaundice, inappetence, vomiting, diarrhea, weight loss, or simply, persistently increased liver enzyme activity. This disorder is initially suspected based on blood tests and ultrasound imaging but definitive diagnosis requires examination of a liver biopsy (see liver biopsy below). Treatment is usually medical, although in some cases the gall bladder is removed surgically. Prognosis is usually very good.

Gallbladder Mucocele (GBM): 

A disorder observed in dogs in which the GB fills with consolidated bile and mucus leading to GB rupture. Recent work suggests that a metabolic genetic disorder increases risk for GBM in some dogs (e.g. Shetland Sheepdogs). Clinical signs may be vague in the early stage of GBM development: inappetence or evidence of distress after eating. With chronicity, the patient may become jaundiced. Severe distention of the GB may lead to GB rupture necessitating emergency surgery. Diagnosis of GBM is made through routine chemistry tests and abdominal ultrasonographic imaging. Early diagnosis is aided by examining the GB for normal contractility by sequential ultrasound examinations. Prophylactic GB removal is recommended for some dogs with a developing GBM non-responsive to medical management. The success of medical management is not well established.

Hepatic Mass Lesions: 

Mass lesions within the liver are often identified on ultrasound examination and can represent an area of liver healing (or regenerative nodule in a damaged region), a change in tissue content caused by storage of glycogen (starch, common in dogs with Cushing’s Disease described below), infections (abscesses), biliary cysts, chronic fibrous tissue secondary to chronic hepatitis, or benign or malignant tumors. Routine blood tests and fine needle aspiration samples of the mass lesion under ultrasound guidance are needed to determine whether a mass lesion requires surgical intervention (removal).

Chronic Hepatitis: 

Chronic hepatitis is a common disorder in the dog causing increased liver enzyme activity over weeks to months and only vague clinical signs in the early stages. This syndrome represents ongoing inflammatory liver injury and is often immune-mediated. It may initially start as a primary disease process or secondary to another disease syndrome or exposures to toxins, drugs, or infections. Chronic hepatitis is initially considered as a differential diagnosis based on history, physical assessment, and routine laboratory tests and usually requires ultrasonographic imaging and diagnostic biopsy for definitive diagnosis. In some cases, a simple fine needle aspiration sample is collected to rule out easily diagnosed conditions (neoplasia, vacuolar hepatopathy). An important subcategory of chronic canine hepatitis is that caused by pathologic copper retention (Copper Associated Hepatopathy). This important syndrome can be entirely eliminated with medical and nutritional intervention. The prognosis for dogs with chronic hepatitis and copper associated hepatopathy is variable depending on the stage at time of diagnosis and the underlying cause. In most cases, chronic treatment and periodic health assessments are needed.

Feline Hepatic Lipidosis (FHL): 

The most common acute liver disorder causing severe jaundice in the cat that is potentially lethal without judicious supportive care. FHL is a syndrome initiated by several days of inappetence. Thus, many primary disease processes initiate FHL and must be concurrently managed during FHL diagnosis and treatment. After vitamin K treatment to reduce risk of bleeding, placement of an esophageal feeding tube is needed to allow owner feeding and treatments that support feline metabolic needs during FHL recovery. We have come a long way in managing this common feline syndrome over the last 20 years and now most affected cats can recover. Early diagnosis improves chance of recovery and involves routine laboratory tests, ultrasonographic abdominal imaging, and fine needle aspiration of the liver.

Liver Biopsy: 

Diagnosis of many liver disorders requires blood tests, abdominal ultrasound imaging, and liver biopsy. Liver biopsy is usually necessary to establish a definitive diagnosis and can be completed at the time of an exploratory abdominal surgery or by minimally invasive methods (tru cut needle biopsy, laparoscopic surgery). The best non-invasive method of liver sampling is by laparoscopic “key-hole” surgery as this offers the ability to examine the entire organ grossly, to sample selective lesions, and obtain adequately sized tissue samples.

Endocrine diseases. 

The endocrine system is the collective system of organs that control hormones in the body. There are many types of endocrine diseases, but three we see commonly include:

Cushing’s syndrome in dogs: 

Cushing’s syndrome is a commonly diagnosed endocrine condition of the dog resulting in high blood cortisol levels from the adrenal glands. The disorder usually develops from adrenal gland enlargement stimulated by signaling from the pituitary gland, but also may be caused by an adrenal gland tumor. Common symptoms include increased thirst, excessive urination, ravenous appetite, and thinning hair coat. The condition is diagnosed through blood and urine tests and imaging scans in dogs with appropriate clinical signs. Treatments include medications to reduce cortisol levels, or in some instances surgery. Prognosis is variable depending on the underlying cause.

Diabetes mellitus: 

In this condition, your dog or cat does not have enough insulin to control blood sugar levels and maintain normal body function. As a result, blood sugar levels rise leading to clinical signs of increased urination, excessive thirst, and weight loss. Diabetes mellitus is routinely diagnosed by blood and urine tests. Successful treatment involves daily insulin injections and dietary modification.

Hyperthyroidism in cats: 

Excessive production of thyroid hormone by an overly active thyroid gland can lead to weight loss, behavioral changes, vomiting, and diarrhea. Diagnosis is based on appropriate clinical signs and physical examination findings in conjunction with routine blood and urine tests and thyroid hormone measurement. This common condition in older cats may be treated by anti-thyroid drugs, radioactive iodine therapy, surgery, or dietary management. Prognosis is generally good to excellent.

Gastrointestinal diseases

Inflammatory bowel disease or IBD: 

Dogs often present with diarrhea, weight loss and sometimes vomiting. In cats, loss of appetite, vomiting, weight loss and diarrhea are common signs associated with IBD. Diagnosis is informed by a thorough history and physical examination, blood tests, fecal analysis, and diagnostic imaging. Taking a biopsy of the intestine either by endoscopy or surgery is required for definitive diagnosis. Treatment depends on the type and severity of IBD and frequently involves diet changes, vitamin supplementation, antimicrobial or immunosuppressive therapy. Prognosis varies according to type and severity of IBD, with good responses observed in the majority of dogs and cats with lymphocytic plasmacytic IBD. Cats with IBD frequently have concurrent diseases of the liver (cholangitis, lipidosis) and or pancreas (pancreatitis) that need to be addressed for optimal response to treatment.
Small Intestinal lymphoma in cats: Small intestinal lymphoma is an important gastrointestinal disease in cats, with clinical signs similar to those of cats with IBD. Intestinal biopsy is required to reliably distinguish small intestinal lymphoma from IBD. Treatment typically includes vitamin supplementation, prednisolone and chlorambucil. Prognosis is good for cats with small cell lymphoma.

Infectious diseases

We see and treat a wide range of infectious diseases. The two most common are:

Lyme disease in dogs: 

Unlike in human, dogs with Lyme disease rarely show clinical signs. The most common sign is lameness due to inflammation of several joints. Some dogs develop kidney disease. Diagnosis is based on history, physical examination, diagnostic imaging (radiograph) and blood and urine tests. Joint fluid may be sampled in some cases. Treatment is by using appropriate antibiotics. Prognosis is usually excellent for dogs with Lyme associated lameness, although dogs rarely clear the infection completely. Kidney involvement carries a much poorer prognosis.

Leptospirosis in dogs: 

A very serious condition that can result in kidney and liver failure. Diagnosis is informed by a thorough history and physical examination, blood and urine tests, and diagnostic imaging. Often dogs need to be hospitalized for an extended stay to treat kidney disease with intravenous fluids and antibiotics. Prognosis is good as long as the kidney function recovers. 

Your scheduled visit to the Internal Medicine Service at the Cornell University Hospital for Animals begins with a check-in at the reception desk.  Following a small amount of paperwork, you will be greeted in the waiting room by one or two students rotating on the Internal Medicine Service and be taken to a private examination room.  Once there, the students will collect information relative to the history of your pet’s health and then perform a physical examination.  We appreciate your patience and understanding in allowing these future veterinarians to interact with you and your pet.

The students will then consult with the Internal Medicine resident and faculty regarding their findings and assessments.  The resident will accompany the student back into your examination room and will examine your pet again and then discuss a plan to reach a diagnosis, including optional next steps, cost and logistics. Although we encourage our residents to take the lead on first stage assessments and interactions, they are always required to consult with a faculty member to develop a plan for further diagnosis and treatment.

Often, you will be asked to leave your pet in our care such that we can begin appropriate testing. Given our schedule and consultations with other specialists regarding your pet's care, you may be asked to return to discuss the findings later in the day. Some animals with more serious conditions will be admitted to the hospital for further monitoring and treatment.

Finn’s Fund was created to help animals, and their families with financial limitations, clarify the diagnosis and medical care if they are suspected or confirmed to have hepatic vascular abnormalities. Eligibility will be based on recommendation from a referring DVM through Drs. Sharon Center or John Loftus in the Small Animal Internal Medicine Service at Cornell. Qualifications include financial need, hopeful prognosis for quality of life commensurate with the typical household family companion, treatment compliance and dedication to medical management of the disease.

In 2006, Finn was adopted by Christina Fried '94 and became a beloved member of her family.  Unfortunately, at a very young age, he started exhibiting signs of serious and chronic illness.  Just before his second birthday, through a liver biopsy, Finn was diagnosed with Primary Portal Vein Hypoplasia (PPVH) with portal hypertension.   PPVH cannot be cured, but Christina was committed to finding treatment to help hold the disease at bay, manage the symptoms, and ward off complications.  The medical management of Finn's health was complicated, time intensive, and costly.  Through her tenacious dedication to Finn and finding him the best care available, they were able to share an additional 9 years together.
Christina established Finn's Fund to assist other families whose dogs are facing a vascular liver abnormality.  She knows how difficult it can be to get an accurate diagnosis, let alone manage the costs associated with treating the disease.  She wants to ensure that families have access to top-notch care, allowing them to make the necessary treatment choices without financial hardship.
"Finn was a constant reminder to myself and those around him of all of the good and wonderful things that life can bring.  Despite being abandoned as a puppy to the streets of New York, he chose to see the world around him as full of love, excitement and wonder.  Though he had to spend far too much time in the hospital, he always bounded up the stairs with a wagging tail and kisses for everyone.  He brought such happiness and joy to all the people he encountered, and I truly believe that he made us become better people.  Although his absence leaves a big hole in all of our lives, I feel so lucky to have been able to share his life and so grateful for every day that we were able to extend it through the treatment designed by his doctors and Cornell." – Christina Fried '94

For more information or to be considered for this fund please Contact Us

American College of Veterinary Internal Medicine 
A non-profit board created to enhance animal and human health by advancing veterinary internal medicine through training, education, and discovery.

If you have an appointment for an outpatient imaging examination, check in at the main reception desk. After registration, a technician will meet you in the reception area, answer questions and take your pet for their examination. For most ultrasound examinations, you may accompany your pet.

Your animal may need to be sedated or anesthetized to prevent movement during imaging. We do this when we anticipate that the procedure might be uncomfortable or painful, if the animal is anxious and whenever we expect that not holding perfectly still would defeat the procedure – motion is the bane of imaging! We work with your primary Cornell veterinarian to decide which sedative or anesthetic is most appropriate. Radiographs and ultrasound are often done awake, sometimes with a sedative and occasionally, when necessary, we manually restrain the animal. We minimize manually holding animals for radiographs to limit our own exposure to radiation. Animals receiving a CT are sedated or anesthetized but MRI patients are almost always given general anesthesia. Anesthesiologists are available to consult on all cases and ensure the safety of your animal.

We interpret images and provide an oral report on the same day the study is obtained followed by a written report. For hospitalized animals, emergency imaging and interpretation is available 24/7/365 by residents and faculty on back-up.

Radiography

Agfa DX-G CR
Commonly referred to as “x-rays”, radiographs are used widely in all species for examination of any body region. Radiographs are often the initial modality used to investigate a disease problem and can be diagnostic on their own or useful when recommending additional types of imaging.

Ultrasound

Philips EPIQ5 and Philips IU-22
Sonography is commonly used by radiologists to evaluate the internal structure of organs, search for fluid accumulations, evaluate blood flow, detect infections, tumors, and help determine the extent of trauma. While abdominal sonography is our most common examination, all body regions can be examined. Our cardiologists use ultrasound for echocardiography – a specialized examination of the heart. 

Computed Tomography (CT)

Toshiba Aquilion Large-Bore, 16-slice
CT scanning uses x-ray and sophisticated computer processing to render cross-sectional images of the body. The current CT equipment is fast enough to scan through an entire large-breed dog in under a minute and much less for a cat, rabbit or other small animal. While general anesthesia is necessary for some examinations, others can be obtained with sedation or very short acting anesthetics leading to faster and safer examinations. CT scanning is useful in the evaluation of trauma, neurological conditions in the back, chest and abdominal cancers, head and neck diseases, and for planning both surgical and radiation cancer treatments.

Magnetic resonance imaging (MRI)

Toshiba Vantage Atlas 1.5 Tesla
MRI examines body structures using the property of nuclear magnetic resonance to stimulate with radiofrequency energy the nuclei of hydrogen atoms aligned in a strong magnetic field and detect those signals for imaging. MRI provides excellent contrast between soft tissues that are otherwise indistinguishable by other means, which makes it especially useful in imaging the nervous (brain and spinal cord) and musculoskeletal (muscles, tendons, ligaments) systems.

Nuclear Medicine

MIE Equine Scanner HR/Scintron VI-VME
In nuclear medicine imaging, radiopharmaceuticals are injected into the animal and a gamma camera detects the distribution of the isotope in the body. These examinations are used mainly for the diagnosis of bone, thyroid, kidney and liver diseases. The radiation dose from the isotope is minimal and use is fully regulated by Environmental Health and Safety at Cornell and the New York State Health Department.

We offer I131 Radioiodine treatment for cats with hyperthyroidism. 

Digital Fluoroscopy

Philips R/F and Ziehm C-arm
Fluoroscopy guides interventional procedures (placement of pacemakers, occlusive coils, and catheters) and is used to examine organ function (swallowing, tracheal collapse syndromes, and gastrointestinal motility). Examinations may be performed in the radiology suite on awake animals. The “C-arm” systems permit fluoroscopy in the operating room during surgery for real-time guidance in catheter placements and orthopedic repairs and prosthetic implantations.

American College of Veterinary Radiology

The ACVR sets standards for veterinary imaging professionals, certifies training programs, and examines residents during and at the completion of a three-year, post-graduate program. Passing a written and oral examination leads to “board-certification” and is the credential required to practice as a veterinary radiologist. CUHA radiologists are board-certified and dedicated to service, education and research in veterinary imaging. We regularly have three or four residents training in the Hospital.

Veterinary Diagnostic Imaging Residency Program

The American College of Veterinary Radiology (ACVR) accredits Cornell’s residency program in Veterinary Imaging. This 4-year program generally enrolls one new candidate each July and provides specialty training in radiology, fluoroscopy, ultrasonography, nuclear medicine, computed tomography, and magnetic resonance imaging in small and large animals, and radioiodine treatment of hyperthyroidism in cats. 

• Diagnosis and treatment of dental disease in rabbits and rodents
• Diagnosis and treatment of upper and lower respiratory tract disease in rabbits
• Medical and surgical treatment of adrenal gland disease in ferrets
• Medical and surgical treatment of birds for chronic egg laying
• Medical and surgical treatment for reptiles with follicular or egg stasis
• Upper and lower gastrointestinal and respiratory tract endoscopy in birds
• Surgical treatment of fractures in birds, exotic mammals, and reptiles
• Diagnosis and treatment of bladder stones in rabbits, guinea pigs, lizards, and chelonians                           
• Diagnosis and treatment of birds with medical or behavior feather destruction tendencies

Your scheduled visit to the Exotic Pet Services at the Cornell University Hospital for Animals begins with check in at the reception desk. Following a small amount of paperwork, you will be greeted in the waiting room by one or two students currently in their exotic pet rotation and brought to a private examination room.

The students will inquire about your pet's history. They may perform a physical examination of your pet - an invaluable experience for their education and development. We appreciate your patience and understanding in allowing these future veterinarians to interact with you and your pet.
The students will then leave to consult with a resident or faculty member about the history, physical examination and recommendations for case management. The faculty member or resident will accompany the student back to your examination room to examine your pet again and discuss the diagnosis, next steps, cost and logistics.

Often, you will be asked to leave your pet in the care of our students so that we can begin appropriate testing, which can include blood tests and imaging studies. Given our busy schedule and consultations with other specialists regarding your pet's care, you may be asked to return to discuss our findings later in the day. Some animals with more serious conditions will be admitted to the hospital for further monitoring and treatment.

When nature needs a little help...

For nearly six years, Buddy was an active, healthy ferret. But when the ultimate power outage occurred – the natural electrical system in his heart stopped functioning properly – his heart rate became too low, a potentially life threatening condition. With the natural rhythm gone awry, owner Tara Fish looked to experts at the Cornell University Hospital for Animals for a man-made cadence.

Drs. Jamie Morrisey and Ricardo DeMatos, from the Exotics Service, and Dr. Marc Kraus from the Cardiology team, diagnosed the three-pound family pet with a third-degree heart block. Considered to be a complete obstruction, Buddy’s failing heart was responsible for the once spry ferret’s current difficulty completing simple tasks, like walking and breathing. Effectively, Buddy’s heart was beating at only 30 percent of what it usually would, making it difficult for Buddy’s brain and organs to get the blood and oxygen needed for optimal functioning.

“It happened so suddenly,” said Fish, who is a lab technician with the USDA. “He was playing as he usually did, and collapsed without warning. He was breathing very fast, so I knew something was wrong.”

With the initial diagnosis, medical and surgical treatment options were discussed with the owner. Considering the high risk of pacemaker implantation and novelty of the procedure in the species, the team and Fish decided to treat medically, administering medicine and observing. For a few months, Buddy’s heart rate was manageable and he was holding his own, according to Fish, but then, just as unexpectedly, the sable bundle of fur took a turn for the worse and surgery was scheduled. A team of veterinarians, including exotics specialists, cardiologists, and surgeons worked together to implant a pacemaker that was originally designed for a human and is the size of a silver dollar.

“The first 24 hours after the surgery were a bit rough, but Buddy is a fighter,” said Fish, who was able to visit him in the recovery area and took him home to his sister, Bella, two days later. “There were definite risks involved, and I knew it could have gone either way.” Buddy loves his life, so I decided to give him that chance. Who wouldn’t do that for someone they love?”

Fish has seen the wire from the pacemaker that is directly linked to Buddy’s heart and the generator in his belly on the x-rays. Listening to his heart beat with her stethoscope – something she does regularly – is the ultimate reassurance, though.

“I’m thankful that there are people who realize life-saving surgeries and treatments should not just be for people,” said Fish. “I will continue to do whatever I can for both of my ferrets. They’re my babies”

Indeed, this wasn’t Buddy’s first surgery with Cornell. In July of 2010, he had an adrenal gland and his spleen removed. Currently, Buddy’s sister is undergoing chemotherapy treatment for intestinal lymphoma. Bella was first diagnosed in June of this year, after emergency surgery for an intestinal rupture and peritonitis. So far she is doing quite well.

“It’s been quite an emotional roller coaster over the last year or so, and I have had to make some very difficult decisions for Buddy and Bella, but I am so thankful for the caring, and professional staff at the Cornell University Hospital for Animals, especially the Exotics department; they been very helpful, for sure,” said Fish.

Some people might ask: Why ferrets? The answer comes easily to Fish: “They have taught me so much, and they bring a level of quality and joy to my life. Their heartwarming personalities are amazing. It doesn’t matter what kind of day I’m having, as soon as I see their curious, bright eyed, little faces, it makes me smile. They really do leave tiny pawprints on your heart.”

The American Federation of Aviculture
A non-profit organization dedicated to educating the public about keeping and breeding birds in captivity.

The House Rabbit Society
This national non-profit organization rescues rabbits and provides information about keeping rabbits as pets.

The Association of Avian Veterinarians
This international professional organization advances and promotes avian medicine and stewardship.

Herp and Green Iguana Information Collection 
A comprehensive collection of information about the care and health of reptiles and amphibians.

Association of Exotic Animal Veterinarians
Advancing the veterinary care of ferrets, guinea pigs, rabbits, hamsters, rats, mice, chinchillas, hedgehogs, and other exotic companion mammals.

American Ferret Association

• Oxygen support
• Multimodal analgesia
• Component and whole blood transfusion
• Enteral and parenteral nutrition
• Intensive monitoring (central venous pressure, arterial pressure, electrocardiogram, oximetry, capnography, and cardiac output)
• Vasopressor and positive inotropic support
• Custom composition intravenous fluids
• Mechanical ventilation
• Extracorporeal blood purification (dialysis for kidney failure, etc.)

Examples of emergent conditions, if your pet is experiencing a life-threatening emergency, please proceed immediately to the nearest emergency clinic.

1. Unconsciousness or unresponsiveness
2. Difficulty breathing
3. Collapse
4. Blue, purple, or pale gums
5. Trauma (vehicular trauma, falls, wounds, etc.)
6. Excessive bleeding
7. Loss of balance
8. Lethargy or weakness
9. Difficulty urinating
10. Unintended ingestion of a medication or toxic substance
11. Seizure activity or active tremoring
12. Non-weight bearing lameness
13. Difficulty walking
14. Hives or facial swelling
15. Difficulty giving birth
16. Pain
17. Severe or protracted vomiting
18. Non-productive retching
19. Severe diarrhea with blood (red or black and tarry)
20. Bloated, distended or painful abdomen

Your emergency visit to the Cornell University Hospital for Animals begins when you pull up to front of the Companion Animal Hospital. Please park your vehicle in the patient parking in front of the hospital and check-in at the reception desk.

After you register, a veterinary student or LVT will perform a triage. During the triage you will be briefly interviewed about your pet’s condition. To further evaluate your pet’s stability, the student or LVT may also obtain baseline vital parameters. After this brief assessment the student or LVT may ask you to wait with your pet in the waiting room, or they may ask your permission to take your pet to the emergency treatment area where they will be further evaluated by one of our emergency clinicians. If stabilization is recommended, they will also ask your permission to perform basic diagnostic tests and institute the therapy deemed necessary to stabilize your pet. If your pet is taken to the emergency room you must wait in reception area. Space restrictions and the intense activity that may involve your pet as well as other patients being cared for in the emergency room preclude your ability to stay with your pet. Please remain in the reception area, so emergency personnel can find you when needed.

In turn, you will be escorted to an exam room where a veterinary student will obtain a full clinical history. If your pet is waiting with you, the student will also perform a complete physical exam. Subsequently, the student will leave to discuss your pet’s history and physical exam findings with the emergency clinician that is caring for your pet. Afterwards the emergency clinician will enter the exam room, review the history, clarifying any questions, and perform their own physical exam. After this complete assessment the emergency clinician will discuss their findings, thought processes and recommendations with you. 

Throughout the emergency visit, please understand that there may be delays. The reasons for the delays may not be obvious to you, but always are related to how many critically ill and emergency animals our patient care team is treating at the time. We will do our best to keep you informed about your animal’s status, what our patient caseload is, and what you might expect in terms of the length of time you may need to wait. Please be assured that your doctor’s priority is the care of your animal and the other emergency and critically ill patients in the hospital. 

If your animal’s condition requires the opinion of a specialist and the specialist is not on-site at the time of your emergency visit, you may have to wait for the specialist on-call to come to the hospital, or your animal may have to stay overnight for a consultation the following day.

If your animal needs to be admitted to the hospital as an inpatient, your animal will be transferred to a specialty service within 24 to 48 hours and will be cared for by a different veterinarian. Every case is thoroughly reviewed upon transfer to ensure excellent patient care and an outstanding educational experience for our students.

If you would like to visit your pet during their hospitalization, this can be arranged with the doctor caring for your pet. For safety reasons, all visitors must be accompanied when in the clinical areas of the hospital. Please remain in the public areas of the hospital unless escorted by your doctor, student or LVT.

If your veterinarian arranged for your pet to visit our Emergency Service, or if you provide us with the contact information for your veterinarian, the Cornell University Hospital for Animals doctors will do their best to keep your veterinarian informed of your animal’s progress and our diagnosis. Discharge statements outlining diagnosis and treatment are faxed to your veterinarian unless you instruct us not to do this.

The Critical Care and Extracorporeal Blood Purification Team are pleased to be able to offer dialysis treatment for dogs and cats in kidney failure and blood purification for other indications.

The kidneys are part of the body’s system for filtering impurities out of the blood and eliminating them in the urine. If your pet is experiencing problems with kidney function, this can result in a wide variety of serious health concerns. Our dialysis unit can serve as a temporary kidney of sorts, giving time for the organ to heal, filtering out impurities from the blood and reducing the length of your pet’s hospital stay.

Extracorporeal blood purification is used in several cases, including

• kidney failure – treated with hemodialysis
• toxin ingestion – blood purification before organ damage occurs
  • carprofen/Rimadyl, ibuprofen, anti-inflammatory drugs, baclofen, antifreeze, and many other toxins/medications
• immune system dysregulation – treated with therapeutic plasma exchange
  • immune-mediated hemolytic anemia (IMHA), myasthenia gravis, others

If your pet is experiencing kidney issues, has ingested a toxin from the list above or has an immune-mediated condition, please see the sidebar for our contact information, triage instructions and a map to the Cornell University Hospital for Animals.

American College of Veterinary Emergency and Critical Care
A specialty organization that promotes the practice of veterinary emergency and critical care medicine, fosters training programs and encourages research in this important field.

Academy of Veterinary Emergency & Critical Care Technicians
Academy of Veterinary Emergency & Critical Care Technicians (AVECCT) is the first organization to be recognized by the National Association of Veterinary Technicians in America as a veterinary technician specialty. Veterinary Technicians who successfully meet the credential requirements and pass the AVECCT examination are designated as Veterinary Technician Specialists (VTS).

ASPCA Poison Control
Your best resource for any animal poison-related emergency, 24 hours a day, 365 days a year. If you think that your pet may have ingested a potentially poisonous substance, call (888) 426-4435. A $65 consultation fee may be applied to your credit card.

• Intradermal allergy testing
• Serologic allergy testing
• Cryotherapy
• CO2 laser

Your scheduled visit to the Dermatology Service at the Cornell University Hospital for Animals begins with check in at the reception desk. Following a small amount of paperwork, you will be greeted in the waiting room by one or two students currently in their dermatology rotation and brought to a private examination room.

The students will inquire about your pet's history and perform a physical examination of your pet - an invaluable experience for their education and development. We appreciate your patience and understanding in allowing these future veterinarians to interact with you and your pet.

The students will then leave to consult with an intern, resident or faculty member about the history, physical examination and recommendations for case management. The faculty member, resident, or intern will accompany the student back to your examination room to examine your pet again. They may recommend further testing, and will discuss with you potential diagnosis, next steps, cost and logistics.

Often, you will be asked to leave your pet in the care of our students so that we can begin appropriate testing, which can include blood tests or allergy testing. Given our busy schedule and consultations with other specialists regarding your pet's care, you may be asked to return to discuss our findings later in the day.

The Dermatology service also frequently sees Cornell patients admitted under the care of other specialties.

Many skin diseases are chronic in nature and require a lifelong treatment plan. Our service will plan follow-up phone consultations with you or your referring veterinarian to ensure any chronic conditions are management well over time. 

Please follow these instructions exactly, or we may not be able to do all that is required on the day of the appointment.

1. Do not bathe your pet for 7 days before the scheduled appointment.
2. Give NO food or snack of any kind to your pet the day of the examination. Your pet may have as much water as he/ she wants.
3. Bring the completed history form, along with as much additional information about your pet's condition as possible. A referral letter from your veterinarian or a copy of your pet's medical record is very helpful. Also, New York State Law requires a valid rabies certificate to be presented upon arrival to our hospital. Failure to do so may result in your pet not being evaluated.
4. Write down and bring with you the names of all medications (pills, capsules, shots, shampoos, ointments, drops) your pet uses now or has used within the last 30 days. For oral medications (pills or liquids taken by mouth), please write down:
   1. the size (number of milligrams) of the pill/capsule,
   2. the number of pills or amount of liquid being given at each dosage, and
   3. how many times each day the medicine was/is given.

 

Skin testing usually is not done during the first appointment, especially if the appointment is in the afternoon. Occasionally, an exception can be made and the testing will be performed on the day of the initial examination provided that time and space allow and if all the following requirements for allergy testing are met:

1. The skin on either the right or left side of the chest must be fairly normal. If you have any question about whether there is enough normal skin for testing, please have your local veterinarian examine your pet within one week of the Cornell appointment.
2. If your pet has previously been seen by Cornell's Dermatology Service, bathing with a grooming or antiseptic shampoo is allowed up until the date of testing.
3. If your pet has not been seen by Cornell's Dermatology Service, do not bathe your pet 7 days before the scheduled appointment.
4. Oral antibiotics or anti-yeast medications may be given until the night before the testing.
5. Certain medicines must be taken away from your pet in order to obtain an accurate allergy test. Withdraw the following drugs according to the schedule below. If you have questions, please check with your veterinarian and/or with us:

Steroids: (Prednisone, Cortisone)	[ ] No oral medications for 3 weeks prior to the test [ ] No topical steroids for 3 weeks, such as ear medications, eye medications, sprays, shampoos, etc. [ ] No steroid injections for 6 weeks
Nonsteroidals:	[ ] No Zubrin® , antihistamines, tricyclic antidepressants, pentoxifylline for 2 weeks
Cyclosporin:	[ ] No Atopica®, Neoral® or generics for 4 weeks
Fatty acids:	[ ] No fatty acid supplements for 14 days

Allergic skin conditions

Allergies are common in dogs and cats. The flea and other insects are the most common allergens, but allergies to environmental materials including pollens, dust mites and mold spores, or foods are also common. The ease and success of treatment depends on the inciting cause. Flea or food allergy is relatively easy to deal with while “pollen” allergies are more problematic and often require allergy testing.

Staph infection

Staphylococcus bacteria is the most common cause of skin infection that we see. The bacteria can be transmitted easily from animal to animal and rarely from animal to human, and is found on all breeds of animals. 
The most typical symptoms are a tender or itchy rash. The infection is diagnosed using skin tests and microbiology and treated with topical and/or oral antibiotics. Some strains are antibiotic resistant and require stronger medicines for treatment.

Ear Disease

Ear infections with bacteria or yeast are common in dogs, but also occur in cats. The infections are caused by a trigger - for example excessive moisture due to swimming, ear mites or allergies - that needs to be resolved along with the infection. Some organisms like Pseudomonas or methicillin-resistant staphylococcus are particularly difficult to deal with and can take months of continual treatment.

Fungal infections

Fungal infections from external sources are not as common in central New York as they are in other parts of the United States. The most common fungal disease seen by the dermatology group is an overgrowth of Malassezia yeast, which are part of the normal flora of an animal’s skin. In these cases, the yeast have to be treated aggressively but the underlying trigger event - for example, allergies, greasy skin disorders or excessive swimming - also needs to be resolved. The most common external source of fungal disease is ringworm, but we occasionally see animals with more severe internal fungal disease that have spread to the skin.

Immune-mediated Disorders

Immune-mediated disorders are fairly common in companion animals. In some diseases, the animal’s immune system is fighting off a foreign substance, such as a fungal organism, and the skin gets attacked accidentally. Drugs are the most common triggers for this type of reaction. In other cases, the animal’s skin isn’t recognized as belonging to the animal and the immune system tries to reject the skin. These are the autoimmune diseases and require lifelong treatment.

The American College of Veterinary Dermatology
The official specialty organization created to advance and promote excellence in veterinary dermatology, oversee postgraduate training in veterinary dermatology, sponsor research, and organize scientific and educational programs for both veterinary dermatologists and general practitioners.

• Conventional and surgical root canal treatment
• Partial coronal pulpectomy
• Routine periodontal treatment
• Simple and surgical extractions and coronectomy
• Periodontal surgery
• Management of traumatic malocclusion
• Treatment of carious lesions
• Crowns
• Surgical biopsies and oral tumor staging
• Oral tumor resection
• Palatal defect repair
• Maxillofacial repair
• Sialoadenectomy

Dental disease

Dental disease is the most common disease of small animals. The most common types of dental disease among small animals include periodontal (gum) disease, endodontic (nerve) disease, and tooth resorption, where part or all of a tooth is lost because body cells attack the tooth. 

Cavities or decay are not as frequent in dogs as they are in humans, and apparently do not affect cats. 

Even though dental disease can be severe and painful, and seriously affect the general health status and quality of life of an individual, animals usually conceal their discomfort, so clinical signs and symptoms can be very subtle. Possible signs of dental disease include bad breath, excessive drooling, pawing at the face, difficulty eating, bleeding or recessed gums, and tooth loss.

Dental disease can be suspected based on reported symptoms and a conscious oral and physical examination. However, a definitive diagnosis and treatment plan can only be established with the animal under general anesthesia; the standard of care for the diagnosis of dental disease includes dental probing and charting, and full-mouth x-rays. Once a diagnosis is established, treatment is usually performed while the animal remains under anesthesia. 

Common treatment for canine and feline dental disease includes ultrasonic scaling and polishing of teeth above and below the gumline, periodontal surgery, root canal therapy, extractions and fillings. 

When properly diagnosed, most dental conditions are treatable and the prognosis is excellent. Adequately treated patients usually experience relief and owners normally notice a dramatic improvement in attitude, appetite and overall health.

Oral and Maxillofacial Surgery

Cats and dogs also present with diseases and conditions that require oral or maxillofacial surgery. The most common conditions include traumatic injuries, such as fractures or lacerations; palatal defects, such as oronasal fistula and cleft palate; and oral tumors. 

Many patients with traumatic injuries are initially treated by the Emergency and Critical Care Service for initial stabilization, and are then transferred to the Dentistry and Oral Surgery Service for specific maxillofacial procedures. To diagnose their injuries, typically x-rays and/or CT scanning are performed.

The treatment approach and techniques differ with each case and depend on a variety of factors. The outcome and prognosis of most maxillofacial traumatic injuries is good.

Patients with oral tumors typically require an initial appointment where we conduct an examination and imaging scans to determine the exact nature of the tumor and any associated disease. After a precise diagnosis is made, many oral tumors can be removed surgically. Often times, the Oncology Service will recommend additional treatments such as chemotherapy or radiation. The outcome and prognosis of patients with oral tumors varies, and depends on the exact nature of the tumor and stage of the disease.

Patients with palatal defects typically undergo definitive surgical repair after a planning session that may include CT imaging. Depending on the size and location of the defect, final correction may require a multi-stage approach. The outcome of palatal defect repair is usually good.

Maxillofacial Reconstruction for "Bella" Dasson

Bella is a dog that was involved in a serious car accident when she was 11 months old. Even though her owners did not witness the accident and were not there to help her immediately, Bella had the strength and courage to make it back home on her own. As soon as her owners realized what had happened, they took Bella to a local emergency clinic, where she was stabilized and referred to Cornell’s Emergency and Critical Care Service. When she arrived at our hospital, she had multiple maxillofacial injuries, as well as a fractured right front limb.

The next day, we performed a CT scan of Bella's head to better document the extent and severity of the injuries sustained to her face. Bella’s upper and lower jaws had multiple, severe fractures. Without surgery, she would have been permanently disfigured and disabled. Bella was transferred to the Dentistry and Oral Surgery Service for repair of her maxillofacial injuries and facial reconstruction. Dr. Santiago Peralta performed the surgery assisted by Shantell Hassey, a fourth-year veterinary student.

The procedure took a total of 7 hours to complete; the results could not have been better, however. We were able to stabilize her fractures and properly align her bones during the surgery, our orthopedic service also casted Bella’s fractured right front limb. After surgery we monitored Bella in our Intensive Care Unit overnight.

Bella recovered incredibly well and was discharged to her family the day after surgery. Although we placed a feeding tube during surgery in case she was not able to eat on her own while her injuries healed, Bella started eating without assistance within the first 24 hours after surgery. Bella required one more surgical procedure a few weeks after her maxillofacial injuries healed to address some dental injuries. Today, Bella is completely healthy, both physically and emotionally, and is enjoying her life to the fullest.

The American Veterinary Dental College
The American Veterinary Dental College is recognized as the specialist certification organization in veterinary dentistry in North America by the American Board of Veterinary Specialties. AVDC diplomats are veterinary dental specialists.

American Veterinary Dental Society
The American Veterinary Dental Society is a non-profit organizations created to advance the knowledge, education, and awareness of veterinary dentistry and increase awareness of the importance of this facet of animal medicine.

Veterinary Oral Health Council
The Veterinary Oral Health Council is an independent organization that awards a registered seal to products intended to help retard plaque and tartar on the teeth of animals.

Your scheduled visit to the Cardiology Service at the Cornell University Hospital for Animals begins with check in at the reception desk. You will be greeted in the waiting room by one or two students currently on their Cardiology rotation.

The student(s) will then inquire about your pet's history and perform a physical examination of your pet. This experience is invaluable to the education and development of our students, and we appreciate your patience and understanding in allowing these future veterinarians to interact with you and your pet.

The student(s) will then excuse themselves and consult with either a cardiology resident or cardiologist on service regarding their recorded history, physical examination findings, and recommendations for case management. A cardiologist or cardiology resident will then examine your pet and discuss their initial findings and recommendations for management of your pet's case.

In most cases, you will be asked to leave your pet in the care of the student(s) after this initial examination so that we may begin appropriate diagnostic testing, which commonly includes: electrocardiography, echocardiography, thoracic radiography, and noninvasive blood pressure measurement.

Given our busy schedule and requisite interaction with other services in the care of your pet, you will most commonly be asked to return to discuss our findings and recommendations in the afternoon. Please understand that our primary concern is the well being of your pet, and that although we will always strive to minimize the duration of your stay, we do not wish to compromise patient care, and this may take some time. If minimal diagnostics are required, we may be able to significantly shorten the duration of your visit.

When you return to pick up your pet, you will meet with the cardiologist/cardiology resident and the student(s) who received you and your pet and discuss their findings and therapeutic recommendations (if any). In most cases, therapy will be in the form of medication that you can administer at home. In some cases, your pet may require hospitalization for supportive care and/or diagnostics, and the rationale and logistics of this recommendation will be discussed in depth upon your return. In the event that your pet requires an elective interventional procedure, the rationale, logistics, and risks associated with the procedure will be discussed at this time, and the procedure can often be scheduled either at the time of discharge or within 24 hours of discharge.

Prior to your leaving the Hospital, you will receive a copy of the cardiology report, which outlines the findings and recommendations for management of your pet's case using some medical terminology that you may not be familiar with. Your referring veterinarian (who will be more familiar with terminology used) will also receive a copy of this report via mail. You will also receive a copy of discharge instructions, which outlines our findings and recommendations in more vernacular terms, and we will strive to make sure that we have answered any and all questions that you may have prior to your departure.

Arrhythmias	Degenerative Atrio-Ventricular Valve Disease	Pulmonic Stenosis
Canine Dilated Cardiomyopathy	Patent Ductus Arteriosus	Aortic/Subaortic Stenosis
Hypertrophic Cardiomyopathy

Cardiac mapping and ablation (also called catheter ablation; radiofrequency ablation) is a procedure used to diagnose and treat abnormal heart rhythms (arrhythmias). It consists in finding (mapping) the precise location of the source of the arrhythmia with catheters that are threaded through blood vessels and guided into various areas of the cardiac chambers. The abnormal heart tissue is then destroyed (ablated) using radiofrequency energy (heat).

This technique is used to treat arrhythmias that cause rapid heart rates. It is an alternative to antiarrhythmic drugs, when these medications fail to control an arrhythmia or when they are associated with side-effects. Catheter ablation can be curative.

How do I know that my pet is a candidate for an ablation procedure?

Currently cardiac ablation is only performed in dogs. Dogs with arrhythmias that can be treated with this procedure might experience episodes of weakness or fainting, exercise intolerance and extended periods of panting, and even heart failure. Because not all arrhythmias can be treated via cardiac ablation, several diagnostic tests, performed by a board-certified cardiologist are necessary to determine if your pet is a candidate.

Which arrhythmias are treatable with cardiac ablation?

The arrhythmias that are treatable with this procedure are called tachycardia because they are responsible for rapid heart rates, on occasion above 300 beats/minute. Most of these tachycardias originate from the upper portion of the heart, above the ventricles, and are called supraventricular tachycardias. They include:

• Accessory pathway-mediated tachycardia (atrioventricular orthodromic reciprocating tachycardia)
  • Common in Labradors and Boxers
  • >90% success rate with ablation
• Focal atrial tachycardia
  • 55% to 60% success rate with ablation
• Atrial flutter
  • Common in Bernese Mountain dogs and Dogue de Bordeaux
  • 60% to 95% success rate depending on the type of atrial flutter
• Persistent atrial fibrillation

Some specific forms of ventricular tachycardia, that occur in English bulldogs, can be treated with cardiac ablation.

Which tests are required to determine if my dog can be treated with this technique?

In order to determine if your pet can benefit from cardiac ablation, the following tests need to be performed:

• An electrocardiogram (12-lead ECG)
• An echocardiogram, which is an ultrasound of the heart
• A 24-hour Holter, which is a 24-hour recording of an ECG
• Blood tests

What should I expect when I bring my dog to Cornell?

Your pet will usually be hospitalized the day before and will be able to go home the day after the procedure. Blood tests will usually be performed at the time of admission. The day of the procedure, your dog will be placed under general anesthesia and hair will be clipped in various areas of his body. Catheters will be inserted into veins from the neck and groin regions. Continuous X-ray imaging, called fluoroscopy, will be used to guide the catheters into various areas of the cardiac chambers. Once in place, the catheters will be used to record the electrical activity of the heart and trigger the arrhythmia using specialized equipment. Finally, radiofrequency energy will be delivered from a catheter where the arrhythmia is originating from to destroy the abnormal heart tissue. The procedure takes 3 to 4 hours. Your dog’s recovery will be monitored overnight in the intensive care unit.

Are there risks associated with this procedure?

Cardiac ablation is generally safe. We will discuss with you some rare complications:

• Bleeding where the catheters are inserted
• Anesthetic complications, adverse drug reactions
• Fluid around the heart (cardiac tamponade)
• Damage to the normal cardiac electrical conduction system, causing slow heart rate (bradycardia) and requiring pacemaker implantation
• Damage to the heart valves, walls and large vessels
• Ventricular fibrillation

Are rechecks needed after the procedure?

In order to confirm that the ablation was successful, we recommend that you bring your pet back to Cornell for a recheck evaluation approximately 1 month after the procedure. An echocardiogram, a 12-lead ECG and a 24-hour Holter are performed at the time of the visit. If it is not possible for you to come back to Cornell, these tests can also be done by your local board-certified cardiologist, who will share the results with us.

When can cardiac ablation be performed on my pet?

We are currently not able to perform cardiac ablations year-round. Call for current availability.

Always have your veterinarian first contact us before referring you and your dog to the cardiology service at Cornell University Hospital for Animals for an ablation procedure.

Holter monitoring is a noninvasive method of assessing the heart's rhythm and rate. It is a 24-hour electrocardiogram that is recorded while the animal is "wearing" a recorder. This permits an analysis of the rhythm and rate of the heart throughout the day and night of the dog with activities documented in a diary by the owner. Your veterinarian may recommend this diagnostic procedure for the following reasons:

• an arrhythmia is suspected in your pet
• your pet exhibits signs of weakness, dizziness, lethargy, excessive panting and agitation, or even collapse or fainting episodes
• to monitor drug therapy and effects on the heart rate and rhythm
• to monitor programming effects if your pet has an implanted pacemaker

After clipping away some fur and cleansing the skin, several electrode patches are adhered to the skin over the right and left chest areas and along the sternum. The Holter monitor is a small digital unit with a main cable and 7 wires. The wires snap onto the electrode patches. It is then wrapped up with soft bandage materials around your pet’s ribcage. If an appropriately sized vest is available, your pet will be outfitted with a vest over the wrap.

The technician will communicate with you on the removal procedure. A daily log will be your homework. Recording your pet's activities during the 24 hours is extremely important and will help correlate daily activity with the heart's rhythm and rate. The ECG data is not sent out to a human medicine lab but is meticulously edited by our cardiology technical staff and reviewed and interpreted by the clinicians who will make therapy recommendations based upon the results.

American College of Veterinary Internal Medicine
A non-profit board created to enhance animal and human health by advancing veterinary internal medicine through training, education, and discovery.

If you have contacted us previously, please note that we are in the process of phasing out initial remote appointments and will be scheduling a single in-person initial appointment going forward. Remote appointments are still available for follow-up if we have seen your pet in person the last 8-12 months. See below for more information.

What to Expect

The initial behavior consultation is approximately 90 minutes, conducted in person at our Small Animal Community Practice, 968 Campus Road, Ithaca, New York. More details about the appointment are included below. At that time, we will also schedule a 30-minute follow-up appointment (typically conducted via Zoom 4-8 weeks after the initial appointment).

• We will review your pet’s medical and behavioral history and conduct a risk assessment.
• We will also discuss the diagnosis, prognosis and initial treatment options.
• You will be provided with an immediate action plan, including safety and management protocols, tools and educational materials specific to your pet’s needs.
• Medications and supplements will be discussed and prescribed if appropriate for your pet.
• A physical exam will be performed as much as your pet will allow without causing unnecessary stress.

Following the consultation, you will receive a written summary of the visit, which will also be shared with your primary care veterinarian. Follow-up appointments can be completed in person or via video conferencing (Zoom). However, we must see your pet a minimum of every 6-12 months in person in order to make treatment recommendations and prescribe medications.

Please note that all our consultations focus on behavioral issues rather than general veterinary care. Please contact your regular veterinarian if there appears to be a medical problem with your pet. If a medical problem is recognized during a behavioral consultation, it will be referred to your regular veterinarian.

Our goal is to communicate the cost of care and payment policies as clearly and transparently as possible prior to starting and throughout treatment. We welcome any questions you have at any time. 

Please call (607) 253-2300 for the current cost of behavioral health consultations and progress appointments. All diagnostic tests, training tools, medications, supplements, and additional training and behavior modification sessions are priced separately.

Payment is due at the time of service. More information about our payment policy can be found here.

Here is how to prepare for your appointment with the Behavior Medicine Service.

• Bring your pet: Your pet should be present for the initial appointment. Your pet does not necessarily need to attend remote follow-up appointments, but we will touch base with you on the best course of action. If your concern is two pets fighting in your home, please let us know and we can decide which pets need to attend the appointment.

• Who should attend: We encourage everyone who lives with your pet, or who interacts with your pet regularly, to attend, particularly for the remote consultation. Also, if you are working with a trainer, they are also welcome. We find the team approach to behavioral care always works best. 

• Pre-veterinary medications: If medications for fear and anxiety have been prescribed by your primary care veterinarian, please plan to administer those to your pet on the day of your in-person visit. If you have any questions about giving medications prior to your visit, please let us know when scheduling.

• Video: Video of the problem behavior is helpful and should be provided prior to the appointment if possible. If file size is small enough, you can email video to communitypractice@cornell.edu. We would recommend DropBox or Google Drive for larger video files. Take video only if it is safe to do so and you are not creating or escalating a dangerous situation.

• Medical records: Prior to your appointment, please have your primary care veterinarian send a copy of your animal's medical records, recent test results and vaccination records to communitypractice@cornell.edu. We require proof of rabies vaccination. 

• SAFETY: Animals that have bitten people should be appropriately restrained either on leash or in a carrier at the start of the appointment until instructed otherwise. Please keep your animal under control at all times so that there is no risk to hospital staff. 

In cases of aggression, we strongly recommend avoiding known triggers for your pet until the visit. If you are concerned about your safety or the safety of a family member, please let us know so we can discuss things further.

• The American College of Veterinary Behavior

• American Veterinary Society of Animal Behavior

• The Cornell Duffield Institute for Animal Behavior