What is Veterinary Cardiology?
Veterinary cardiology is a specialty of veterinary medicine that focuses on diseases of the heart. Both dogs and cats can develop heart disease and it represents one of the most common health conditions affecting older pets.

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What is a Board-certified Veterinary Cardiologist? A board certified veterinary cardiologist is a licensed veterinarian who has obtained intensive, additional training in veterinary cardiology. This includes four to five years of post-doctoral training after graduation from veterinary school including a residency in cardiology and two years of extensive examinations. Our cardiologist, Dr. Damon Leeder, is a Diplomate of the American College of Veterinary Internal Medicine within the College of Cardiology (

Why does my pet need to see a Board-certified Veterinary Cardiologist? Cardiologists are veterinary specialists that diagnose and treat disease of the heart. Common conditions managed by cardiologists include:

  • Damage to the heart valves
  • Heart muscle disease (cardiomyopathies)
  • Congestive heart failure
  • Coughing and other breathing problems
  • Congenital (present at birth) defects
  • Cardiac arrhythmias (problems with the heart rate or rhythm)

Your pet’s primary care veterinarian can diagnose and treat many health problems. However, certain conditions benefit from the involvement of a specialist with intensive training in cardiology. Additionally, specialists have access to advanced diagnostic tests not readily available to general practitioners. At the Veterinary Emergency and Specialty Center, services offered by our cardiologist include:

  • Murmur evaluations
  • Pre-anesthetic evaluation
  • Diagnosis and treatment of pets with clinical signs of heart disease
  • OFA Heart Certification
  • Heart screening tests for predisposed breeds (e.g., Boxers and Dobermans)
  • Consultation for patients with a pre-existing diagnosis of heart disease

What should I expect during the visit with a Board-certified Veterinary Cardiologist? Our cardiologist will first obtain a health history and perform a thorough physical examination. Based on these initial findings additional tests will be discussed. The most common tests performed in pets with heart disease include:

  • Echocardiography: Noninvasive form of ultrasound that provides detailed images of the beating heart.
  • Electrocardiography (ECG): Recording of the heart’s electrical activity and rhythm.
  • Radiography (chest x-rays): Provides images of the heart and lungs and facilitates the diagnosis of congestive heart failure.

Other tests that may be considered include:

  • Blood tests
  • Cardiac catheterization procedures
  • Angiography
  • Blood pressure evaluation
  • Holter monitor (24-hour ambulatory ECG recording)

Does my pet need all these tests? Not all pets require multiple tests. The echocardiogram is the most common test and may be the only one required. More complex cases require more additional testing to reach a diagnosis and determine the best therapy. The diagnostic plan is individualized to every patient’s needs and is made in consultation with you and your primary care veterinarian.

What can be done if my pet has a heart problem? A large number of medical treatments are available. Many of the treatments available for humans with heart disease are now available for pets. The recommended tests help determine the best therapy. Some pets do not require any treatment and simply need to be monitored. Others require medications to control their disease. For certain conditions, minimally-invasive procedures may be recommended to treat or cure the disease. Pacemaker implantation or surgical procedures are rarely required.


In order to earn the right to be called a specialist in veterinary surgery, one must become board certified by the American College of Veterinary Surgeons (ACVS). 

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All ACVS Diplomates have received a Doctorate of Veterinary Medicine from a school accredited by the American Veterinary Medical Association, completed a one year multi discipline internship and a three year surgical residency program under the supervision of other ACVS Diplomates. During their extended education, applicants must become proficient in medicine, anesthesiology, radiology, pathology, anatomy, physiology, as well as surgery. They are also required to perform and publish original research for the aid and benefit of veterinary surgery. Qualified applicants must submit extensive credentials to the ACVS documenting their training, clinical competency and scientific contributions. If their credentials are accepted, candidates then qualify for the board certification examination which is a comprehensive, two day exam with case based/oral, written and practical portions. Upon successful completion of the final examination, the applicant may then be called a board certified veterinary surgeon and a Diplomate of the American College of Veterinary Surgeons. Click here to visit the ACVS website for more information.

Critical Care

What is an emergency and critical care specialist?
A board certified specialist in emergency and critical care is a veterinarian who has obtained intensive training in treating life-threatening conditions.

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What additional training does an emergency and critical care specialist have? Veterinarians who want to become board certified in emergency and critical care medicine must seek additional training to become a specialist and earn this prestigious credentialing. Specialty status is granted by the American College of Veterinary Emergency and Critical Care (ACVECC). A veterinarian who has received this specialty status will list the initials DACVECC after their name in addition to DVM and may indicate that they are a Diplomate of the ACVECC. The word Diplomate typically means the specialist has achieved the following:

  • Obtained a veterinary degree (three to four years of college plus four years of veterinary school).
  • Completed a one-year internship at a veterinary teaching hospital.
  • Completed a three year residency of advanced training in emergency medicine, surgery, and critical care at a veterinary teaching hospital. Residents train with some of the best specialists in the field and obtained hands on experience. This training focuses on the most up to date techniques for the diagnosis and treatment of life threatening disease processes or injuries.
  • Passed a rigorous examination.After completing and passing all of these requirements, the veterinarian is then recognized by his or her peers as a board certified specialist in veterinary emergency and critical care.

What does an emergency and critical care specialist do? An emergency and critical care specialist provides primary case management or supervision and guidance of emergency doctors in emergency stabilization and intensive management of acutely injured or critically ill patients. Some illnesses require several days of therapy before improvement is noted, so close attention to all aspects of treatment of the disease process and specialized monitoring under the supervision of a critical care specialist provides the best chance for a positive outcome. The critical care specialist acts as the patient’s advocate in identifying all reasonable diagnostic and treatment options, gaining an accurate prognosis, and administering advanced life support. They also facilitate the family’s decision-making process by coordinating consultations and information obtained from the primary care veterinarian, emergency doctor, and other specialists.

What medical conditions can benefit from an Emergency and Critical Care Specialist?

  • Trauma
    • hit by car
    • head trauma
    • bite wounds
    • burns
    • crush injury
  • Sepsis (severe infection)
  • Heart failure
  • Kidney failure
  • Liver failure
  • Respiratory failure (trouble breathing)
  • Toxin ingestion
  • Blood clotting disorders
  • Immune-mediated diseases
  • Seizures
  • Chemotherapy reactions
  • Fluid build-up in the chest, abdomen, or around the heart
  • Envenomation
    • snake
    • spider
    • bees

Diagnostics and procedures performed by an Emergency and Critical Care Specialist:

  • Advanced Intravenous fluid therapy
  • Advanced techniques for pain management
  • Advanced techniques in anesthesia
  • Blood transfusions
  • Oxygen administration
  • Mechanical ventilation (use of respirators)
  • Cardiopulmonary resuscitation and post-resuscitation life support
  • Blood gas analysis
  • Identification and acute management of abnormal heart rhythms
  • Wound management
  • Emergency surgery
  • Blood pressure monitoring and the use of medications to control blood pressure
  • On-site blood testing
  • Advanced nursing care

The integration of all the hospitals services is a major advantage for the patient as veterinary medicine continues to become more advanced. The primary care (or referring) veterinarian has a very important role in the care of critical patients by offering their client’s referral to VESC and providing follow-up or long-term care where necessary. We make communication with the client and primary care veterinarian a top priority when their patients are with the critical care service.


A Radiologist (ACVR Diplomate) is a veterinarian who has undergone advanced training and passed the ACVR examinations to become board-certified as a specialist in veterinary radiology or radiation oncology. 

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Dr. Winegardner diagnoses disease by obtaining and interpreting medical images. The results of imaging interpretation are correlated with the results of examinations or other tests so that medical care recommendations for your pet can be made through consultation with our veterinarians, specialists or your primary care veterinarian.

Internal Medicine

What does it mean to be board certified (achieve Diplomate status)?
Veterinarians wishing to become board certified must complete a 2-3 year residency program, meet specific training and caseload requirements, perform research and have their research published.

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This process is supervised by current Diplomates in each specialty to ensure consistency in training and adherence to high standards. Once the residency has been completed, the resident must sit for and pass rigorous examinations. Only then does the veterinarian earn the title of Diplomate in that specialty.

Do I need an appointment to see a specialist? Consultations with a specialist are by appointment only. The emergency and critical care services are available 24 hours a day. No appointment is required for ER, but it is recommended that you call before arriving.

How do I make an appointment? Our referral coordinators are available to schedule your appointment and help answer any questions you or your primary care veterinarian may have regarding the referral process. A referral coordinator is available Monday through Friday from 8:00am to 5:00pm. Feel free to call anytime to speak with our referral coordinator. If they are serving another client at the time of your call, please leave a message and they will return your call promptly.

What diognostic services do you offer? The Internal Medicine team will work closely with your primary care veterinarian to diagnose perplexing problems causing illness in your pet. In addition, our entire team of board-certified specialists routinely collaborates on challenging cases to ensure the most comprehensive care for your loved one.

  1. Consultation
    1. Dr. Daugherty will review your pet’s history, evaluate any laboratory and radiology tests previously performed by your primary care veterinarian, and will perform a complete physical exam. These information gathering steps will help Dr. Daugherty to identify problems and formulate a diagnostic plan tailored to your pets needs. Dr. Daugherty’s advanced training prepares her to deal with complex and challenging cases. Commonly treated cases referred to the internal medicine service include animals with diseases of the endocrine, gastrointestinal, urinary, and hematologic systems.
  2. Blood work and urinalysis
    1. Our hospital offers in-hospital blood testing (CBC, chemistry profiles, coagulation testing, blood gas analysis, lactate evaluation, blood typing and cross match) and urinalysis services. This allows us to quickly receive test results and to closely monitor our critically ill patients. Ancillary testing may also be recommended. We work with many reference laboratories to provide expanded specialized testing options for evaluation of endocrine function, gastrointestinal function, screening for infectious disease, and therapeutic drug monitoring.
    1. Radiology
    2. Ultrasound and ultrasound guided needle aspiration or biopsy

Endoscopy Endoscopy is a procedure which allows the doctor visually exam of any cavity of the by body using an endoscope. Endoscopes are a highly specialized piece of equipment. They are shaped like a long narrow tube. This tube contains a video camera and bright light which allows the doctor to “look inside” your pet in a minimally-invasive way. The endoscope also has channels for small instruments that allow us to collect biopsy or fluid samples or remove foreign objects.

Common uses for endoscopy include:

  • Endoscopy – evaluation and biopsy of esophagus, stomach, and small intestine in patients with vomiting/regurgitation, difficulty swallowing, weight loss, removal of foreign objects (bones, rocks, fish hooks, coins, etc.), and for dilation of esophageal strictres
  • Colonoscopy – evaluation and biopsy of the colon in patients with diarrhea, bloody stools, or difficulty defecating
  • Broncoscopy – evaluation of the trachea and lower airways in patients with chronic coughing, lung disease, or suspected of tracheal collapse
  • Rhinoscopy – evaluation of the nasal passages in patients with chronic nasal discharge or bleeding
  • Cystourethroscopy – evaluation of the urinary tract in patients with persistent infections, difficulty urinating, or persistent bloody urine

Endoscopy is discouraged in patients who are not adequately fasted or who have bleeding disorders. Anesthesia is also necessary for this procedure. Each patient is evaluated prior to this procedure to adequately determine their risk for anesthesia.

Complications with endoscopy are uncommon but possible. The information gained from endoscopy can be very helpful in both diagnosis of disease and in treatment (such as removal of foreign material, dilation of esophageal strictures). Endoscopy can also help to avoid surgical intervention leading to a faster recovery time. Possible risks associated with endoscopy include:

  • Perforation of the gastrointestinal wall, with resultant infection of that area
  • Overdistension of the stomach with air during the procedure can cause the stomach to turn on itself or can cause a decrease in blood pressure
  • Laceration of the esophagus or rupture of major blood vessels could occur during removal of foreign material from the stomach or esophagus
    • Tracheal Wash
    • Bone Marrow Aspiration and Core Biopsy
    • Arthrocentesis (Joint Tap)

What therapeutic services do you offer? The Internal Medicine team works closely with your family veterinarian. Therapeutic (treatment) plans are tailored to meet the individual medical needs of your pet. In many cases, we may recommend outpatient care. Regular follow-up visits will help us to monitor your pet’s response to treatment and alter the medical plan as needed. In some cases, hospitalization may be recommended for more intensive care and treatment. Throughout treatment, your pet will be cared for by our highly trained doctors and nursing staff.

  1. Endoscopic removal of foreign objects
  2. Esophageal stricture dilation
  3. Placement of feeding tubes
  4. Management of chronic disease – Some examples include Diabetes mellitus, Cushing’s disease, Addison’s disease, Inflammatory bowel disease, Chronic vomiting or diarrhea, Bronchitis/asthma, Lung diseases orbreathing problems, Chronic anemia, Chronic kidney disease/failure, Protein losing kidney disease, Chronic urinary tract infections, Chronic liver disease, Hepatic lipidosis in cats (fatty liver disease), and others
  5. Management of immune mediated disease – Some examples include Immune mediated hemolytic anemia (IMHA), Immune mediated thrombocytopenia (ITP), Immune mediated polyarthritis, Lupus
  6. Management of complicated cases
    • Patients with more than one problem or disease process
    • Patients who are not responsive to traditional therapies
    • Patients who have drug resistance



Cancer Treatments for Small Animals

Surgery is often the most important first step in treating cancer in dogs and cats. Not only does it often remove the tumor and therefore improve or eliminate clinical signs associated with the tumor, but it also allows us to diagnose exactly what type of cancer is present.

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Depending on the size of the tumor and the location on the body, it may not be possible to remove the entire tumor, and therefore additional therapy may be indicated following surgery to prevent the tumor from regrowing. Depending on what type of cancer is diagnosed, removal of the tumor may result in complete control of the cancer. However, some tumors will require additional therapy in addition to surgery (such as chemotherapy and radiation therapy).

Chemotherapy Chemotherapy is the use of medicines or drugs to treat cancer. Chemotherapy drugs are either injected or taken by mouth. Chemotherapy may cause side effects in dogs and cats, but these effects are typically much less severe than what humans experience when they are treated with chemotherapy. The number and frequency of chemotherapy treatments administered varies depending on the type of cancer that is diagnosed and your pet’s response to therapy.

Radiation Therapy Radiation therapy involves the use of a linear accelerator or other machine to deliver radiation to a very specific location on the body. Unlike chemotherapy, radiation therapy does not affect the entire body and therefore side effects are generally limited only to the area that is treated. Radiation treatments may be administered daily for as many as 20 treatments, or may be given less frequently depending on the type of cancer that is being treated. Dogs and cats must be placed under anesthesia for a brief amount of time for each treatment in order to ensure they are placed in an identical position each time.

Melanoma Vaccine The melanoma vaccine is a relatively new cancer therapy that was developed the use in dogs diagnosed with melanoma (oral cavity, skin, or toenail beds are the most common sites for this tumor). This vaccine is administered as a treatment, not a preventative, and stimulates your dog’s own immune response to combat the tumor. The melanoma vaccine causes no adverse side effects in treated patients.

Complementary and Alternative Therapies In addition to traditional cancer therapies such as radiation therapy and chemotherapy, many patients will benefit from the use of complementary and alternative therapies. The use of herbal medicine, acupuncture, or other supplements may help boost the immune system and allow your pet to more effectively respond to traditional therapy, and can also help combat potential side effects associated with these treatments. Acupuncture is often a great addition to the treatment protocol for any type of pain associated with certain tumors.

Radioactive Iodine

The VESC is one of the few hospitals nationwide to offer radioactive iodine (I-131) treatment as an alternative treatment for feline hyperthyroidism.

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Radioactive iodine therapy is administered by a single injection of radioactive iodine intramuscularly in the rear limb. Treatment is cost effective when compared to long term medical therapy, monitoring or surgery. It eliminates daily pilling, does NOT require anesthesia, typically does not affect healthy thyroid tissue, does NOT damage any other tissue or organs, does NOT have any harmful side effects, returns thyroid function to normal usually within one month, and selectively destroys thyroid tumors irrespective to their location or number.

One injection of Radioiodine (I-131) is all it takes!

  • Cost effective when compared to long term medical therapy and monitoring or surgery
  • Eliminates daily pilling and associated compliance issues
  • Does NOT require anesthesia
  • Typically does NOT affect healthy thyroid tissue
  • Does NOT damage any other tissue or organs, including the parathyroid glands
  • Does NOT have any harmful side effects
  • Selectively destroys thyroid tumors irrespective of their location or number
  • Returns thyroid function to normal usually within one month

I-131 therapy is generally regarded as the treatment of choice for most hyperthyroid patients who are systematically stable without clinically significant cardiopulmonary, gastrointestinal, renal, hepatic, endocrine or neurological disease. Nonthyroid related medical problems should be discussed with I-131 personnel to determine if I-131 is appropriate for your patients.Please review the following information with clients when considering referring a patient for I-131 therapy. Required pre-therapy workup: CBC, Complete Biochemical Profile, T4, Urinalysis with sediment, Retrovirus testing for FeLV and FIV and diagnostic quality radiographs depicting thoracic and abdominal structures… all tests should be current with 30 – 45 days.

An initial screening appointment is required with Dr. Howard before the scheduled admission date to confirm the diagnosis of hyperthyroidism, evaluate and discuss overall patient health, obtain additional or updated test results and allow clients to discuss concerns or questions they may have regarding therapy.

  • In most cases, discontinuation of antithyroid medications approximately 7 days prior to scheduled therapy is recommended.
  • Patients are admitted for therapy by appointment after all information relating to the screening examination has been evaluated.
  • Patients are hospitalized in the nuclear medicine ward for five days. Clients cannot visit patients during therapy, nor can patients be removed from the ward until officially released. Clients cannot terminate therapy or arrange for early release once therapy has begun. These rules are dictated by the Federal guidelines on radiation safety.
  • After admission for I-131 therapy, information on patient’s daily status will be available to clients by a referral coordinator or other designated personnel.

I-131 therapy includes:

  • Review of all patients case records and radiographs
  • Physical examination
  • Hospitalization in the nuclear medicine ward
  • Administration of I-131
  • I-131 and appropriate radiation monitoring
  • Daily care and feeding
  • Telephone Consultations with primary care veterinarians and clients as needed to discuss post treatment follow up tests and patient clinical status.

If you have any questions please call Dr. Howard or a Referral Coordinator at (804) 353-9000


Animal Eye Care of Richmond is a veterinary referral practice offering complete medical and surgical eye care for all species of animals.

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Our services include phacoemulsification cataract surgery, glaucoma surgery, complete blepharoplasty (eyelid plastic surgery), Keratoplastics (corneal surgery), slit lamp biomicroscopy, laser and cyro surgery, and C.E.R.F. examinations (Canine Eye Registration Foundation). We offer advanced medical and surgical treatment of eye injuries and diseases. We work with your veterinarian to provide the best care possible for your pet. Upon the conclusion of your visit with us, we report all of our findings to both you and your veterinarian via written and verbal report.

When your primary care veterinarian refers you to Animal Eye Care, please have the pcDVM fax one of our referral form with the following information filled in: Any medications your pet is or has been receiving for his or her eye problem, any medical conditions your pet has been diagnosed with, when the eye conditions was first noticed and attach any recent lab tests, such as blood work.

Hours of Operations: Monday, Tuesday and Thursday 8:30am-4:45pm Wednesday 8:30am-12 noon Friday 8:30am-3:45pm

3318 West Cary Street Richmond, VA 23221 Phone: 804-355-5594 Fax: 804-213-0339

PLEASE NOTE: Animal Eye Care of Richmond is an independently owned practice that we work with for the convenience of our clients.

Allergy & Dermatology

For a pet owner, skin problems can be very frustrating. Sometimes, the symptoms can be so severe that the skin may become irritated, sore and infected. The single most important aspect of controlling the itching sensation is to identify and treat the underlying problem.

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In most cases, your veterinarian is capable of treating your pet’s skin problem, however, some skin problems can become chronic and difficult to diagnose. To insure your pet receives the latest and highest quality of dermatological care available, your veterinarian may decide to refer you to a board certified veterinary dermatologist. Many skin diseases look very much alike, having only subtle differences in appearance and historical background. A board certified veterinary dermatologist is trained to recognize these differences and pursue a specific diagnostic and therapeutic plan. As specialists, we strive to stay current on newly recognized diseases and therapies.

Conditions that may require an evaluation by a board certified veterinary dermatologist include:

  • Allergies (food, inhalants, contact and fleas)
  • Parasites (fleas and mites)
  • Autoimmune Diseases
  • Infectious Diseases (bacterial and fungal)
  • Hormonal Diseases
  • Recurring Ear Infections
  • Skin Cancer

Animal Allergy and Dermatology Founded by Dr. Dunbar Gram in 1991, Animal Allergy and Dermatology is a full time veterinary dermatology specialty practice dedicated in providing the latest and most advanced dermatological care available. It is our hope that with a foundation of exceptional service we will continue our mission in providing primary care veterinarians the support needed to meet the needs of their patients and clients. Currently, Animal Allergy and Dermatology is operating out of four locations throughout Virginia. We only treat animals with skin and ear disease or allergies. We do not provide services unrelated to dermatology or allergy. Click here to visit our website.

Your Veterinarian When your veterinarian refers your pet to a specialist, this indicates that your veterinarian cares about your pet and wants the problem treated in the safest, most up-to-date manner possible. Optimal patient care requires close communication among the client; board certified dermatologist and referring veterinarian. At the conclusion of your appointment, we will notify your veterinarian of our clinical findings and treatment recommendations. Because we only treat patients with dermatological or allergy problems, your veterinarian will continue to provide comprehensive veterinary care.

Animal Allergies Allergies are the most common cause of skin problems in dogs and cats. An estimated 1 out of 5 domestic animals, such as dogs and cats, suffer from some form of allergy. Dogs and cats can suffer the discomfort from allergies in different ways such as itching, skin irritation or secondary skin and ear infections caused by sensitivity to a specific allergen.

Signs that may indicate your pet has allergies include:

  • Continuous scratching
  • Face rubbing
  • Excessive licking of feet, legs and belly region
  • Hair loss
  • Recurring skin infections
  • Chronic anal sac problems
  • Biting and chewing at the skin
  • Ear infections

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