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. 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
a. 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

a. 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.
     3. Radiology
     4. Ultrasound and ultrasound guided needle aspiration or biopsy
     5. Endoscopy
a. 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.
b. 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
c. 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.
d. 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
     6. Tracheal Wash
     7. Bone Marrow Aspiration and Core Biopsy
     8. 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


megen_daughtery_head-X2Dr. Megen Daugherty

Dr. Daugherty attended college and veterinary school at Michigan State University graduating with honors in 2002. During her internship in small animal medicine and surgery at Purdue University, Dr. Daugherty developed an interest in internal medicine which prompted her to pursue specialty training. She completed a three year residency training and Master’s degree program at the Virginia-Maryland Regional College of Veterinary Medicine in July of 2006 and attained Board Certification in the American College of Veterinary Internal Medicine in the specialty of Internal Medicine in August of 2006. In her free time, Dr. Daugherty enjoys canoeing and camping with her husband and two English setters, reading, and spending time with family and friends. Dr. Daugherty works together with your primary care veterinarian as well as specialists in other areas of veterinary medicine to provide the best comprehensive care for your pet.


stephanie_kemp_FullDr. Stephanie Kemp

Dr. Kemp is originally from Colorado Springs, and went to college at the University of Colorado at Boulder (go Buffs!). At Colorado, she completed a BA in Biology (Magna Cum Laude), a BA in Psychology with a certificate in neuroscience, and minored in Biochemistry. She then moved to Illinois for veterinary school and received her DVM from the University of Illinois at Urbana-Champaign in 2009. Dr. Kemp then completed a one year rotating internship in small animal medicine and surgery at the University of Minnesota.  She then went on to a residency in small animal internal medicine combined with a masters degree in Biomedical and Veterinary Sciences at the Virginia-Maryland Regional College of Veterinary Medicine. Her medical interests endocrinopathies (particularly diabetes mellitus and hyperthyroidism), hepatobiliary disease (the area of her masters work), and hematology. In her free time she enjoy running with her dog, Payton, cooking, playing guitar (badly), fishing, reading, and or course spending time with her family, friends, and pets.

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