Front Office FAQs
Why Do I Need A Referral?
Your veterinarian has determined that advanced diagnostics or therapeutic intervention may be necessary for your pet. Specialists have advanced training and capabilities that may be needed.
Why Can I Not Just Schedule My Own Appointment?
VSNT is a by referral only specialty hospital. We strive to build a strong relationship with the referring veterinarians in the Dallas-Fort Worth metroplex and work as a team to ensure your pet has the best possible care. With the compassion and care of your veterinarian and a board certified specialist, we hope to achieve life-saving management of your pet’s condition.
Can My Pet Be Seen Sooner Than Scheduled?
If your pet suddenly becomes worse, or your veterinarian feels it has become an emergency, we can often schedule your pet sooner.
How Long Will The Appointment Take?
VSNT schedules a one-hour initial consultation for new patients. During that time, your doctor will review your pet’s case and have a detailed conversation with you regarding your pet’s problems/diagnosis, recommended tests, and treatment options. If additional diagnostics, testing, or treatments are required, your pet may need to remain in the hospital for several hours.
Why Does My Pet Need To Fast?
There are two main reasons for fasting. Some diagnostic tests are markedly affected if the patient has eaten. The other major reason for fasting is in case sedation or an anesthetic procedure is required. If your pet is diabetic, please check with your veterinarian about fasting and their insulin dose.
What Should I Expect At The Initial Consultation?
Please refer to What to Expect at Your First Appointment.
Why Can You Not Just Tell Me What Is Wrong With My Pet Over The Phone?
Even though VSNT has your pet’s medical records and previous test results, it is very important that we physically examine your pet to put together the entire picture. Veterinarians, specialists included, are required by law to have a client-pet relationship before offering medical advice.
Why Not Just Run The Tests My Veterinarian Says They Need?
In some cases, VSNT may be performing tests your veterinarian recommends. However, in some cases, based on the most likely diagnosis or treatment, your pet’s medical needs, or current advancements in specialty care, other tests or therapies may be indicated.
What Is Radiation Therapy?
Radiation therapy is a form of cancer treatment that utilizes high energy radiation to treat tumors. It is a localized therapy used for solid tumors that are confined to one area of the body. Radiation therapy can be administered after surgery for incompletely removed tumors, before surgery to shrink an inoperable tumor to allow for resection, or as a stand-alone therapy.
How Is Radiation Therapy Administered?
A focused beam of radiation is targeted directly to the tumor site from outside the body (external beam radiation therapy). For tumors that are easy to see on physical examination, this can be done by aiming the beam directly at the visible tumor. If a tumor is not easy to see externally or is close to vital structures, a CT scan may be needed to allow for computerized radiation therapy planning. A radiation oncologist will determine if an individual patient needs a CT scan and computerized planning.
Will My Pet Be Radioactive?
No. Patients undergoing external beam radiation therapy are not injected with radiation-emitting materials. They do not need to be isolated from family members or other household pets, and they do not require special handling.
Does My Pet Need Anesthesia For Radiation Therapy?
Yes. Patients must be completely still for each radiation treatment to allow for precise targeting of the tumor. This requires a brief anesthesia. The treatments are not painful, so injectable pain medications are not required. For this reason, radiation therapy patients do not experience a prolonged sedation like that seen after surgical or dental procedures.
How Many Radiation Treatments Will My Pet Receive?
The recommended radiation protocol (number and frequency of radiation treatments) will vary depending on the tumor type, treatment goals, and general health of the patient. Treatments may be administered once weekly, 2-3 times weekly, or daily (Monday through Friday), and the protocol may last anywhere from 2-7 weeks. A radiation oncologist will provide options specific to your individual pet and their diagnosis.
May My Pet Receive Vaccinations While Receiving Radiation Therapy?
We generally do not recommend that patients receive vaccinations while undergoing radiation therapy due to stress on the immune system in those patients. Heartworm and flea preventive medications should be continued.
Does My Pet Need To Be Fasted For Radiation Therapy?
Yes. Patients should not eat after midnight on the night before each treatment. They may still receive water until brought in for treatment in the morning. We recommend that patients still receive prescribed medications the morning of their treatment. These medications can be given with a small meatball, pill pocket, or other bite of food (cheese, peanut butter, etc). If your pet is diabetic, please discuss how to administer their insulin with your oncologist. A meal can be fed once the patient has recovered from anesthesia, and another meal can be given prior to bedtime.
How Long Does My Pet Stay In The Hospital For Each Radiation Treatment?
Radiation treatments are usually outpatient visits, so your pet does not need to stay overnight during treatment. On the days that radiation therapy is scheduled, you will need to have your pet arrive at the clinic between 7:00am and 9:00am each morning. Alternative arrangements can be made if this is not feasible. A complete physical examination and assessment of vital signs are done prior to each radiation treatment. After treatment, the pet is monitored during recovery from the anesthetic procedure and cannot be discharged until fully recovered. Each pet reacts differently to anesthesia, so recovery time varies with each patient. Every effort is made to get our patients treated and released as quickly as possible without compromising medical care. We anticipate that each visit will require a minimum of three hours. Due to variation in treatments, number of patients being treated, different medical needs, and unexpected emergencies, your pet may spend different amounts of time at the hospital for each visit.
Can My Pet Board At The Hospital During Radiation Therapy?
Yes. We are fully staffed to provide 24 hour care to all of our patients.
Will My Pet Be Sick During Radiation Therapy?
“Radiation sickness,” manifested by nausea, vomiting, and diarrhea, is not seen in veterinary patients. Sometimes patients will experience loose stool secondary to stress related to visits to the hospital. We often will prescribe a supplement to minimize this issue during treatment. Uncommonly, patients can exhibit nausea related to the anesthesia, but this is typically easy to manage medically.
What Sort Of Side Effects Should I Expect From Radiation Therapy?
Most radiation side effects develop due to inflammation of the normal tissues immediately adjacent to the tumor site. How that will manifest in your pet is dependent on the location of the tumor. Your pet will lose the hair only in the irradiated area. In the vast majority of cases, the hair regrows, but it may be a different color or texture. A moist dermatitis (the so-called “radiation burn”) also may occur toward the end of therapy. This reaction will last about two to three weeks and will heal. Temporary inflammatory changes can also be seen in other tissues that are located close to the tumor site (oral cavity, eyes, airway, colon, etc). The chance of a severe local response to normal tissues is less than 5%. If the eyes have to be included in the treatment field, a cataract may eventually develop over the next 6 months to one year that could limit vision. A radiation oncologist can discuss the specific side effects that may be expected and how to treat them.
When Will I Start To See The Tumor Respond To Radiation Therapy?
Tumor response will vary depending on the tumor type. Generally, a measurable decrease in tumor size lags behind the radiation treatments with a maximum objective response occurring 1-2 months after completion of treatment. Clinical improvement in symptoms associated with the tumor can improve as soon as a couple weeks after starting radiation therapy. A radiation oncologist can help guide expectations regarding response to treatment based on your pet’s specific tumor type.
Internal Medicine FAQs
Why Did My Veterinarian Send Me To An Internal Medicine Specialist?
It is common for pets to have multiple disease conditions (such as kidney disease, heart disease, and high blood pressure) that might be complicated and challenging to manage. In some cases, specialized testing may be recommended to help pet owners determine what is wrong with their pet. For example, a pet with long term diarrhea, may need an ultrasound (sonogram) of his/her belly or a colonoscopy to help determine the cause of the diarrhea.
Why Does My Pet Need Additional Blood Work Or Radiographs Performed If My Primary Care Veterinarian Just Performed Them 2 Weeks Ago?
Serial monitoring of blood work and radiographs can aid in better understanding what your pet is experiencing. For example, if a new medication was started recently (either before or at your appointment) and your pet is not improving, repeating tests may be helpful as things may have changed and may alter your pet’s treatment plan.
Why Does My Pet’s Ultrasound/Sonogram/Echocardiogram Need To Be Repeated If He/She Already Had One?
Sometimes it is necessary to compare to previous scans to look for changes. Other times, we may need a focused ultrasound of a specific body area. In some cases, we may even need to perform a diagnostic CT scan.
What Is A Fine Needle Aspirate (FNA) Or Needle Biopsy?
This is a common, relatively non-invasive, technique that allows for the collection of cells from an organ in the body or a lump on the outside of the body. Analysis of these cells under a microscope can potentially lead to a diagnosis for your pet’s condition without the need to perform surgery.
What Is Endoscopy/Laparoscopy?
This is non-surgical (endoscopy) or less invasive (laparoscopy) procedure where a camera can be inserted into the body to better evaluate an organ or system. Common areas to evaluate include: the nose, liver, urinary bladder, lungs, stomach, intestines, or colon. Additionally, during these procedures, samples are often collected for analysis by a pathologist.
Why Do I Need To Recheck With My Veterinary Internist Instead Of My Primary Care Veterinarian?
In some cases, follow up can be coordinated with your primary care veterinarian, especially if you live far away from VSNT. However, most internal conditions require regular physical exams, medication adjustments, and monitoring that are best done in person. Your veterinary internist is very familiar with your pet and may notice subtle changes on your pet’s physical exam or blood work that suggests a change in treatment plan is needed.
If My Primary Care Veterinarian Has Already Sent My Pet’s Records, Why Do You Still Ask What Medications Or Supplements My Pet Is On And What Tests Have Been Done Already?
With long-term complicated conditions, it’s common for medications as well as the dosages to be changed frequently. Therefore, it’s important to have the most up to date information so that we can better help your pet. VSNT wants to confirm what tests have or have not been performed so we can determine the best plan for your pet. It is also helpful to bring your pet’s medications and records to their appointment.
Why Should I Get My Pet’s Medications From A Veterinarian Or Human Pharmacy? It’s Usually Cheaper Online?
Sometimes online pharmacies are not under the same regulations as veterinary hospitals or human pharmacies. Therefore, medications may not be stored properly and subtle variations (generic vs brand name) can be overlooked as insignificant. Additionally, pet owners have been sold fraudulent medications online. VSNT can help you find the most cost-effective options for your pet.
Who Treats Cancer In Dogs And Cats?
At VSNT, a team of specialists is involved in cancer treatment. This team includes a medical oncologist and a radiation oncologist and may include an internal medicine specialist or a consultation with a surgeon in our sister practice, Dallas Veterinary Surgical Center, located within our building. These are all Board-certified Veterinary Specialists. Specialists are veterinarians who, after graduating from veterinary school, pursue more training in a specific field. This training usually lasts an additional 3-4 years (one year of internship, and 2-3 years of residency, depending on the specialty). To become Board-certified, they must pass a certifying exam after completing the training program.
How Can I Find A Veterinary Oncologist?
How Often Do Dogs And Cats Develop Cancer?
Cancer is the leading cause of death in older dogs and cats. Approximately one in three dogs will develop cancer and one in four cats will develop cancer. Cancer is responsible for nearly 50% of the deaths of dogs 10 years and older and for approximately 30% of deaths in older cats.
Why Do Animals Develop Cancer?
Despite much research, it is still not well understood why animals (and humans) develop cancer. One big role player seems to be genetics. In addition, exposure to certain environmental cancer-causing agents, called carcinogens, has been shown to increase the risk of cancer development. Some of these carcinogens include tobacco smoke, asbestos, lawn pesticides and herbicides, certain older type flea and tick dips (mostly older dip-type products), radiation, and sunlight (especially for white and light-skinned dogs and cats). Obesity and poor diet (such as unbalanced home-made type diets) has also been implicated in cancer development. Intact female dogs and cats are at a much higher risk for mammary cancer than their spayed counterparts.
How Do I Know My Pet Might Have Cancer?
It might be time to see your veterinarian if you notice your pet has:
- Lumps and bumps on their body
- Sores that don’t heal
- Bleeding or discharge from any opening in the body
- Persistent bad breath or offensive odors
- Unexpected weight loss
- Change in eating and/or bowel habits
- Labored breathing
- Persistent limping
- Difficulty breathing, urinating, or defecating
- Lethargy/unwilling to exercise
- Change in interaction with the family/ Hiding
- Vomiting or diarrhea
- Bleeding from the nose or mouth
Do not wait. Early detection is critical! Diagnosis of cancer is NOT a death sentence. Many types of cancer can be treated if diagnosed early.
How Is Cancer Diagnosed?
- Fine-needle aspirate cytology. Your doctor collects a few cells from the tumor using a small needle. This test is quick, inexpensive, and non-invasive. It does not require anesthesia.
- Biopsy and histopathology. Your doctor collects a piece of the tumor. This generally requires anesthesia.
What Is Benign Versus Malignant Tumor?
- Tumor: a tumor means swelling, not necessarily cancer.
- Benign: a non-cancerous, slow-growing tumor; does not metastasize, usually not life-threatening; Will not grow back if appropriately removed.
- Malignant: a cancerous growth, can metastasize; most malignant tumors grow rapidly.
What Are Some Of The Common Cancers Of Dogs And Cats?
- Skin tumors (Such as mast cell tumor in dogs)
- Mammary tumors
- Oral tumors
- Bone tumors
- Sarcomas (connective tissue tumors)
- Thyroid tumors
- Anal sac/gland tumors
How Is Cancer Treated In A Dog Or Cat?
The veterinary oncologist works together with the owner to discuss and decide on the best treatment plan for their pet. Treatment often depends on several things, such as tumor size and whether the tumor has already spread to other parts of the body (metastasized). The veterinary oncologist may use the following treatments alone or in combination with each other:
- Radiation therapy
Do Pets Get Sick From Chemotherapy Like Humans?
Unlike their human counterparts, chemotherapy usually does not adversely affect most dogs and cats. Side-effects occur only in about 10-15% of treated cases and are usually self-limiting and easily treatable at home. Most animal chemotherapy patients don’t get sick at all!
Do Pets Lose Their Hair From Chemotherapy Like Humans?
Most dogs and cats don’t lose their hair coat after chemotherapy. Rarely, breeds that grow their hair coat continuously, such as Poodles, Old English Sheep Dogs, Maltese, Lhasa Apso, Shi tzu and poodle breed mixes like Goldendoodles may lose some of their hair during chemotherapy. Cats typically don’t lose their hair, but they may temporarily lose their whiskers. Shaved areas tend to grow back slowly, however.
Can My Pet Be Cured From Cancer?
Quite a few cancers can be cured if they are diagnosed early. This can depend on the type of cancer and the types of treatments chosen for your pet. Some cancers are not curable but they can be put in remission and quality of life during treatment and remission can be normal or near normal. With treatment your pet can enjoy a longer, happier life. Many pets can live a completely normal life with few signs of illness during treatment.
What Is Chemotherapy?
Chemotherapy is a type of treatment that uses a medication or combination of medications designed to kill or slow the growth of cancers. Many of the drugs used to treat cancer are the same drugs used in human medicine and are actually derived from natural substances such as plants, trees, and even bacteria.
How Is Chemotherapy Administered?
Many drugs must be given by injection either intravenously (IV). Some may be given orally in a pill form, under the skin or into a muscle (IM). Rarely, the drug may be injected directly into the tumor itself. IV drugs: an IV catheter is placed for safe administration of the drug. After the drug is given the catheter is removed and a light bandage is applied. The bandage may be removed 1-2 hours after the drug is administered. Oral drugs: these are often administered in the hospital or at home by the owner after instruction by the oncology nurses and doctors. It is important that your pet receives all medication as prescribed and that the pills are not crushed or split. Drugs in capsule form must never be opened. If you are administering an oral chemotherapeutic drug, you MUST wear nitrile gloves when handling pills. After treatment remove the gloves and wash hands with soap and water.
What Is The Proper Way To Handle My Pet’s Waste When They Are On Chemotherapy?
For three days post treatment, we recommend that you wear nitrile gloves when picking up after your pet. If there is an “accident” in the house or car wear gloves and clean the area with disposable items (paper towels, baby diapers, etc.) wrap in a separate plastic bag, tie off and then dispose in the trash. Wash your hands thoroughly when you are finished cleaning. In general, we recommended that clothing/bedding which is soiled by feces, urine or vomit should be washed twice in hot water and bleach.
How Often Is Chemotherapy Given?
This will vary between different tumor types and the treatment chosen. It may be given daily, weekly, or once every 2-3 weeks.
How Long Will My Pet Receive Chemotherapy?
Again, this will vary between different tumor types and the treatment chosen. Typically the patient will receive multiple treatments. Your pet’s oncologist will discuss the protocol recommended for your pet and options that may be considered.
May My Pet Receive Vaccinations While On Chemotherapy?
We recommend that you ask your veterinary oncologist about your pet’s specific case. Research states it is safe to give your pet vaccines when they are receiving chemotherapy, however we typically recommend that pets do not receive vaccines until they have completed their treatment protocol. We also do not recommend that lymphoma and leukemia patients receive vaccinations.
What Sort Of Side Effects Should I Expect During Chemotherapy Treatment?
Pets are much less likely than humans to experience side effects from chemotherapy. Eighty to 85% of pets have minimal side effects while the remaining 15-20% may experience mild to moderate side effects listed below. Stomach and intestinal side effects include nausea, vomiting, diarrhea, most of which are easily controlled with medications/diet change and may last for a few days. VSNT’s oncology team will automatically send your pet home with medications for this to have on hand in case it is needed during the course of treatment. Bone marrow suppression is the second most common side effect leading to a decreased white blood cell count. Some drugs can cause kidney, liver and heart side effects. All potential side effects of any prescribed drug will be discussed with you prior to treatment of your pet. While hair loss is rare in dogs, it is seen mainly with breeds that have continuously growing hair (Poodles, Old English Sheepdogs, Shih tzu, Maltese, Lhaso apso, etc.). Cats do not lose body hair but may temporarily lose their whiskers. Hair re-growth is delayed during and after chemotherapy. Shaved areas often darken in color (pigmentation).