Internal Medicine

Portland Veterinary Emergency and Specialty Care’s team of internal-medicine specialists can help your animal with a variety of diseases and illnesses including infectious, immune-mediated, pulmonary, endocrine, liver, kidney, intestinal, and urinary issues. PVESC utilizes laboratory services, ultrasound, and various scoping technologies to help achieve a definitive diagnosis for the best treatment plans and outcomes possible.



Firstly, ultrasound is an internal medicine procedure that uses high-energy sound waves to look at tissues and organs inside the body. The sound waves make echoes that form pictures of the tissues and organs on a computer screen. Ultrasonography is used to help diagnose diseases, such as cancer. Secondly, diagnostic tests such as guided biopsies and needle-aspirates can be performed with the aid of these safe sound waves. Thirdly, ultrasound is a rewarding technique to evaluate the liver, spleen, adrenal glands, pancreas, kidneys, prostate, bladder, and uterus. Lastly, endoscopy may be recommended in addition or instead of ultrasound for diseases of the stomach or intestines. The ultrasound examination is virtually risk-free in most cases and is commonly completed without anesthesia or sedation.

To begin, patients are fasted for 12 hours prior to the ultrasound to ensure a proper view of each organ system. Depending on the type of ultrasound, your pet’s ultrasound may be completed while you wait, or your pet may be admitted to our hospital for a few hours. If a biopsy is needed, often these biopsies can be completed with ultrasound-guided instruments, and brief sedation and/or anesthesia may be required.

Most importantly, the ultrasound examination itself is virtually risk-free in most cases. It can usually be done without anesthesia or sedation and requires about twenty to thirty minutes to complete. A review of your pet’s medical records, tests, and a physical examination will precede the ultrasound. Patients are fasted at least 12 hours prior to the ultrasound to ensure a proper view of each organ system. Depending on the type of ultrasound, your pet’s ultrasound may be completed while you wait, or your pet may be admitted to our hospital for a few hours. However, if a biopsy is needed, sedation and/or anesthesia (brief) may be required.  Biopsies can be completed with ultrasound-guided instruments. Finally, the tissues are sent by overnight courier to board-certified pathologists and the results are usually received in three to five business days.


The word “endoscopy” denotes the use of fiberoptic instruments to investigate and possibly biopsy certain body cavities. It is a “noninvasive” internal medicine procedure which means no surgical incisions are required. For the patient, this means a short anesthetic period with a rapid recovery. All endoscopies in small animals require full anesthesia and therefore may require pre-anesthetic evaluations such as blood tests, radiographs (X-rays), and/or ultrasound. Endoscopies are usually considered among the low-risk internal medicine procedures in veterinary medicine.

All pets admitted for these procedures are first evaluated by a veterinarian who will examine your pet, the medical history, the feasibility of endoscopy, and carefully determine any ancillary tests that will be required. At that time, a written estimate can be given, and questions or concerns you may have can be discussed in detail. Pets are generally required to be admitted to the hospital for the day. Please fast your pet (no food; water OK) for at least 12 hours prior to the admission time.

Canine Cystoscopy
Cystoscopy is a rigid endoscopic evaluation of a female dog’s vagina, urethra, and bladder, and the male dog’s urethra and bladder.  Cystoscopy is specific and sensitive for the diagnosis of urinary tract problems and it provides additional information not obtained through radiographs, contrast studies, or ultrasound. Indications for cystoscopy are: blood in the urine (hematuria), bladder/ urethral cancer, incontinence (leaking urine), recurrent urinary tract infections, small bladder stone removal, and vaginal discharge. Cystoscopy can be completed on all sizes of female dogs, and medium to large male dogs.

Bronchoscopy is the fiberoptic examination of the respiratory system. This includes the larynx (voice box), trachea (windpipe), and bronchial tree. This is a short, day procedure that allows the internist to take samples and bacterial cultures of the airways. It may be preceded by chest radiographs (X-rays), and certain blood tests. Common reasons for bronchoscopy are chronic cough, suspected pneumonia, allergy, or cancer.

Gastroscopy allows the internist to closely examine an animal’s esophagus, stomach, and the first portion of the small intestine. The health of these tissues can be assessed, biopsies harvested, and sometimes foreign objects can be retrieved. The pet is fasted at least 12 hours prior to the procedure and is usually released on the same day. Common reasons for gastroscopy are weight loss, vomiting, diarrhea, and anorexia.

Colonoscopy allows the doctor to evaluate disease processes of the large intestine (colon) and rectum. This process is recommended for animals that have chronic diarrhea, are straining to defecate, and/or have blood in their stools. Similarly, this procedure sometimes requires a 24 hour fast (water is okay).

Rhinoscopy is the use of fiberoptics to investigate the nasal cavity. It can be used for dogs and cats in a short day procedure. In addition, it is usually accompanied by skull and nasal radiographs, and biopsy. Chronic sneezing, snorting, “reverse sneezing,” chronic nasal discharge or nasal bleeding would be indications for rhinoscopy.