Services Appointment Overview As a general rule, patients should be fasted (food withheld) for at least 8 hours prior to their appointment. Please confirm feeding instructions with our staff when your appointment is scheduled, particularly if you have a "special needs" pet (e.g. diabetic patient). An explanation of the recommended tests and estimated costs will be discussed with you prior to any procedures being performed. The diagnostic work up is typically started immediately following the initial evaluation by the internist, although it is possible that some tests or procedures may need to be scheduled for another time. There are some procedures that can be done while the owner waits, but other procedures may require your pet to stay for the day or even overnight. Sick patients that require hospitalization are admitted to our intensive care unit (ICU), and after-hours care is provided by the Animal Emergency Hospital of North Texas. Rest assured that our internists will communicate their findings and recommendations with your primary care veterinarian so that complete medical care is provided for your pet. Diagnostic Testing For most patients, some degree of testing is usually indicated so that a diagnosis may be obtained. Based on history, clinical signs, physical examination findings, and previously performed test results, a veterinary internist develops a plan for your dog or cat. The following tests may be considered: Minimum database of complete blood count (CBC), serum biochemistry panel, and urinalysis. Specific blood and/or urine tests for internal organ dysfunction or infectious diseases. Fecal testing for infectious organisms. Digital x-rays (also called radiographs) of the area of interest (e.g. thorax and/or abdomen). Blood pressure monitoring and electrocardiogram (ECG) to assess the cardiovascular system. Ultrasound examination (or sonogram) of the abdomen, thorax, and heart (known as echocardiogram). Tissue samples collected by fine needle aspiration (small sample for cytology) or by biopsy (larger sample for histopathology). These procedures typically require some level of sedation and/or anesthesia. CT scanning (a 3D x-ray) of the area of interest (e.g. nasal passage and sinuses, brain, thorax, or abdomen). This requires anesthesia to immobilize the patient. Endoscopy examinations of the digestive tract, respiratory tract, and urinary tract. This requires general anesthesia to allow for visualization of "hard to reach" places, sample collection, and even foreign body retrieval.