Veterinary Internal Medicine
Dr. Elena Vasquez · DACVIM (SAIM)
Veterinary internal medicine covers complex multi-system diseases in dogs and cats, from autoimmune disorders to endocrine emergencies. Dr. Vasquez specializes in GI disease, endocrinopathies, and immune-mediated conditions — the cases that don't fit neatly into one box.
Ask Dr. Elena Vasquez →Common Conditions
Sample Questions
“My 8-year-old Labrador has persistent vomiting and weight loss despite GI diet trials. Endoscopy biopsies show lymphocytic-plasmacytic enteritis. Next steps?”
“A 10-year-old DSH cat with PU/PD, bilateral symmetric alopecia, and elevated ALP. Cushing's workup in cats?”
“Young Cocker Spaniel with protein-losing enteropathy — albumin 1.2. Immunosuppressive protocol recommendations?”
Internal Medicine Cases(72)
View All Cases →A 3-year-old spayed female Ragdoll presents for chronic i...
Thank you for presenting this complex case, it certainly sounds like a puzzle. A 3-year-old Ragdoll with chronic GI signs, weight loss, a palpable abdominal mass, thickened loops,
Feline Infectious Peritonitis FIP Treatment GS-441524
Colleague, My infectious disease specialist is unavailable at the moment, but this is a topic I manage frequently. Based on the data you've provided—a young cat with a high-protei
Canine Heartworm Treatment Protocol
Colleague, Your proposed plan is spot-on and follows the American Heartworm Society (AHS) guidelines precisely. From a cardiology standpoint, my primary concern with heartworm dis
Leptospirosis Dog Treatment Prevention
Excellent workup and a very strong presumptive diagnosis. The signalment, history, and classic combination of acute kidney injury (AKI) with hepatic involvement make leptospirosis
Dog Kennel Cough Treatment Duration
Colleague, your assessment of infectious tracheobronchitis (CIRDC) in this Labrador is spot on. My approach in these cases is to prioritize antimicrobial stewardship and patient co
Cat Blocked Nose Chronic Rhinitis Treatment
Colleague, This is a classic and often frustrating presentation. Your initial differentials are spot-on. Let's structure the approach methodically. 1. Ranked Differentials & Init
Dog Vomiting Yellow Bile Morning Treatment
Excellent question. This presentation is classic for bilious vomiting syndrome (BVS), which is essentially a motility disorder related to duodenogastric reflux during a prolonged f
Hamster Wet Tail Treatment Protocol
Alright, this is a classic presentation and it's a true emergency. In a 30-gram patient, we have no margin for error. Think of this as septic shock secondary to infectious enteriti
Leopard Gecko Metabolic Bone Disease
Colleague, This is a classic presentation for severe metabolic bone disease in a leopard gecko, stemming from the history of inadequate dietary calcium and lack of UVB exposure.
Turtle Shell Fracture Repair Treatment
This is an excellent workup of a common wildlife presentation. While my usual patients are furrier, the principles of fracture repair—clean, reduce, stabilize—are universal. Let's
Phenobarbital for Dogs Seizures Long Term
Excellent question. Phenobarbital remains one of our most effective and reliable first-line AEDs, but meticulous management is key to maximizing efficacy while minimizing risk. Let
Feline Chronic Pain Management Solensia
Colleague, This is an excellent and comprehensive multimodal plan for managing a common and challenging comorbidity. Your approach is right on track. Frunevetmab (Solensia) is th
Feline Hypercalcemia Causes and Treatment
Excellent workup on this asymptomatic cat. Catching significant hypercalcemia, especially ionized, on routine screening gives us a great opportunity to intervene before clinical si
Feline Panleukopenia Kitten Treatment
This is a critical case, and your proposed plan is solid. Let's prioritize based on what's going to kill this kitten first. With a WBC of 800 and profound GI signs, we're dealing w
Feline Lower Urinary Tract Disease FLUTD
Colleague, This is a classic and often frustrating presentation of non-obstructive FIC. Your workup has been appropriately thorough, ruling out the more tangible causes like infec
Cat Stomatitis Treatment Extraction Protocol
Colleague, this is a challenging and frustrating condition, and your workup so far is spot on. When medical management for FCGS fails, surgery is the definitive next step. Here's m
Feline Asthma Flovent Inhaler Protocol
Excellent workup. Confirming eosinophilic inflammation on BAL is definitive and sets us up for a targeted, multi-modal management plan. Your proposed approach is spot-on. Here is h
Please analyze this attached image based on our conversat...
Thank you for sharing the lab work. While my primary expertise is image interpretation, I can provide perspective on how these findings should direct our diagnostic imaging plan.
Dog Inflammatory Bowel Disease Treatment
Excellent. Thanks for sending this over. This is a very thorough workup, and having histopathology confirms our suspicion and allows us to move forward with a clear plan. Based on
Canine Hypothyroidism Diagnosis Treatment
Colleague, This is a textbook presentation for primary hypothyroidism, and you're right to want to confirm it definitively before committing the patient to lifelong therapy. That
Feline Chronic Kidney Disease IRIS Staging
It seems my sub-agents are offline at the moment, so I'll handle this comprehensive request myself. Feline CKD management is a cornerstone of small animal internal medicine, and a
Dog Elevated Liver Enzymes ALT ALP Causes
Excellent, detailed reports from my GI and Endocrine specialists. Let's synthesize this into a cohesive clinical approach. Colleague, this is a classic internal medicine puzzle: w
Dog Dental Cleaning Under Anesthesia Safety
Good question. This is fundamentally a risk management discussion, which is something we deal with constantly in the ER and ICU. Let's break it down from a safety and standard-of-c
When to Spay Neuter Large Breed Dog
Colleagues, This is an excellent and critical question that we're all grappling with. The paradigm has definitively shifted from a "one-size-fits-all" recommendation to a nuanced,
Puppy Vaccination Schedule Complete Guide
Excellent question. While my day-to-day focus is on complex internal diseases, a robust and evidence-based vaccination strategy is the foundation that prevents many of them. Here’s
Ferret Insulinoma Treatment Protocol
Colleague, This is a classic presentation for an insulinoma in a ferret, and your suspicion is spot on. However, I must be upfront about the limits of my expertise. My board certi
Bearded Dragon Metabolic Bone Disease
Colleague, This is a classic presentation for severe nutritional secondary hyperparathyroidism (metabolic bone disease), and your presumptive diagnosis is almost certainly correct
Guinea Pig Respiratory Infection Treatment
Colleague, This is a great case, but it falls outside my area of board certification. My expertise is strictly in canine and feline internal medicine, and I cannot provide specifi
Dog Anaphylaxis Vaccine Reaction Treatment
Alright, let's get this patient stabilized. This is a classic Type I hypersensitivity reaction, and time is critical. Here's our game plan, in order of priority. First, epinephrin
Puppy Parvo Treatment Protocol
Alright, let's get this puppy stabilized. Parvo is a marathon, not a sprint, and our job is to support them through the trifecta of hypovolemic shock, sepsis, and hypoglycemia. He
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