Annapolis • (410) 224-0121
Towson • (410) 828-0911
Columbia • (410) 441-3304

NEWS & EVENTS

Columbia Location NOW open!!

AVIM&O is excited to announce that we are now open in CVRC Columbia!!  Please call today to make an appointment with our Internal Medicine Specialist Dr Jacob or Oncology Specialist Dr Silver at 410-441-3304.  The Columbia location is a 10,000 square foot facility that also offers other veterinary specialists in surgery, cardiology, emergency/critical care. 

 

Questions and Answers about Ebola and Pets

http://www.cdc.gov/vhf/ebola/transmission/qas-pets.html

 

CVRC Sponsored Continuing Education Events

Each year, Chesapeake Veterinary Referral Centers sponsor three full day continuing education events at no cost to the veterinary profession of our region.  One each in the spring and fall for veterinarians and a fall conference for veterinary technicians. Continuing education is required by the state and our meetings are approved by the State Board of Veterinary Medical Examiners for credit.

The Spring CVRC CE Conference is being held Sunday April 3, 2016 at the Tidewater Inn in Easton, MD. This event is provided cost free, and provides 6-7 hours of Maryland-approved CE, includes lunch, and is sponsored by CVRC.

CVRC Spring 2016 Save the Date

For more information about these events contact CVRC at 410-224-0121 or email cvrcce@gmail.com.

Laparoscopy at CVRC!  

NEW !!!   Interventional Stenting Procedures at AVIM in Towson -
urethral  and  tracheal procedures available

Diagnostic Endoscopy, Endoscopic Interventional Procedures & Urethral Collagen Injections

Advanced Imaging for your pet - MRI or CT?

Talks and Travels

Advanced Medical Care at AVIM

Grief Counseling Discussion Group through AVIM

 

Publications Relating to AVIM&O's Doctors


 

New diagnostic equipment represents a reinvestment in the qualities of our efforts and care of your pets. Two, new, state of the art GE Logiq E ultrasound units have been purchased to facilitate added ultrasound capabilities in our Annapolis and Towson offices.

 

Interventional Endoscopy - Nitinol Stents

In our Towson location, Dr. Frederic Jacob has pursued advanced technical training in the use of nitinol stents which are placed with endoscopic and fluroscopic assistance.  This technique allows for pets with advanced diseases of the trachea, urethra, colon, and rectum to have extended quality life.  Tracheal stenting is used for pets with diseases that cause the collapse or narrowing of the trachea when all other options have failed.  Similarly, medical conditions such as invasive cancers of the urethra can prevent a pet from being able to urinate yet the cancer itself would not otherwise be the cause of loss of that patient.  Urethral stenting allows for additional quality time with the pet in many circumstances.  If your pet may be in such a circumstance as to benefit from interventional stenting, please ask your veterinarian to discuss the option with one of the internists of AVIM or Dr. Jacob directly at our Towson facility.

Laparoscopy at CVRC! 

The use of operating telescopes, called laparoscopes, is now available as part of the overall professional efforts towards minimally invasive surgeries.  The use of minimally invasive surgery is helpful for the pet.  It reduces the size of the surgical incisions needed while still accomplishing the intended medical goals for the patient. This also reduces the degree of discomfort and may cost less than normal surgical approaches.  Atlantic Veterinary Internal Medicine (AVIM) performs diagnostic laparoscopy.  This is usually done in situations when we want to obtain good quality (and larger than needle procedures can obtain) biopsies of the liver, kidneys, tumors, or lymph nodes inside the abdominal and thoracic cavities of dogs and cats.  Our specialists also participate with the surgery service (Chesapeake Veterinary Surgical Specialists) in providing a combination of diagnostic and therapeutic laparoscopic assisted procedures. The equipment is "high tech" and used for the advantage of the patient. However, we also remain aware that there are limitations for laparoscopic procedures.  Not every case should have laparoscopy. There are situations when a normal surgical approach or percutaneous needle biopsy may still be better for an individual patient.  Examples of such situations could include obesity, multiple or large targets of the interest, and others.  Our approach is to discuss all the options with you and then make the best decision for your pet.   

 

Endoscopy and Endoscopic Procedures with AVIM 

Videoendoscopy is a very useful diagnostic test that balances results with using a less invasive approach.   Endoscopy provides our internists the ability to visually examine and biopsy the insides of various organs in the body.  Flexible videoendoscopy is a form of "endoscopy" .  AVIM  has recently added Olympus (human level) videoendoscopy for both of our locations. We have a combination of five flexible and seven rigid endoscopes that allow us a wide ability to use endoscopy for the range of sizes and body types that encompass our patients. We can look into the urethra of a cat or the colon of a Great Dane.  AVIM also uses these scopes for removal of foreign bodies from the esophagus and stomach of dogs and cats. We perform radial balloon bougienage via these endoscopes, notably for esophageal strictures.  Common endoscopic procedures include examination of the inside of the nose, ear canals, esophagus, stomach, duodenum (first portion of small intestine), colon, rectum, urethra, vaginal tract, and urinary bladder.  There are some limitations, including the need for general anesthesia in our patients, and some specific situations. Overall, these are great tools to help us with diagnostic and therapeutic efforts for your pets in the 21st century.   

 

Advanced Imaging for your pet - MRI or CT? 

There's a lot of discussion in the media and on the internet regarding the "need" for advanced imaging techniques.  These are great diagnostic tools.  Our Annapolis facility does have an MRI on site, and we are currently still working on a CT to be available soon.  The decision to have an MRI completed is based upon the interaction with your specialist.  MRI does not produce increased exposure of your pet to radiation as is the case with CT procedures.  When a CT is preferred we often refer our clients and patients to another regional facility (VRA).  A high quality machine is needed for a high quality image.  If you pet is in need of an MRI please call and schedule an appointment with the specialist.  MRI's can be completed the same day and a full detailed report with interpretation is available to the specialist the next business day. 


Talks and Travels 

  • Dr. Hitt, Dr. Klaser, and Dr. Martinez attended ACVIM in Nashville June, 2014.  The doctors returned with new information and new approaches for internal medicine cases.
  • Dr. Hitt was an invited panelist for discussion of questions regarding the diagnosis and treatment of canine liver disease. The other panelists participating were three other specialists with special interest in liver disease (Dr. David Twedt, Dr. Cynthia Webster, Dr. Keith Richter) at the ACVIM Forum Liver Study Group meeting in Nashville in early June 2014. 
  • Dr. Calo and Dr. Peterson attended the mid-year VCS, Veterinary Cancern Soceity, joint meeting with Surgical Oncologist in March, 2014.  Dr. Calo and Dr. Peterson returned with enthusiaism and new approaches for oncology cases.  
  • Dr. Hitt was invited to speak to regional veterinarians of the Treasuer Coast Veterinary Medical Association in Ft. Pierce, Florida in October 2013 on the topic of “Excessive panting – a clinical symptom and what drives dog owners crazy”
  • Dr. Hitt recently spoke at the Comparative Gastroenterology Society annual meeting this March in Puerto Rico on the topic of “Canine hepatocellular adenomas associated with proteinuria”.  If you have to speak somewhere, Puerto Rico seems pretty good, doesn’t it?
  • All of our AVIM&O doctors continue to attend local continuing education meetings in the Greater Baltimore and Anne Arundel County area on regular basis. This helps maintain our awareness of what is new in veterinary medicine but also keeps us in personal touch with your pet’s local veterinarian.
  • Dr. Hitt was co-author on a paper written by Dr. Pedro Armstrong.  Dr. Armstrong was one of our past internal medicine residents at AVIM&O.  This article, Fungal myelitis by Phialosimplex caninus in an immunosuppressed dog, is a first report of a unique fungal organism using DNA molecular identification (which was done at an outside research laboratory of course) and was published in the journal of Medical Mycology in 2012. 
  • In the Fall of 2011, Dr. Hitt spent three days as an invited speaker presenting to other internists from across the country. This was part of the ACVIM Advanced Gastroenterology Course. It was held in Las Vegas at the impressive Oquendo Center for Continuing Education.  His topics included Exploration of Prebiotics and Probiotics, Antibiotic Responsive Diarrhea of Dogs and Cats, and four panel discussions.  In addition he helped to teach the abdominal ultrasound lab sessions.
  • Several of our internists and our oncologists, attended the annual ACVIM Forum 2013 that was held in Seattle the first week of June.  This event provides numerous hours of "cutting edge" updates in the realm of veterinary internal medicine and oncology.  The Annual ACVIM Forum 2014 will be held in Nashville and a number of the AVIM&O internists will be attending.
  • Doctor Mark Hitt is a chapter author on several topics for the 5th Edition of Blackwell's Five Minute Veterinary Consult. Chapter titles include topics on chronic diarrhea of dogs and cats, irritable bowel syndrome in dogs (canine IBS), toxins of the liver (Hepatotoxins), and immunoproliferative enteropathy of Basenji's.  
  • Doctor Mark Hitt has traveled quite a bit in 2011.  He was a presenter of a lecture at the Comparative Gastroenterology Society meeting in Costa Rica in 2011, talking on the topic of clinical presentations for portal venous thrombosis (blood clots in the portal vein).  He also was an invited spearker on the topic of Veterinary Practitioner-Specialist Relationships at the National AAHA meeting held in Toronto, Ontario.
  • Dr. Hitt spoke with Dr. Daren Roa at the local Anne Arundel Count Veterinary Medical Association meeting in fall of 2012 on the topic of hospital acquired infections, antibiotic resistant organisms, and steps that hospitals can take to reduce risks of these infections  (nosocomial infections such as MRSA, MRSPi, ESBL enterobacteriaceae, and developing concerns for carbenapenase resistance) as applicable to a veterinary hospital setting.
  • Doctor Mark Hitt has several textbook chapters that have been published in the past few years. These include topics on inflammatory liver disease of cats, drug induced liver disease, diagnostic procedures such as cystoscopy (endoscopy of the bladder) and endoscopic assisted feeding tube placements in critically ill patients.   The chapters published in the past year can be found in Current Veterinary Therapy XIV, Cote's Veterinary Clinical Advisor, and August's Feline Medicine 6th edition. 
  • AVIM&O participated with the other specialty services of CVRC in presenting a day of approved continuing education to regional veterinarians of the DELMARVA penninsula on Kent Island as our Spring Conference in May 2012.
  • Dr. John Paola will be speaking on current topics within veterinary Internal Medicine at the upcoming Spring Conference this April, 2013. 
  • Dr.  Hitt was recently an invited member of a committee of four people to assess current facilities and function of the Iowa State University - Lloyd Veterinary Medical Center. This was a three day process at the request of the university provost and dean of the College of Veterinary Medicine.
  • The next ACVIM Forum, featuring up to date topics across the breadth of veterinary internal medicine, will be held in Seattle in June 2013.  Several of our doctors will be attending this conference.  Others of our internists will be attending the European College of Veterinary Internal Medicine conference. Attending these continuing education conferences is not only required to maintain our status but a vital part of our efforts to remain in touch with the most recent knowledge of veterinary internal medicine and oncology.

Grief Counseling Discussion Group

Doctor Barbara Kohl, Grief Counseling Discussion Group - AVIMO is sponsoring, with CVRC, a small discussion group meeting at our facility in Annapolis that will have the goals of imparting information, understanding and comfort for our clients who have lost a beloved pet companion.  An experienced psychologist specializing in grief counseling (for loss of pets or people) will lead the discussions. Please contact Mr. Andy Furtado of CVRC at 410-224-0121 about details of times and topics. 

Ethanol ablation therapies

Dr. Hitt has been doing ethanol ablation therapy with ultrasound guidance for several years.  Although not a commonly required procedure, there are cases of hyperparathyroidism and hyperthyroidism where nodule/tumors can be injected to reduce function (induced chemical necrosis).  This procedure is chosen cautiously and with some specific selection criteria.  It is generally reserved for situations when a pet cannot handle deep anesthesia, cannot be hospitalized for radiation therapy due to other critical conditions, or that there are other factors limiting more routine options for treatment of these conditions.  Please feel free to contact Dr. Hitt via your pet's regular veterinarian if it seems that this procedure may be a treatment option for your pet.

Advances in Medical Care

Palladia (toceranib phosphate). Palladia has been approved for use in canine patients only for Patnaik Grade II or III recurrent cutaneous mast cell tumors with or without regional lymph node involvement.  Surgery should still be considered as a primary treatment option. Palladia works via interference with the genetic expression of certain enzyme systems that the cancer cells are commonly dependent upon for reproduction/survival of the cancer cells.  It  works in two ways: by killing tumor cells and by reducing the development of  blood supply to tumor cells. As with all chemotherapies, there can be side effects. This is why the drug is currently restricted to use by board certified veterinary oncologists (Dr. Peterson of AVIM ) and by special permission to veterinary internists where permitted by the drug manufacturer. Careful monitoring of both the response of the patient as well as for tolerance to the drug are needed.  Cautious well instructed use is a requirement for using this new, advanced and potent medication. Consultation with Dr. Janet Peterson, board certified veterinary oncologist with AVIM, can be pursued via discussion with your pet's regular veterinarian.

Canine Melanoma Vaccine - the melanoma vaccine is used for the treatment of dogs with stage II or stage III oral melanoma and for which local disease control has been achieved but prevention of recurrance is desired. Some other dogs may benefit from this product as well under direction of a veterinary oncologist.  Initial treatment requires a commitment to ongoing treatment with administration of the vaccine once every two weeks for a total of four doses.  A booster should then be administered at six month intervals.  Monitoring is as with more routine forms of chemotherapy as this remains a potent advanced medication. Each dose of the melanoma vaccine contains a plasmid DNA that expresses the gene coding for human tryosinase.  Tyrosinase protein is over expressed on many canine  melanoma cells resulting in the pet's immune system attacking this required enzyme system for the survival and replication of the cancer cells.  Consultation with Dr. Janet Peterson, board certified veterinary oncologist with AVIM, can be pursued via discussion with your pet's regular veterinarian.

Publications related to AVIM&O's Doctors

Journal of Veterinary Internal Medicine. 2012 Jul;26(4):888-96. doi: 10.1111/j.1939-1676.2012.00951.x. Epub 2012 Jun 7. A Multi-Institutional Study Evaluating the Diagnostic Utility of the Spec cPL(™) and SNAP® cPL(™) in Clinical Acute Pancreatitis in 84 Dogs.   McCord K, Morley PS, Armstrong J, Simpson K, Rishniw M, Forman MA, Biller D, Parnell N, Arnell K, Hill S, Avgeris S, Gittelman H, Moore M, Hitt M, Oswald G, Marks S, Burney D, Twedt D. *Colorado State University, College of Veterinary Medicine.  Abstract: SNAP and SPEC have higher sensitivity for diagnosing clinical acute pancreatitis than does measurement of serum amylase or lipase activity. A positive SPEC or SNAP has a good positive predictive value (PPV) in populations likely to have AP and a good negative predictive value (NPV) when there is low prevalence of disease.

Medical Mycology. 2012 Jul;50(5):509-12. Epub 2011 Nov 28. Fungal myelitis caused by Phialosimplex caninus in an immunosuppressed dog. Armstrong PF, Sigler L, Sutton DA, Grooters AM, Hitt M.  * Southeast Veterinary Referral Center , Miami, FL , USA. Abstract:  A bone marrow infection caused by Phialosimplex caninus was diagnosed in a seven-year-old female spayed Cocker Spaniel that was receiving prednisone for autoimmune hemolytic anemia. Histopathologic examination of a bone marrow core biopsy revealed clusters of oval to round yeast-like cells of varying shape and size and occasional irregular hyphae. Culture of a bone marrow aspirate sample yielded a mould initially suggestive of Paecilomyces inflatus or Sagenomella species but later determined to be P. caninus. The dog was treated with itraconazole and amphotericin B, and prednisone was continued at the lowest dose needed to control the hemolytic anemia. The patient died after 18 months of treatment. This is the first detailed clinical report of infection caused by P. caninus, a newly described fungus associated with disseminated disease in dogs.

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News & Events

Columbia Location NOW open!!

 Questions and Answers about Ebola and Pets – CDC guidelines

CVRC Sponsored Continuing Education Events

Laparoscopy at CVRC!  

Diagnostic Endoscopy, Endoscopic Interventional Procedures & Urethral Collagen Injections

Advanced Imaging for your pet - MRI or CT?

Talks and Travels

Advanced Medical Care at AVIM

Grief Counseling Discussion Group through AVIM

Publications Relating to AVIM&O's Doctors

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Conveniently located in
Annapolis and Towson.
Map and Directions . . .
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Atlantic Veterinary Internal Medicine & Oncology, LLC
808 Bestgate Road, Annapolis, MD 21401
(410) 224-0121
1209 Cromwell Bridge Road, Towson, MD 21286
(410) 828-0911
10000 Old Columbia Rd, Columbia, MD 21046 (410) 441-3304
© 2016 Atlantic Veterinary Internal Medicine, LLC
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