Sometimes, the needs of pets seen at the University of Minnesota Veterinary Medical Center are simple and straightforward—a quick checkup or a patched-up cut. Other times, they are complicated and complex cases, needing a deep understanding of the body and its functions. That’s where the Small Animal Internal Medicine Service team comes in.

The diagnostics, procedures, and treatments conducted by the service team cover a wide breadth of body systems, which means communicating and collaborating with other speciality services is a key part of its members’ work. It also creates a unique challenge as their expertise could be needed for any patient who walks through the hospital doors. 

“Because we have to do a lot of collaboration, we need to be available basically 24/7, particularly in emergency cases,” says Lindsay Merkel, associate professor of internal medicine and head of the service. “We are on call for things like scoping foreign bodies or cases where the patient has a chronic disease, and we help the emergency staff stabilize things in such a way that we are not harming the long-term management of the disease.”

Among the team’s most common procedures are using instruments such as an endoscope to see inside patients’ nasal passages, gastrointestinal tracts, and other parts of the body—often to find foreign objects in need of removal or to perform biopsies to help inform next steps in the treatment of cancer or polyps. 

Treating urinary tract disease, placing stents to help with urination, and removing urinary stones through methods such as laser or burstwave lithotripsy encompasses another set of commonly performed services.

The team also diagnoses and manages chronic conditions such as diabetes, Cushing’s disease, Addison’s disease, and thyroid disorders. Given the nature of those and other ailments, Merkel says their patients tend to be older animals. 

“We have really lovely long-term, very complicated cases with very dedicated owners who are committed to their animals for years and years and years—so we typically aren't seeing the cute, fluffy puppies and kittens,” she says. 

That includes managing conditions such as high blood pressure and inflammatory bowel disease experienced by a canine patient named Zesty. The opportunity to build those relationships with patients and clients over the course of years is a special and rewarding part of internal medicine. 

“When you have that long-term relationship with somebody, we see them at their best and their worst, but we always know that they're in the fight with us and want the best for their pet,” Merkel says. 

The service recently added two new faculty members, Brian Hardy and Craig Ruaux, who Merkel says each adds to the collective expertise—Hardy in 3D medical device printing and Ruaux in gastrointestinal conditions and scope procedures.