Veterinary Internal Medicine in Sherwood Park

Arthrocentesis is a minimally invasive procedure used to collect synovial fluid (joint fluid) from one or more joint capsules. Using a fine-gauge needle and syringe, our specialists carefully extract a small sample of fluid to be analyzed under a microscope or sent for laboratory culture.

Why is this procedure performed?

This is a critical diagnostic tool for pets experiencing joint swelling, lameness, or "shifting leg" pain. It helps our medical team differentiate between:

• Immune-Mediated Polyarthritis (IMPA): Where the immune system mistakenly attacks the joints.
• Septic Arthritis: A serious bacterial infection within the joint.
• Degenerative Joint Disease: Common "wear and tear" or osteoarthritis.
• Trauma or Neoplasia: Identifying blood or abnormal cells within the joint.

What to Expect

To ensure your pet’s comfort and the collection of a sterile sample, this procedure is typically performed under sedation. The skin over the joint is clipped and surgically cleaned to prevent contamination. By analyzing the viscosity, clarity, and cellular makeup of the fluid, we can pinpoint the underlying cause of joint pain and begin a targeted treatment plan.

Lower airway endoscopy/ Bronchoscopy – a flexible camera (bronchoscope) is used to look inside air ways (trachea and the bronchi) and collect samples for cytology and culture.

This is how a normal trachea looks during bronchoscopy. The exam allows us to look for evidence of tracheal collapse.

This is how the bronchi look on the bronchoscopy. Samples of the mucous (yellow) would be collected for a pathologist to look at and also for a culture to identify micro-organisms that could be causing disease.

Esophagoscopy / Gastroscopy / Duodenoscopy or upper gastrointestinal endoscopy: Endoscopic examination of the upper digestive tract includes an evaluation of the esophagus, stomach and duodenum. These procedures are done to visualize the lining of the tract and collect biopsy samples without the need for surgery.

Sometimes, we use an endoscope to remove foreign objects, such as pennies, tennis balls, etc. from the stomach.

Upper gastrointestinal endoscopy is also used in conjunction with fluoroscopy for balloon dilatation of esophageal strictures, or polyp removals etc. We also do offer capsule endoscopy as an option in larger dogs and those who cannot undergo general anesthesia. 

Colonoscopy or lower gastrointestinal endoscopy: A flexible endoscope is used to examine the lining of the colon and rectum and sometimes the terminal part of the small intestine the ileum in pets with frank blood in the stool, or issues with defecation.

Lower gastro-intestinal endoscopy in a dog showing the ileo-cecal junction which is the connection between the small and large intestines. 

Cystoscopy: A rigid camera is used to examine the bladder (cystoscopy) and urethra (urethroscopy) are performed in female dogs with various urinary tract problems, like recurrent infections, tumors, urinary incontinence, or difficulty urinating. This serves as a method of a definitive diagnosis and for collecting biopsy samples.

Rhinoscopy: An endoscope is used to examine the front and back of the nose for cancer, inflammation, cancers etc. and collect biopsy samples. Sometimes this is used to treat nasal and fungal infections.

Laparoscopy is a state-of-the-art surgical technique that allows our specialists to examine the internal organs of the abdomen through tiny, "keyhole" incisions. By using a high-definition camera (laparoscope) and specialized long-handled instruments, we can visualize the abdomen in great detail on a monitor, providing much better magnification than the naked eye.

Why is Laparoscopy the preferred choice?

Laparoscopy is considered the "gold standard" for investigating liver disease and other abdominal issues in dogs and cats for several reasons:

• Superior Diagnostic Accuracy: The camera allows us to see subtle changes on organ surfaces and collect high-quality, targeted biopsies from the liver, kidneys, or pancreas.
• Reduced Trauma: Traditional "open" surgery requires a large incision to see the organs. Laparoscopy achieves the same results through one or two incisions often less than 1 cm in size.
• Less Pain & Faster Recovery: Because the incisions are so small, there is significantly less post-operative pain, and most patients are able to return home the very same day.
• Safety: The high magnification helps the surgeon avoid blood vessels and identify abnormal tissue more precisely.

How we use Laparoscopy at Pulse

Our Internal Medicine service often uses laparoscopy in conjunction with our Surgical Service. While it is primarily used for biopsies to diagnose chronic diseases, it can also be used for preventative procedures, such as laparoscopic gastropexy (to prevent stomach twisting in large-breed dogs) or laparoscopic spays.

What to Expect

Your pet will be under general anesthesia for the duration of the procedure. After the biopsies are collected, the tiny incisions are closed—often with just a few small stitches or surgical glue. Because the procedure is so gentle, your pet’s activity only needs to be restricted for a short period compared to the weeks of rest required for traditional surgery.

When a pet is unable or unwilling to consume enough calories to support healing, a feeding tube provides a safe, stress-free way to deliver essential nutrition, hydration, and medications directly into the digestive tract. This is a common and highly effective supportive measure for pets recovering from severe illness, oral trauma, or specialized surgeries.

Types of Feeding Tubes We Provide:

• Esophagostomy (E-Tubes): Placed into the esophagus through a small incision on the side of the neck. These are the most common for long-term home care as they are well-tolerated and do not interfere with the pet eating on their own if they choose to.
• Gastrostomy (G-Tubes or PEG Tubes): Placed directly into the stomach, often with endoscopic assistance. These are ideal for patients who require long-term nutritional support or those with esophageal issues.
• Jejunostomy (J-Tubes): Placed into the small intestine, these are used in rare, critical cases where the stomach must be bypassed entirely.

What to Expect

Placement is performed under a short period of general anesthesia. Once the tube is in place, our team will provide you with a comprehensive demonstration on how to blend specialized food, administer feedings, and keep the tube site clean. Most pets are significantly more comfortable once their nutritional needs are being met.

While a standard blood test (CBC) tells us how many cells are currently circulating in the bloodstream, a bone marrow evaluation allows our specialists to look directly at the "factory" where those cells are produced. This procedure is essential when a pet has unexplained blood abnormalities that cannot be diagnosed through external blood work alone.

Aspiration vs. Core Biopsy

In most cases, our specialists perform both techniques during the same session to get the most accurate picture:

• Aspiration: A small amount of liquid marrow is collected to look at the individual shape and health of the cells (cytology).
• Core Biopsy: A small, solid "core" of bone marrow is collected to examine the overall structure and "cellularity" of the marrow (histopathology).

What to Expect

Because we must access the center of a bone (usually the humerus or the hip), this procedure is performed under deep sedation or general anesthesia with local numbing agents to ensure your pet is completely comfortable and still. The site is shaved and surgically cleaned. After the procedure, your pet may have a tiny stitch or a small bandage, and most experience only mild soreness that is easily managed with routine pain medication.

How it Helps

By evaluating the marrow, we can determine if the body is simply failing to produce cells, if it is being attacked by an immune-mediated disease, or if there is an underlying malignancy. This allows us to move from "managing symptoms" to "treating the cause."

Interventional Radiology (IR) is a cutting-edge field that uses advanced imaging—such as fluoroscopy (real-time X-ray)—to guide tiny catheters and stents directly to the site of a problem. This allows our specialists to treat complex conditions that previously required major "open" surgery through much smaller, less invasive entry points.

By collaborating across our Internal Medicine, Surgery, Radiology, and Cardiology services, we provide comprehensive care for conditions that were once considered difficult or impossible to manage.

Common Interventional Procedures We Offer

• Urinary Stents: Small, flexible mesh tubes placed within the urethra or ureters to bypass obstructions caused by stones, tumors, or strictures. This restores normal urine flow immediately without the need for traditional bladder or kidney surgery.
• Subcutaneous Ureteral Bypass (SUB) Devices: An innovative system used primarily in cats with ureteral obstructions (often from tiny stones). The SUB device creates a new pathway for urine to flow from the kidney to the bladder, bypassing the blocked ureter.
• Vascular Stenting & Embolization: Using catheters to navigate the blood vessels to treat internal bleeding, certain types of tumors, or congenital vascular abnormalities (like liver shunts).
• Tracheal Stenting: Placing a self-expanding stent in the airway of dogs suffering from severe tracheal collapse to help them breathe easily again.

What to Expect

These procedures are performed in our specialized imaging suite under general anesthesia. Because IR relies on high-tech equipment like fluoroscopy, our team can visualize the procedure on a screen in real-time, ensuring extreme precision. After the procedure, your pet is monitored closely by our medical team to ensure the device or stent is functioning perfectly before they return to your care.

Our team facilitates chemotherapy administration and monitoring for dogs and cats who reside locally and require chemotherapy after virtual consultation with a board-certified oncologist. Currently there is no medical or radiation oncologist on staff at Pulse Veterinary Specialists & Emergency.  

What to Expect

Most chemotherapy sessions are performed on an outpatient basis. Your pet will stay with us for a few hours to receive their medication and undergo monitoring before returning home the same day. Our team will guide you through home-care instructions, including how to safely handle your pet's waste and what signs to watch for during the recovery phase.