Referral Pearl


Referral Pearl                                                   
Volume 4. Issue 2

February 2018                                          
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Our Neurology Service at the Center for Veterinary Specialty + Emergency Care is comprised of experienced Board Certified Neurologists, Neurology Residents / Interns, and a compassionate support Staff who work closely with our other Specialists and ER Doctors to provide exceptional Patient care.  When preparing a referral to our Neurology Service for your Patients, please consider the following:

  • All Neurological Patients receive a comprehensive neurological exam to determine the correct diagnostic option - an MRI or CT/myelogram.
  • At CVSEC we have a Collaborative Team of on-site Doctors.  During non-peak hours (weekends and after 4:00 pm Monday - Friday), our Neurosurgeons are available to consult remotely with our Emergency and Critical Care Team (E/CC) and to perform neurosurgery on an emergency basis (if needed).
  • We have the capability to evaluate cerebrospinal fluid (CSF) on site.
  • We do pre-anesthetic baseline blood-work screening and chest radiographs in Patients over six years of age to rule out other abnormalities.
  • We always use the safest intravenous and inhalant anesthetic medications, such as Alfaxan and Sevoflurane.
  • Evaluation by a Neurologist prior to MRI ensures that the correct neuroanatomical location is imaged, and that your Client and Patient will receive the best recommendations for treatment options.

  • We provide MRI services in collaboration with Animal Imaging.  One of our Neurologists will assess the Patient to ensure that the Pet is safe for MRI and anesthesia prior to transport to Animal Imaging.  Our Neurologists interpret the MRI in conjunction with Board Certified Radiologists (
  • MRI machines vary in quality.  CVSEC provides 3T MRI in collaboration with Animal Imaging which yields the highest quality diagnostic images available.
  • MRI results are usually available within 24 hours.
  • There are onsite MRIs that may be able to offer a faster appointment, however, faster is not always better.  If the diagnostic quality of the images is poor, there may be no benefit to the Patient.
  • Radiologists will often call to address other problems that are found by the MRI such as incidental masses.  We can then work with our Internal Medicine Team to have them evaluated for continued care.
  • Our Patients are monitored overnight after the MRI to make sure that there are no post-anesthetic complications, and intravenous fluid support is provided to protect the Patient's kidneys since contrast is used during an MRI.

  • 100% of our Neurosurgeries are performed by Doctors who are specifically trained in Neurosurgery.
  • We have two dedicated Nurses assigned to a Patient while in the O.R.
  • We have Board Certified Criticalists on staff who are available if an issue with anesthesia occurs during surgery. 
  • Our Hospital has Doctors and Staff who are trained in ventilator therapy (if needed).

  • We provide superior aftercare:  Patients are hospitalized until Clients are comfortable taking their Pet home.  Until then, physical therapy is done multiple times a day in Hospital which includes laser therapy, cold/warm packs, Passive Range of Motion (PROM) exercises, massage, and standing exercises.
  • We have Doctors present 24/7, and our overnight Doctors always assess post-surgical Patients to confirm they are recovering well.  Our Neurologists are updated whenever necessary, ensuring the best outcome.
  • Staple removal and one month post-op assessment are complimentary.
  • Our Collaborative Team takes care of your Patient, so you can get a good night's sleep.
  • Our dedicated ICU Team is always available to update your Clients on how their Pets are doing overnight.
 (Dr. Hollman pictured with three of her Patients - Natasha, Boris and Nellie Price)

Copyright © 2018 Center for Veterinary Specialty + Emergency Care, All rights reserved.
"As one of our Top Referring Facilities, you have been included on our new monthly newsletter, The Referral Pearl".

Our mailing address is:
Center for Veterinary Specialty + Emergency Care
2700 Lake Vista Drive
Lewisville, TX 75067

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Referral Pearl
Volume 4. Issue 1


January 2018

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Canine Liver Enzymes:  Choosing the Right Path for Diagnosis

Valerie Case, DVM
Diplomate ACVIM - Internal Medicine

Interpreting canine liver enzymes can be very challenging.  Reversible but severe elevations can occur with administration of certain drugs, while diffuse neoplasia may be present in the liver without causing any enzyme changes.  This article summarizes the guidelines our Internal Medicine Department uses to evaluate canine liver enzymes.

Alkaline phosphatase (ALP) has high sensitivity but low specificity for hepatobiliary disease.  Elevation of ALP alone without other enzyme abnormalities is most often associated with drug induction, hyperadrenocorticism, and benign reactive changes within the liver including nodular hyperplasia and vacuolar hepatopathy. Occasionally ALP is the only abnormal enzyme in Patients with hepatic neoplasia.  If a Patient's history does not support exposure to ALP inducing drugs or endocrine disease, monitoring the ALP over time is an acceptable course of action in asymptomatic Patients.  If the ALP elevation persists or is progressive over 4-6 weeks, abdominal ultrasound and liver function testing is recommended for further investigation.  Our on-site laboratory can measure both serum bile acids and blood ammonia levels.

Gamma glutamyl transferase (GGT) has greater specificity for hepatobiliary disease compared to ALP.  When both GGT and ALP are elevated, the specificity for liver disease nears 100%.  Gall bladder and bile duct disease will cause the largest elevations in GGT.  The combination of increased GGT, ALP, total bilirubin, and cholesterol should be immediately concerning for biliary tract obstruction, and warrants referral for abdominal ultrasound and critical care management.

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increase due to leakage from damaged hepatocytes.  Mild elevations can occur with diseases outside of the liver including pancreatitis, gastroenteritis, congestive heart failure, and endocrine diseases.  Toxic and infectious hepatitis generally cause the largest elevations of ALT and AST due to widespread hepatocyte inflammation and necrosis.  A thorough history exploring risk of exposure to known hepatotoxins as well as testing for Leptospirosis are indicated in these cases.  AST elevation exceeding ALT may indicate muscle cell damage rather than liver disease.  Evaluation of creatine kinase (CK) can help to differentiate.

Abdominal radiographs are excellent for evaluating hepatic size and screening for mineralization or gas within the parenchyma or biliary tree.  Abdominal ultrasound can determine if disease is focal or diffuse, as well as evaluate the biliary system and portal vasculature.  In some cases extrahepatic portosystemic shunts can be visualized, but should always be confirmed with portal scintigraphy.  Fine needle aspiration can be diagnostic when focal lesions are present, or when the liver is enlarged with diffuse parenchymal changes (hepatic lipidosis, lymphoma).  Patients with suspected chronic or chronic active hepatitis require liver biopsy for definitive diagnosis.  Biopsies obtained via laparotomy or laparoscopy are recommended over ultrasound guided techniques.  We offer laparoscopic liver biopsy for Patients over 20 pounds body weight.

Our Internal Medicine Team is proud to offer extensive diagnostic testing and care for your Patients with hepatic disease.  Call our Client Service Representatives today to schedule your Patients (972.820.7099)!



CVSEC is proud to introduce our newest member of the IM Team!

Teresa Seyfert, DVM
Diplomate ACVIM - Internal Medicine


Dr.Teresa Seyfert grew up in Iowa and Kansas and received her DVM from Kansas State University in 2005.  She completed a rotating small animal surgery and medicine internship at The Ohio State University and then an Internal Medicine internship and residency at Oklahoma State University.  She became board certified in Small Animal Internal Medicine by the American College of Veterinary Internal Medicine in 2012.  Dr. Seyfert worked at private specialty practices in Wichita, KS (2011-2015) and Grayslake, IL (2015-2017) prior to joining CVSEC in 2017.

Dr. Seyfert's professional interests include hematology/immunology, infectious disease, and minimally invasive diagnostic procedures.

When not at work, Dr. Seyfert enjoys spending time with her husband, daughter, and 2 dogs.  She likes to watch movies, read for fun, and travel to enjoy sporting events, concerts, and amusement parks.  She is also trying to learn more about cooking.

Dr. Seyfert can be reached at 972.820.7099 or  She is looking forward to meeting our Referring Community and partnering with you in Patient care.




Copyright © 2018 Center for Veterinary Specialty + Emergency Care, All rights reserved.
"As one of our Top Referring Facilities, you have been included on our new monthly newsletter, The Referral Pearl".

Our mailing address is:

Center for Veterinary Specialty + Emergency Care

2700 Lake Vista Drive

Lewisville, TX 75067

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Referral Pearl

Volume 3. Issue 6 

October 2017

CVSEC Veterinary Social Workers Discussion Series 2017


The Veterinary Social Workers at CVSEC will be hosting a series of presentations at our Hospital over the next four weeks.  The topics of interest were based on an internal survey that the Team recently participated in.  We would like to invite members of our Referring Community to attend any of the sessions.  The schedule is provided below and 2:00 pm to 3:00 pm will be the time for all presentations:

Thursday, November 2nd:  "Communication to Enhance Work with Clients and Co-Workers:  It's all in how you say it"

Thursday, November 9th:  "Boosting Resilience and Resistance to CF and Burnout:  Mindfulness and other EASY techniques"

(Dr. Ducote' will teach the technique of Mindfulness)

Thursday, November 16th:  "Client Types:  Preparing for the Types and Satisfying Even the Angry Client"

Thursday, November 30th:  "Stop Eating/Beating Yourself Up:  Shedding Negative Inner Dialogues and the Moral Stress of Practicing in Vet Med"

Kendall Day, DVM
Neuro Intern

Dr. Kendall Day is originally from upstate New York.  She obtained a BS in Marine Biology from the University of Rhode Island in 2011.  She then worked as a Veterinary Technician for one year before she got sick of the cold weather and decided to travel to the south for veterinary school.

She attended Auburn University College of Veterinary Medicine and graduated in 2016.  She then moved to Tampa, Florida for a one year rotating internship at Blue Pearl Veterinary Partners.  She recently moved to Dallas, Texas with her boyfriend and their two mixed breed dogs, Callie (Australian shepherd mix) and Lexie (Boxer mix) for a one year Neurology specialty internship at CVSEC.

Her love of Neurology began after adopting a sweet golden retriever named Molly with idiopathic epilepsy.  The fascination continued throughout veterinary school where she decided to pursue a career as a Neurologist.  In her free time, you can find her at the gym, hiking outside with her dogs or roasting her own coffee beans.
Super cute Hotdog and Bubble Bee!

The Poop Machine
Go Cowboys!

CVSEC is a Teaching Hospital

Center for Veterinary Specialty and Emergency Care is dedicated to compassionate care of our Patients.  We are also committed to the education of our future veterinary colleagues.  CVSEC is the only Specialty and Emergency Hospital in North Texas that has two ACVIM approved residency programs:  one in Internal Medicine and one in Neurology.  Currently, we train three residents:  Dr. Stikeman in Internal Medicine and Drs. Williams and Lindsay in Neurology.  All three residents are licensed veterinarians that have extensive specialized training prior to starting their residencies including rotating general medicine and surgery internships as well as one or more specialty internships in their respected field.

Speaking of specialty internships, CVSEC offers three specialized internships in Emergency and Critical Care, Neurology, and Internal Medicine.  Specialty interns work side by side with our Specialists and Emergency Doctors to provide
comprehensive care for our Patients and direct communication with our Clients.  Many of our specialty interns have moved on and become Boarded Specialists across the country.  Both our residents and specialty interns also provide further training to our Hospital Staff through topic presentations and help our Hospital stay up to date on the most current veterinary research by focused journal clubs and topic rounds.

We also train fourth year veterinary students through mentored externships in Neurology, Internal Medicine and Emergency and Critical Care. This is an amazing opportunity for our future colleagues to experience specialty and emergency care in a busy
private practice setting before graduating from their respective veterinary programs.

If you have questions about the residency, internship, and externship opportunities at CVSEC, please contact our House Officer Lead, Dr. Susan Hollman at

Barbara Lindsay, BSc, BVMS

Dr. Barbara Lindsay grew up on a sheep farm in south-east Australia.  She moved to Perth in Western Australia to attend Murdoch University for her veterinary training (which is an American Veterinary Medical Association accredited school).   She has completed a Surgical internship in Sydney and a Neurological internship in New York before relocating to Dallas to pursue further study in Neurology.

Dr. Lindsay enjoys Barre Pilates, jogging, and expresso coffee.  Whist she misses her sheep dogs back on the farm "down under" she is having a fantastic time exploring the Lone Star State and meeting the locals!

Dr. Lindsay Patient - Archie Silverman
Happy Halloween from the Whataburger Family!
Cookie Monster




Copyright © 2017 Center for Veterinary Specialty + Emergency Care, All rights reserved.
"As one of our Top Referring Facilities, you have been included on our new monthly newsletter, The Referral Pearl".

Our mailing address is:

Center for Veterinary Specialty + Emergency Care

2700 Lake Vista Drive

Lewisville, TX 75067


Referral Pearl
Volume 3. Issue 5

September 2017

CVSEC would like to thank our current Top Referring Facilities!  Thank you for your partnership with us!! 

Hillside Veterinary Clinic

Animal Clinic of Farmers Branch

VCA Metroplex Animal Hospital

River Chase Animal Hospital

Banfield - Lewisville

Katy Trail Animal Hospital

Legacy Veterinarian Hospital

All Care Veterinary Hospital

Vestsavers Pet Hospital

Community Pet Outreach

Banfield - West Plano

Stonebriar Veterinary Centre

VCA Angel Vet Center Flower Mound

All Creatures Veterinary Center

North Dallas Veterinary Hospital

Creekside Pet Care Center

I-20 Animal Medical Center

ADC - Dallas

Healthy Paws Veterinary Center

Country Creek Animal Hospital

Animal Emergency Hospital of North Texas

Hebron Parkway Veterinary Hospital

Animal Medical Center of Plano

Valley Ranch Pet Clinic

Allen Veterinary Hospital


Tyson's Story
Tyson presented to CVSEC on 8.28 .17 for upper airway obstruction.  His family was being evacuated from Houston as Hurricane Harvey approached and on the trip, Tyson got worked up and obstructed his airway.  He was sedated and emergently intubated; his soft palate was very long and his laryngeal tissues were swollen and erythematous.  After 36 hours, we tried to extubate him, but were unsuccessful. 

We partnered with Dr. Corbin at VCA Metroplex and she performed brachycephalic airway surgery.  The CVSEC Critical Care Team continued care after surgery, keeping Tyson intubated to allow his airway to heal and swelling to resolve.  We again attempted extubation, and again were unsuccessful.  We partnered with Dr. Corbin again, and she performed a tie back on the right side of the larynx.  She also performed a temporary tracheostomy to limit air movement through the upper airway.

Tyson was maintained with sedatives, and NG tube, IV fluids, and over the subsequent days, his upper airway started to heal.  On Saturday, the temporary trach tube was removed and Tyson's treatments were continued.  He was discharged on Wednesday, September 13th to head back to Cypress with his family.  Tyson was with us for 17 days. His family brought the RV so that Tyson could travel with great comfort and relaxation!

Dr. Heather Rhoden
Emergency / Critical Care

Dr. Rhoden grew up in a small town in Nebraska and always knew she wanted to be a Veterinarian.  In 2014 she received her DVM degree from Oklahoma State University.  She spent the following year working as a Veterinary Intern Instructor at Texas A&M University, training in Emergency and Specialty Medicine and teaching Veterinary students.

After her internship, she spent 8 months working as a General Practitioner and quickly realized that she missed Emergency Medicine.  Dr. Rhoden joined the Team at CVSEC in March of 2016.  She enjoys the challenge of Emergency Medicine in a Specialty Practice and loves that her colleagues are willing to teach and learn new things.

When not at work, Dr. Rhoden can be found in the garden or working on home improvement projects with her husband, Gene.  She also enjoys crafting and spending time with her furry and feathered family members.
Dr. Ragan Vadell
Emergency / Critical Care

Reagen Vadell is a graduate of Texas A&M University.  She was born in San Antonio but made a detour through Portland, OR, and Seattle, WA, before settling in Midlothian, a small town south of the Metroplex.  She considers College Station home as she got both her undergraduate and Doctor of Veterinay Medicine degrees at A&M.  She worked at a few mixed animal practices treating dogs, cats, cattle, sheep, goats and horses before joining CVSEC.

When not working or learning more about vet med, she's passionate about traveling, reading, trying new activities and foods, playing with her horses, and spending time with her husband and three mutt dogs - Belle (a heeler cross), Rich (a Black and Tan coonhound mix) and Deuce (a German shorthair pointer cross).
Copyright © 2017 Center for Veterinary Specialty + Emergency Care, All rights reserved.

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Referral Pearl
Volume 3. Issue 3

June 2017
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Why Veterinary professionals rank highly among professions at risk of suicide is an engaging topic for discussion and for further research.  However, reality hit the DFW veterinary community hard in May 2017 when we experienced four suicides in our area.  When there is one suicide, there may be others, because for every suicide completed 6-7 individuals are at risk for suicide.  All who knew the person may have long-lasting psychological and/or existential issues related to that type of loss.  Grief due to suicide is complicated, unique, excruciating, and some survivors may not ever heal completely.  For the DFW veterinary community, action is needed NOW for prevention of more suicides.

I've been around your profession for a long time, and more information can be found at  I care a lot about your well-being, and I hope to help prevent suicide in your community.  I've been supervising a Veterinary Social Work Internship at the Center for Veterinary Specialty + Emergency Care for several years now, and former interns are now licensed and ready to help you and your staff.  Some of them contract with me in my private practice, and others are referral sources.  We are uniquely qualified to offer counseling and other services to you and your staff, because we know a little about your profession, your personalities, and your stressors.  Recently, I've become a part-time employee at CVSEC, continuing the internship program as well as providing staff support and intervention.  Veterinary Social Work is not a specialty of CVSEC to which you can refer, but you may contact me for services through my website or by phone.

So most importantly, how does one prevent suicide if you're co-worker, boss, friend, or other peripheral person?

Recognize the clues:
  • Direct or Indirect Verbal Clues:
    • Direct:  I want to kill myself.  I wish I were dead.
    • Indirect:  You won't see me again.  I want to go home.  I am done.
  • Situational Clues:
    • Other losses recently...humans, pets, therapists...
    • Break ups in a relationship or divorce
    • Loss of freedom
    • Unexpected financial difficulty
    • Unwanted relocation
  • Behavioral Clues:
    • Marked changes in behavior
    • Newly interested in religion or disinterest when formerly religious
    • Giving precious things away
    • Making arrangements for children or PETS
    • Gong to the doctor (hoping to feel better)
    • Relapse into drug or alcohol abuse (If drinking or abusing other substances, the risk is substantially higher)
    • Buying a gun with no reason for it
    • Making wills and body disposition arrangements
    • Saying goodbye in a creepy, permanent way
Ask the question:

  • I wonder if you're thinking of suicide?
  • I'm concerned that you may be considering suicide.
  • Given what you're feeling/going through/telling me, I need to ask if you're suicidal.

Persuade them to see or talk to a qualified counselor:

THE MOST COMMON EMOTIONAL STATE OF SOMEONE SUICIDAL IS AMBIVALENCE AND HOPELESSNESS.  This means they would choose life if they could have hope that life and their emotional state would get  better.  Sometimes you might give them that hope.  TELL THEM THAT THEY DON'T HAVE TO FEEL THIS WAY FOREVER, and know that they really don't.  There are other solutions, and a qualified counselor must help find those solutions with them.


Call 911 and ask them to make a welfare check if you're worried and unable to contact the person.

Call 911 if the person has a plan, has a readily available weapon, and the person refuses to seek counseling help.

Sandra Brackenridge, LCSW
208.705.0088 Cell


(No RSVP necessary / No cost)


The Center for Veterinary Specialty + Emergency Care is excited to announce that we will be participating in a multi-center clinical trial evaluating a new treatment of acute pancreatitis in Client-owned dogs. 

For more information, or if you think you have a Patient that qualifies, please contact Jen Mahon, DVM DACVECC at 972.820.7099.


We LOVE our Patients as much as they LOVE us!



Our experienced Internal Medicine Team is skilled in the diagnosis and management of acquired cardiac diseases common in your canine and feline Patients.  We also provide the added benefit of extensive experience in managing Patients with concurrent cardiac and extra-cardiac disease.  

Services offered:

  • Echocardiography
  • ECGs / Holter monitoring
  • Doppler blood pressure assessment
  • 24/7 intensive care and monitoring for critical cardiac Patients (part of our continuous "Collaborative Care")

Our training is best suited for Patients over 2 years of age, as we do not perform interventional procedures that many congenital defects require.

Please call our Client Service Representatives today to schedule your Patients!




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Referral Pearl
Volume 3.  Issue 2

May 2017

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CVSEC Launches New Website - April 2017

We hope you check out our newly renovated website.  We are continually adding and updating the content to keep it fresh and interesting.  A few tools that you or your Clients may be interested in utilizing:

  • Patient Referral on-line form
  • RDVM Survey
  • FAQ's (updated)
  • Resource section with available links
  • Request for Marketing materials can be sent via the website (brochures, magnets, business cards, referral pads, etc.)
  • Medical Resource Library
  • ER Pre-Registration form
  • New Patient Registration form
  • Prescription Request form
  • Care Credit on-line application for your Clients
  • Client Survey

Please give us your feedback and let us know if there are any items that would be useful to you.  We are continuously looking for ways to enhance and improve the referring process.


As always... thank you for your continued referrals!!! 

Shelley Martin and the CVSEC Team


Benjamin Williams, DVM, MS
Neurology / Neurosurgery


Dr. Williams graduated from the College of Veterinary Medicine at Western University of Health and Sciences in California 2014.  He completed a 1 year internship in Small Animal Medicine and Surgery at Angell Animal Medical Center in Boston, MA. 

Following that he relocated to Texas to accept a Neurology Specialty Internship position at CVSEC.  Since completing the Specialty Internship in 2016, he has remained at CVSEC and started a 3 year Residency program in Neurology and Neurosurgery.

In his free time outside the Hospital he enjoys reading, hiking, fishing, and watching most sports (football in particular).  Having grown up with Irish Setters, he has a fondness for the breed, but currently shares an apartment with one adopted cat.


Dr. Williams Presenting To The Team

CVSEC Neuro Technicians

Kimberly Claus, DVM
Practice Limited to Emergency and Critical Care

Dr. Claus earned her Doctorate of Veterinary Medicine from Oklahoma State University in 2007.  After graduation, she practiced for 3 years at a Dallas emergency animal hospital. 

Dr. Claus especially loved critical cases and pursued additional training in that area.  She completed a 3 year residency program in  Emergency and Critical Care at the University of Wisconsin-Madison, then came bak to DFW again.  Dr. Claus is proud to have joined the CVSEC family in 2016.

Her professional interests include sepsis, acute abdominal diseases, shock resuscitation, cardiovascular emergency stabilization, and neurologic emergencies.

In her spare time, Dr. Claus enjoys live music, art, wine, traveling (especially to colder climates), and spending time with friends and family.  She has a soft spot for great danes and currently has a deaf, poorly visual white dane, whose antics and goofiness make her laugh every day!


Dr. Claus and Dr.
Williams in the E/CC Area of CVSEC



Referral Pearl

Volume 3. Issue 1






Lunch and Learns with A CVSEC Specialist!


The Center for Veterinary Specialty + Emergency Care is proud to announce that we are taking our 2017 "PAWS4CE Series" on the road visiting our Referring Community!  Our first CE was held at Legacy Veterinary Hospital in Frisco on Tuesday, April 4th.

Dr. Kent Julius chose the topics of discussion and two of our CVSEC Specialists, Dr. Jen Mahon and Dr. Eloise Stikeman presented to his Team.

Dr. Mahon:  "Initial Stabilization of the Thoracic Trauma - or any Trauma Patient"

Dr. Mahon:  "Using the Ultrasound Probe In Patient Assessment - i.e. Fast Scan"

Dr. Stikeman: "Use of Budesonide in Inflammatory Bowel Disease (IBD), Dosing and Usage, Systemic Effects, and Current Case Study Underway at CVSEC."

*** Please contact Shelley Martin at or 972.820.7099 to schedule a "Lunch and Learn" with one of our CVSEC Specialists.  We would love to come and visit your facility and meet your Team!

Dr. Mahon presenting to the Team at Legacy Veterinary Hospital - Frisco.


"Thank you CVSEC for coming out and presenting such an in-depth "Lunch and Learn" at my hospital!  It was much more than any of us expected.  I really appreciate your Specialists being available for the topics of our choice AND for spending as much time as needed for all of our questions.  We will be happy to schedule the next one!" 

Dr. Kent Julius

Legacy Hospital was founded by Dr. Kent Julius is 2003.  He opened a 2,000 sq. ft. shopping center at the corner of Lebanon and Legacy.  At that time he did not offer grooming and had very limited boarding.  Over the next 5 years, Legacy grew from 4 employees and 1 Veterinarian to 11 employees and 2 full-time Veterinarians!  In the winter of 2008 the Team at Legacy moved into their current 6,000 sq. ft. facility.  There are currently over 20 employees and 5 Doctors on staff at their beautiful hospital! 

"Since opening in 2003 our focus has remained on the best possible patient care and customer service.  We like to provide our patients and clients a high quality veterinary service in a friendly, unique, clean and organized setting."




Jen Mahon

Diplomate, American College of Veterinary Emergency & Critical Care Medicine

Dr. Jen Mahon completed veterinary school at Tufts University Cummings School of Veterinary Medicine in 2012, and completed a one year internship in Albuquerque, NM.  She returned to Tufts for a three year residency in Emergency and Critical Care, and achieved Board Certification in the American College of Veterinary Emergency and Critical Care in 2016.

Prior to being a Veterinarian, she worked as a Veterinary Technician in Pennsylvania, Massachusetts, and Texas.  While working as a Technician, Emergency and Critical Care captured her heart and mind and hasn't let go since. Her favorite Patients are the sickest ones, and getting them well enough go home is her goal.  She loves to treat sepsis, trauma, multi-organ disease, and has a special interest in mechanical ventilation for dogs and cats.

In her spare time Dr. Mahon loves to do yoga, bike ride, and knit, but not all at once. She enjoys spending time with her partner and their three cats and exploring all that Dallas has to offer.


Anaphylactic Shock (Apollo's Story)

Apollo is an approximately 2 year old pit bull who was adopted about 2 months ago by a family that found him wandering the woods behind their home.  They brought him to the Allen shelter to see if anyone would claim him, and after 5 days, he was released to their care and Apollo went to his new amazing home! 

On March 20th, Apollo suddenly vomited and collapsed outside.  He was brought to his Primary Care Veterinarian, McKinney Animal Hospital (Dr. Ewa Cissik).  Blood work showed that Apollo could not clot his blood, and one of his liver values was high, suggesting anaphylaxis.  They placed an IV catheter and gave him an injection of epinephrine, and referred him to CVSEC

On presentation to CVSEC, Apollo was in shock- he was weak, with a high heart rate and thread pulses, all classic signs of shock.  We started him on IV fluids to treat shock, and started to thaw frozen plasma to replenish clotting proteins.  We also ran some diagnostics, and one of the key diagnostics was an AFAST.
AFAST stands for "abdominal focused assessment for trauma and shock.  It is a type of ultrasound, or sonogram, which is performed within 2 minutes.  It's not a comprehensive, organ-by-organ test; rather, it looks at a few key areas of the abdomen to allow for rapid assessment and treatment. The striking findings for Apollo were that he had a small amount of fluid collected in his belly, and his gall bladder bore what is called a "halo sign".  The halo sign is a bright ring of fluid, and can serve as a marker of anaphylactic shock. 

Anaphylactic shock is seen with some frequency in our ER, about 1 case every week or two, and is more common in dogs than in cats.  The causes of anaphylaxis can vary from a bee sting to a plant to a drug, but in most cases, the trigger is never identified.  Anaphylaxis differs from a typical allergic reaction in a few ways.  First, in anaphylaxis, shock and collapse are hallmarks, and vomiting or diarrhea is very common.  In an allergic reaction, usually facial swelling or hives are seen on a dog that is still wagging its tail and acting very normal.  Second, the way anaphylaxis is generated in the body is different at the cellular level than an allergic reaction as well, which may explain the difference in the way the two processes appear.  And third, the treatment is vastly different.  Dogs with allergic reactions are usually treated with an antihistamine and maybe a steroid and discharged within an hour or two (the exception to this is if hives develop in the throat, constricting the airway- that is an emergency!).  Patients with anaphylaxis are usually hospitalized for days; require intensive care and monitoring, IV fluids, transfusions, and IV drips of epinephrine (adrenaline) to keep them alive.  Anaphylaxis is survivable, but the best outcomes result from prompt Veterinary attention.  Fortunately for Apollo, he collapsed right in front of his family, so they were able to respond quickly and appropriately. 

Apollo spent 3 days in the Hospital, received three transfusions of plasma, and a lot of medications.  After about 12 hours of treatment, he started to eat and drink.  On his last day of hospitalization, he was off all IV medications, and went home to his family that evening. 

Apollo's story is a success for three reasons:

1. His family had an appropriate and rapid response to his development of shock.

2. His Primary Care Vet, Dr. Cissik, treated him appropriately prior to referral.

3. The CVSEC team is very familiar with the treatment of anaphylaxis and we know that in order to get Patients through, we have to act aggressively. 

By:  Dr. Jen Mahon




Internal Medicine
Budesonide Case Study Reminder

  • Study purpose:  To investigate the long-term effects of a locally acting enteric steroid (budesonide) on proteinuria
  • Hypothesis:  Long-term use of budesonide will result in significant proteinuria
  • Inclusion Criteria:  Dogs with IBD initiating therapy with budesonide

We are looking for Pets with chronic gastrointestinal disease to participate in a study investigating the proteinuric effects of budesonide.  Patients will undergo endoscopic biopsies and treatment for IBD with parallel observations of proteinuria over the duration of treatment.


What Benefits are Procured to the Client?

  • In addition to a comprehensive work up and treatment for the chronic enteropathy, Patients who qualify for study enrollment will receive:

A large discount on the endoscopy procedure and histopathology of the GI tract

Complimentary budesonide medication for the duration of the three month study period

Complimentary food as indicated for the Patient at the start of the study

If you are interested in this case study, please contact Dr. Eloise Stikeman at or 972.820.7099.





Copyright © 2017 Center for Veterinary Specialty + Emergency Care, All rights reserved.
"As one of or Top Referring Facilities, you have been included on our monthly newsletter mailing list - The Referral Pearl."

Our mailing address is:

Center for Veterinary Specialty + Emergency Care

2700 Lake Vista Drive

Lewisville, TX 75067

Add us to your address book

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You can update your preferences or unsubscribe from this list


Referral Pearl
Volume 2. Issue 8

August 2016



Research at CVSEC:  Influence of Budesonide of Proteinuria on Dogs with IBD

In the management of inflammatory bowel disease and related conditions such as protein-losing enteropathies, corticosteroids remain the cornerstone of therapy to control inflammation and resulting clinical signs.  The chronic nature of the disease most often necessitates long-term use of steroids which poses risk of causing significant side effects over time.  In recent years there has been an increasing appeal to utilize budesonide in the treatment of chronic inflammatory gastrointestinal disease due its preferentially localized effects within the gastrointestinal tract.  This focused therapy is the result of the drug being poorly absorbed through the enteric mucosa and undergoing extensive first-pass hepatic metabolism thereby limiting its greatest influence to the intestinal wall.  In human patients, these unique properties of budesonide result in limited systemic side effects but this has not been replicated in the literature pertaining to canine patients.  A recent study demonstrated equivalent frequency of steroid-induced side effects observed in IBD dogs treated with budesonide as with prednisone.  The severity of the effects appeared reduced in those Patients receiving budesonide, however this did not achieve statistical significance.  It has also been demonstrated by numerous authors that budesonide is capable of influencing the hypothalamic-pituitary-adrenal axis resulting in suppression of endogenous steroids with long-term use.

Yet in spite of multiple research papers clearly documenting the systemic effect of budesonide, there remains an allure in its application over prednisone, particularly in Patients in whom a more systemic steroid might be contraindicated or of higher risk.  The classic example would be a diabetic dog who risks deregulation of glycemic control on prednisone or a Patient with congestive heart failure in whom we worry about fluid retention and exacerbation of cardiac disease.  Another realm in which the exertion of steroidal effects is of relevance is in the presence of renal disease.  It has been repeatedly shown that both excessive endogenous steroids (such as manifest in Cushing's disease) and exogenous steroid provision (such as prednisone) are capable of inducing significant proteinuria.  This effect has never been investigated in budesonide, however, thus rendering interpretation of proteinuria in a Patient receiving the medication very difficult.  This is of particular interest in the Soft Coated Wheaton Terrier, the poster-breed for protein-losing enteropathies and one in which a later manifesting protein-losing nephropathy can develop.  If the Patient has been receiving budesonide long-term, will we be able to recognize clinically significant proteinuria and appropriately attribute it to primary renal disease?  Similarly, will we be able to accurately stage a Patient with heartworm disease receiving budesonide who is found to be proteinuric in the pre-treatment evaluation?  Will we be able to have confidence in confining autoimmune dysregulation to the GI tract if we start to see proteinuria, a common marker of immune-mediated glomerulonephritis, in a Patient being treated for IBD with budesonide therapy?

The Internal Medicine Department at CVSEC has launched a new study designed to help answer these types of questions.  Dogs who have been diagnosed with an inflammatory enteropathy will be treated with budesonide and undergo serial urine protein evaluations to investigate if the drug is capable of inducing urinary protein loss over time like its systemically acting counterparts.  In order to interpret the data clearly, Patients will be excluded from the study if they have pre-existing proteinuria or any concurrent illness which may predispose to proteinuria over time (such as systemic hypertension, Lyme disease, or hyperadrenocorticism).  Eligible Patients will undergo a comprehensive gastrointestinal evaluation including endoscopic guided biopsies.  If the histopathology confirms a chronic inflammatory enteropathy, Patients will be treated with budesonide.  Adjunctive therapy (such as dietary manipulation, cyanocobalamin supplementation, or supplemental metronidazole therapy) will be permissible per the needs of the Patient.  In short, they will receive standard of care therapy for a diagnosed chronic inflammatory enteropathy whilst the urine is monitored for the presence of protein over time.

Clients who elect to enroll their Patients in the study will receive a significant discount on the endoscopy and biopsies with Animal Reference Pathology in addition to complimentary budesonide therapy for the duration of the study, courtesy of Pet Health Pharmacy. Any Patient with chronic GI symptoms not currently receiving prednisone may qualify for enrollment.

If you have any Patients that may be eligible, please contact Dr. Eloise Stikeman (estikeman@cvsecvet.comor 972.820.7099).  Or if you simply have questions about the use of budesonide in managing chronic inflammatory enteropathies, please reach out to any Doctor in the Internal Medicine Department or speak with Shelley Martin ( to discuss scheduling a CE Lunch & Learn at your Hospital on the Pearls of Managing IBD:  Budesonide and Beyond!






(972) 395-0786

6:30 PM to 7:00 PM

Meet and Greet  

7:00 PM to 8:00 PM: 



Dr. Karen Felsted


(Race approval pending for 1.0 CE credit.)


8:00 PM to 9:00 PM:



Dr. Eloise Stikeman

(Race approval pending for 1.0 CE credit.)


9:00 PM to 9:40 PM:



Dr. Debra Nossaman

(State approved for 0.5 CE credit.)


We would like to thank the four companies that are sponsoring our event!!



Registration fee:  $25 (Includes dinner, drinks, and door prizes!)

RSVP to Shelley Martin ( by 10.20.16.

Thank you to everyone that attended our CE in April at Maggiano's - Willow Bend.  We enjoyed seeing so many of you at the event.  It was a great success!!!

We are looking forward to seeing you at our 2017 CE functions!




Copyright © 2016 Center for Veterinary Specialty + Emergency Care, All rights reserved. 
"As one of our Top Referring Facilities, you have been included on our new monthly newsletter, The Referral Pearl". 

Our mailing address is:

Center for Veterinary Specialty + Emergency Care

2700 Lake Vista Drive

LewisvilleTX 75067

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The Referral Pearl
Volume 2. Issue 6

June 2016




When you or a family member are ill, you seek the best medical care available, which often includes referral to Specialists and even travel to advanced care centers.  The same can be true for our Pets.  The Internal Medicine Team at CVSEC stands ready to work with you to diagnose and treat your Patients with complex diseases.

Established in 2009, our team of Board Certified Internal Medicine Specialists has more than 20 years of combined experience improving the lives of dogs and cats suffering from a broad range of illnesses. We are also very proud to be the only hospital in the DFW area with an Internal medicine resident in training, who is a driving force for our team to remain current on the latest research and newly emerging tretment options. When you refer to the Internal Medicine Team at CVSEC, we will join you and your Client in the Triad of Care to provide Patients with specialized diagnostic testing and cutting edge therapeutic care.


In addition to the usual diagnostic tools you expect from an Internal Medicine Service, we also practice cardiology (including echocardiography), medical oncology, and are skilled in laparoscopy.  We have on-site CT enabling access to real-time advanced imaging of our patients.  The Internal Medicine Team at CVSEC is also the only specialty practice in DFW to offer tracheal and urethral stent placement.  Patients requiring hospitalization are provided personalized care in our 24/7 ICU staffed with experienced and compassionate Doctors and Technicians.  Our collaborative team approach to veterinary medicine delivers comprehensive and seamless care for your Patients and the Clients who love them.

If you have further questions about what sets our Internal Medicine Team apart from other hospitals, please feel free to call or come by for a visit and a tour.  We are excited to continue working with you and your clients for years to come. 


Thank you for your support!

Valeria Case, DVM
Diplomate ACVIM


Keven Gulikers, DVM, MS
Diplomate ACVIM


Eloise Stikeman, BVMS, Hons.,BSc


Tracheal Stent Placement


Internal Medicine's PAWS4CE Event







Copyright © 2016 Center for Veterinary Specialty + Emergency Care, All rights reserved.
"As one of our Top Referring Facilities, you have been included on our new monthly newsletter, The Referral Pearl".

Our mailing address is:

Center for Veterinary Specialty + Emergency Care

2700 Lake Vista Drive

Lewisville, TX 75067