Internal Medicine
Veterinary Internal Medicine — Advanced Diagnosis for Complex Cases on Long Island
Some cases do not fit a simple diagnosis. A pet that has been sick for months without a clear answer. A condition that is not responding to standard treatment. Symptoms that span multiple organ systems in ways that require methodical, specialist-level investigation to unravel. This is the work of internal medicine.
At Gold Coast, our board-certified internists, Dr. Jacqueline Gest-Poulos, DVM, DACVIM, and Dr. Shannon Monaco, MVB, MS, DACVIM, specialize in exactly these cases. They uses advanced diagnostics, a systematic approach, and years of specialist experience to find answers that elude general practice – and to build treatment plans that address the underlying cause, not just the symptoms.
Conditions We Diagnose and Manage
Our internal medicine team manages the full spectrum of cases, conditions and symptoms that are beyond general practice diagnostics:
Endocrine Disorders
- Diabetes mellitus: Diagnosis, insulin regulation, and long-term monitoring
- Cushing’s disease (hyperadrenocorticism): Complex diagnosis and individualized treatment
- Addison’s disease: Adrenal insufficiency requiring lifelong management
- Hypothyroidism: Common in dogs; managed with hormone supplementation
- Hyperthyroidism: Most common in older cats; multiple treatment options
Immune-Mediated Diseases
- Immune-mediated hemolytic anemia (IMHA): Life-threatening; requires aggressive immunosuppression
- Immune-mediated thrombocytopenia (ITP): Abnormal platelet destruction
- Polyarthritis: Immune-mediated joint disease
Infectious Diseases
- Tick-borne illness: Lyme, anaplasmosis, ehrlichiosis, RMSF
- Leptospirosis: Renal and hepatic involvement; zoonotic risk management
Gastrointestinal Conditions
- Chronic vomiting and diarrhea: Investigating root causes beyond standard treatment
- Inflammatory bowel disease (IBD): Endoscopic diagnosis, dietary management, and immunosuppressive therapy
- Pancreatitis: Acute and chronic; management and prevention of recurrence
- Protein-losing enteropathy: Complex protein loss through the GI tract
Kidney, Liver, and Respiratory
- Chronic kidney disease: Staging, management, and slowing progression
- Acute kidney injury: Intensive management and recovery monitoring
- Hepatitis and liver disease: Portosystemic shunts, chronic hepatitis, copper-storage disease
- Pneumonia and respiratory disease: Chronic cough, bronchitis, and infectious causes
Advanced Diagnostic Tools Used in Internal Medicine
- Endoscopy: Minimally invasive GI and respiratory visualization, with biopsy capability – avoiding surgery for tissue diagnosis
- Advanced HD CT: Exceptional cross-sectional detail for organ, mass, and vascular evaluation
- Abdominal and thoracic ultrasound: Real-time organ assessment and guided sampling
- Comprehensive bloodwork and urinalysis: With advanced panels for organ function and endocrine markers
- Bronchoalveolar lavage (BAL): Airway fluid sampling for respiratory disease
- Bone marrow biopsy: For hematologic and immune-mediated conditions
Is this an emergency?
Gold Coast is a specialty and referral center open Mon-Fri 7am-6pm, Sat 8am-4pm. For emergencies at any hour, West Hills Animal Hospital is on the same campus.