Internal Medicine

Internal medicine 

The umbrella of SmallAnimal Internal Medicine includes many subdisciplines including gastroenterology(esophageal, stomach, and intestinal disease), hepatology (liver and pancreatic disease), endocrinology (hormonal disease), infectious diseases, urology (urinary tract disease), nephrology (kidney disease), respiratory medicine (nose, airway and lung disease), and hematology & immunology (blood cell and immune-disease). In many cases, the clinical signs a patient is displaying may include many of these organ systems. Due to their comprehensive approach, our hospital may manage cases of patients with neurologic, cardiovascular, or cancerous diseases, especially when these patients also share diseases within the scope of internal medicine. If our veterinarians believe your patient needs to see an internal medicine specialist we will facilitate a referral.  

Regular Check-ups

Regular examinations are an integral part of your pet's health care. Exams help us detect and treat medical problems early on, before they become more difficult and expensive to treat and decrease your pet's overall quality of life.


We recommend all pets undergo a complete examination at least once a year, which we will usually do at the time of your pets annual vaccination. Some pets with more serious conditions like heart problems, renal and liver issues will need to come more regularly. We will do a complete external examination of your pet. If necessary, we will recommend further diagnostic tests at our in house lab. The information we obtain during an exam helps us establish your pet's baseline level of health that we will record and compare in future visits. Examinations are also a great time for you to discuss any queries you may have concerning your pets health, behavior and training.


Senior Care

Pets age faster than people. Your pet is considered a senior at ages seven and older. Older pets require regular preventive care, including wellness exams, blood tests, and diagnostic services (including x-rays and laboratory tests). We encourage you to inform us of any changes in your older pet's behavior or lifestyle so that we may take appropriate measures, before these changes affect your pet's quality of life.

We provide special attention to aging pets focusing on preventative measures and the early detection and treatment of problems. Older patients commonly experience the same problems that older humans do – heart problems, diabetes, arthritis, chronic renal insufficiency, dental problems, hearing and vision loss, etc. Many of these conditions we can treat to extend and improve your pet's quality of life. We may also recommend certain supplements that may help in improving the quality of life of your aging pet.

Parasite Prevention & Control

Parasites aren't just a pain for your pet - they can harm you and your family, too! External parasites like fleas, mites and ticks and internal parasites like roundworms and hookworms can affect people as well as pets. Other parasites, like heartworms, pose serious health problems to your pet. Our staff members are knowledgeable about flea, tick and heartworm prevention. We offer a variety of flea and tick and heartworm control products, including Frontline, Pro heart and Heartgaurd. All dogs should receive a heartworm preventative year-round because mosquitoes can appear during warm periods of winter and, once a dog becomes infected, heartworms are life-threatening. Most commonly we use an annual Pro heart injection to prevent your dog catching heartworm.

Fecal testing, for detecting intestinal parasites, is recommended each year for all pets. We can do a fecal flotation of a stool sample to check for worm eggs and also search for Gardia and Tritrichomonas in a fresh stool sample and mucosa scrape under the microscope.

Vaccination for Dogs

Protecting your best friend
One of the most important things you can do to give your dog a long and healthy life is to ensure that he or she is vaccinated against common canine diseases. Your dog's mother gave her puppy immunity from disease for the first few weeks of existence by providing disease-fighting antibodies in her milk. After that period it's up to you, with the help and advice of your veterinarian – to provide that protection.

How do vaccines work?
Vaccines contain small quantities of altered or "killed" viruses, bacteria or other disease-causing organisms. When administered, they stimulate your dog's immune system to produce disease-fighting cells and proteins – or antibodies – to protect against disease. 

When should my dog be vaccinated?
The immunity that a puppy has at birth begins to drop from 6-8 weeks of age. It is then usually time to begin the initial vaccinations, which will be repeated every 4-6weeks until the puppy is about 4-5 months old. Thereafter, your dog will require repeat vaccination annually for the rest of his or her life. Above all, follow the vaccination schedule on your vaccine card. If there is too long an interval between the first vaccination and the booster, your dog may have to undergo the series all over again. 

Which vaccinations should my dog receive?
Most veterinarians believe that your pet should be protected against those diseases which are most common, highly contagious and which cause serious illness. Such diseases could include Canine Distemper, Infectious Canine Hepatitis, Canine Parvovirus, Kennel Cough and Rabies.


Canine Distemper

This disease is very common in HK. Vaccination against this often fatal, hard-to-treat disease is absolutely essential. Highly contagious, it is spread by discharges from the noses and eyes of infected dogs. Symptoms can include listlessness, fever, coughing, diarrhoea and vomiting; convulsions and paralysis may occur in the disease's final stages. The distemper virus attacks many organs, including the nervous system, which may be permanently damaged, even if the dog recovers.

Canine Parvovirus
This virus is contagious, debilitating and common in HK, the disease caused by this virus emerged in many parts of the world only in 1978. Spread through infected feces, the highly resistant virus can remain in the environment for many months. Symptoms include high fever, listlessness, vomiting and diarrhea. Vaccination is the only certain method of preventing this potentially fatal disease, which is most severe in young pups and elderly dogs.


Infectious Canine Hepatitis
Caused by Canine Adenovirus Type I or Type II, this disease is transmitted among dogs by contact with secretions, such as saliva, infected urine or feces. Its symptoms are similar to those of the early stages of distemper. Causing liver failure, eye damage and breathing problems, the course of this disease can range from mild to fatal. Vaccination remains the best protection. This is currently a very rare disease but is still part of the combined vaccine that your pet will receive. 


Canine Tracheobronchitis (Kennel Cough)

Just as with the human common cold, this respiratory-tract infection is easily transmitted from one dog to another. Important if your pet will come in contact with many other dogs in such situations as obedience training or boarding at a kennel. Caused by various airborne bacteria and viruses, including Canine Parainfluenza virus, Canine Adenovirus Type II and Bordetella Bronchiseptica.


This incurable viral disease affects the central nervous system of almost all mammals, including humans. It is spread through contact with the saliva of infected animals (which can include skunks, foxes, raccoons and bats) through bites or any break in the skin. Vaccination will provide your pet with much greater resistance to rabies if he is exposed to the disease, but you must be aware that there is no cure once it occurs. For this reason, many municipalities absolutely require that all dogs receive rabies vaccinations on a regular basis. Plus, you will definitely have to prove that your dog is vaccinated if you travel with him. Currently there is no rabies in HK. You are required by the HK government to have your dog vaccinated every three years and this becomes part of your dogs registration. Rabies is common in China.

Vaccination for Cats

Regular vaccination is an important part of routine health care for your cat and helps to ensure your cat remains fit and well. Many serious and life-threatening diseases can be prevented by vaccination. In Hong Kong, there are a number of vaccines that are currently available for use in cats to protect against the following diseases:-

Feline Herpes Virus Type 1 (FHV-1; feline rhinotracheitis virus) 
Feline Calicivirus ( FCV)
Feline Panleukopenia (feline infectious enteritis; feline parvovirus)
Feline Chlamydial Infection


How do vaccines work?

Vaccines work by exposing the body's immune system to a particular modified infectious agent.  This causes the white blood cells to react to fight the infection by producing proteins (antibodies) which are able to bind to and neutralise the infectious agent (antigen).  Antibodies work together with other white blood cells (lymphocytes) which are able to identify and kill cells within the body which have become infected by the agent (cell mediated response).  After vaccine exposure, the body 'remembers' the particular antigens so that when they are encountered again it can mount a very rapid and strong immune response preventing the cat from showing clinical signs of disease.  It is important to realise that most vaccines work by preventing your cat from becoming ill and may not prevent it from becoming infected.  This means that if a vaccinated cat becomes infected with 'cat flu' it may still shed the disease producing organism which can infect unvaccinated animals which will then become ill.  This is not a major consideration in the pet cat but may be important in the breeding colony.


What is the difference between the various types of vaccine?

The 2 major types of vaccines for use in cats are

Modified live vaccines- these vaccines contain live organisms that are weakened (attenuated) so that they do not produce disease but will multiply in the cat's body. It is not advisable to use modified live vaccines in pregnant queens or cats whose immune system is not working properly e.g. cats infected by feline immunodeficiency virus (FIV).

Killed (inactivated) vaccines - these vaccines are prepared using fully virulent organisms that have been killed by chemicals, UV light or radiation.  Because, on their own, they do not give such a high level of protection, a chemical (adjuvant) is added to the vaccine to stimulate a better immune response.


When should my kitten be vaccinated?

Kittens should be first vaccinated at 6 to 8 weeks and then again for a booster in 4 weeks time. A kitten will not be fully protected until 7-10 days after the last vaccination.  Under specific circumstances we may advise an alternative regime. Also remember a cat will only develop a healthy immune system after five months of age.

 Will vaccination always protect my cat?

Vaccination will protect the vast majority of cats but under some circumstance vaccine breakdowns will occur.  There are many reasons for this including:-

1.       Variations between different strains of viruses – this is particularly true of FCV where many different strains exist, not all of which are covered by the vaccines available.

2.       Maternally derived antibodies – when a kitten is born it is protected in its early life by antibodies passed from the queen in the first milk (colostrum).  These antibodies can also prevent vaccination from working properly. The amount of colostral antibodies that each kitten receives is variable and so the age at which a kitten can respond to vaccination successfully will also vary.  This is part of the reason why we give a number of vaccines for kittens.

3.       The cat was not healthy at the time of vaccination – 'stress' can prevent a good response to vaccination.  For this reason your vet will give your cat a physical examination before a vaccination is given.

4.       The cat may also be pre-infected with the 'cat flu' virus and incubating the disease.

5.       Your cat may be infected with a virus that is suppressing the immune system. (FIV)


Vaccination risk?

Generally the risk of a vaccination reaction are extremely low.  Many cats experience mild reactions at the site of vaccination where a lump may occur that can be painful.  Generalised reactions are sometimes seen, the cat being quiet, lame and often off its food for 24 hours after vaccination.  Occasionally more severe signs occur including itchiness, vomiting, diarrhoea and depression.  Under these circumstances your veterinary practice should be informed.  Vaccine reactions appear to occur more commonly in kittens and some purebred cats.


How often should booster vaccinations be given?

Guidelines for booster vaccinations are constantly being debated around the world. Vaccines currently used in Hong Kong are labeled by the manufacturer are for annual use. We support this and recommend that after the initial series of kitten vaccinations that cats receive a comprehensive examination and vaccine annually.

Which are the most important vaccinations to have?

We suggest all cats be vaccinated against Feline Herpes Virus, Feline Calicivirus, Feline Panleukopaenia and Chlamydia. This is often referred to as a F4 vaccination.

Feline respiratory virus infection
Disease is caused by feline herpes virus or feline calicivirus and is commonly termed 'cat flu'.  It is a common disease in unvaccinated cats and can cause long-term problems, including chronic sneezing, nasal discharge, inflamed eyes and severe gum problems.


Feline panleukopenia infection
This is now an uncommon disease that causes a severe and often fatal gastro-enteritis.  Vaccination provides a high level of long lasting protection.


Feline Chlamydial infection
This tends to be a particular problem in colony cats. Chlamydial infection causes a painful inflammation and swelling of the conjunctiva (the membrane around the eye) and has been associated with infertility in queens. 


Regular vaccination is an important part of health care program for your cat.