Fear Free Approach

We truly work to make each visit for each patient as fear free as possible. This means a gentle considerate approach and minimal restraint with delicious food treats available at each visit.  When the patient is anxious or upset we recommend stopping the procedure and prescribing calming medicine to take away anxiety for the next visit, thus building positive experiences.  This medication is given prior to the visit to take effect at home, and thus is previsit calming medication and not sedation.  It is safer for the patient, for the owners, and for the team when the patient is stressed or afraid of veterinary care.


Cat Friendly

We are cat friendly certified which means we really cater to and appreciate the undue stress experienced by the feline patient in the veterinary setting.  We have a cat friendly exam room with a cubby to hide and well equipped with delicious kitty treats. This room has a calming cat friendly pheromone dispenser and this pheromone is sprayed onto the toweling and clothing of the team members interacting with the patient. If the kitty is afraid of veterinary care we stop the procedure and reschedule when there is an opportunity to give calming medicine at home before the visit or we give calming medicine by injection before proceeding, which is much safer for the kitty and the team.


Minimalist Vaccination

We do provide all standard vaccinations. However we think carefully about the timing and necessity of each vaccine before administering them. The Rabies vaccination is separated from the pediatric series of vaccinations so as not to overwhelm the fragile young immune system and allow proper response. The core DHPPV vaccine (dogs) and FVRCP vaccine (cats) are spaced well apart: 18 months between the pediatric series and the first booster, and then every three years thereafter.  From the second booster and thereafter there is the opportunity offered to have a titer test done to show immunity as an alternative to repeated boosters. This protocol is much safer for the patient. If there are medical issues that would be exacerbated by vaccination such as chronic allergy or inflammatory bowel disease, this is discussed so that unnecessary vaccination does not have a derogatory effect on the health of the patient.


Screening Bloodwork

A blood sample can be a “liquid biopsy” of the health of the patient: early detection of kidney disease, liver disease, or hypothyroidism can dramatically impact treatment of these diseases and pick them up before they have become medical catastrophes.  And so we do recommend annual screening bloodwork for most patients and every six months for the geriatric patient that is experiencing medical issues.  


Surgical Services

We do have three excellent surgeons at HomeCare.  Our surgeons are capable and will in addition consult with and work with each other for more difficult cases.  Above and beyond this there are two highly trained and experienced technical nurses with a deep understanding of anesthesia present in the surgical suite for assistance and monitoring.  This adds a deep layer of anesthetic safety.  State of the art monitors are in place and utilized for each anesthetic procedure: pulse oximetry, EKG, capnography, and temperature are monitored throughout each procedure and documented on the patient chart.  The post surgical recovery cage is equipped with heated flooring and has oxygen capability; it is located just steps away from the surgical table so that the recovering patient is under direct and constant supervision.  Utmost attention is paid to administration and timing of pain medications so that the patient is comfortable. This is critical. Thorough instructions are given upon discharge for ongoing pain management. 


Dental Services

HomeCare truly offers state of the art dental care.  Dental care is performed under general anesthesia so as not to traumatize or hurt the patient.  There are two technical nurses with advanced understanding of anesthesia in the room at all times during the procedure. We have a dental cart on a par with those utilized in human dental care for cleaning and polishing.  Extractions are performed with full dental blocks in place for pain management and are surgically closed.  Dental xray is at the ready and recommended for each patient to assess the health of the hidden part of the tooth down into the roots.  Without attention to the roots of the teeth dental care becomes superfluous and often needs to be repeated at much sooner intervals than if the xrays are performed to identify these areas and address needed care.  The dental procedure includes a follow up visit two weeks later to assess healing of the extraction sites and discuss care to be done at home.

We also offer a variety of products for good dental health including Healthy Mouth water additive and gel, a chlorophyll based water additive and gel that used as directed disinfects the mouth and reduces plaque by 70%.  For the patient that cannot be anesthetized we offer MiraPet ultrasonic tooth brushing and can teach you how to do ultrasonic tooth brushing at home which is far more effective and far better tolerated than traditional brushing and is actually feasible to do for your pet.


Integrative Care

We have studied Traditional Chinese Veterinary Medicine in detail and can offer conventional care combined with a TCVM approach to optimize healing and support of the patient.  The power of proper diet, food therapy, and an herbal approach that supports and matches the needs of the patient cannot be underestimated.  This approach is vital for patients with complex skin diseases and intractable medical issues, and for those with various neoplastic diseases offering a way back to health that cannot be matched by conventional western medication alone. 


Palliative and Hospice Care

We have on staff veterinarians certified in Palliative and Hospice care medicine.  When a patient has a terminal diagnosis and the goal is to keep that patient as comfortable as possible and as functional as possible for the remaining time in our care, then we can help. There is never an answer of “nothing can be done”.  An initial assessment lasts a full hour and reviews all pertinent history and diagnostics, and the plan for comfort care as well as food therapy and environmental changes to accommodate the changing needs of the pet will be outlined in detail.  A plan for end of life care will be discussed at that visit so that as that time draws near there is support and compassionate care in place.


End of Life Care

Can be offered in the comfort and security of the patient’s home or in the quiet of after hours at our home like clinic.  We have developed a special sedation technique in which the sedative is administered within warm fluids so there is no awareness of it being given; it takes effect slowly and gently in the company and love of family.  We are ultra vigilant about our mission to make this experience as gentle and compassionate as possible without any discomfort or awareness for the patient.  We partner with Hamilton Pet Meadow to provide dignified after care that matches the needs and goals of the family.  End of Life care is offered to our own patients as well as new clients; if a housecall is selected the patient must reside within a 30 minute drive of our clinic.


Acupuncture and Laser Therapy

We provide acupuncture often partnered with laser therapy for the arthritic or neurologic patient that will benefit immensely from the restoration of energy and nerve flow through areas of pain and neurologic dysfunction.  Acupuncture is also beneficial for the older patient with multiple medical issues as it can restore blood and nerve flow to struggling internal organ systems such as the heart, lungs, and kidneys.  Our patients are provided with a soft bed and calming music for the procedure, and the endorphin release is obvious as most rush to lie on the bed and fall asleep during the procedure.  We perform an initial evaluation and then encourage the appointment to be as a brief admit so the patient can rest or sleep while the acupuncture needles are in place.  Surprisingly cats really enjoy acupuncture and are similarly provided with a high sided soft bed in which they are happy to sleep as the acupuncture needles take effect. The needles are placed in very specific acupoints that match the peripheral nerve system of the body and are specifically affecting blood and nerve functions served by these specific nerves while causing a systemic endorphin release for pain management and relaxation.  Most patients have their treatment done every two weeks for three treatments and then reassessment; chronic disc disease or osteoarthritic patients generally come in once a month for this therapy.


Rehabilitative Care

Via a thorough assessment of back pain, hip flexibility, shoulder stretches, and stifle or knee strength and discomfort we can identify areas of discomfort and chronic pain.  When the need arises and particularly after orthopedic surgery we can offer not only good pain management but a series of exercises to be performed daily during walks or at home, a few minutes each day, to specifically strengthen certain muscles or areas of the body for healing.  These exercises are provided by video emailed to you and also printed out and supplied in a format that can be posted in the home.  Laser therapy for pain management of back, hips, stifles or knees is readily available and effective for the feline as well as the canine patient.


For the small growths that annoy the patient but do not warrant general anesthesia, or for the patient that cannot have general anesthesia, we offer cryotherapy.  The mass or growth itself is frozen as part of the office visit which seldom requires any sedation as it is painless.  The growth will then fall off about 2 to 3 weeks after the procedure on its own and healing occurs naturally.  This is a wonderful alternative for growths in awkward places or that cause ongoing irritation, bleeding, etc especially in the older fragile patient.  

Cryosurgery


Housecalls

For the patient who does not travel well: the canine with limited mobility, the very timid feline who is terrified of the carrier, or for the owner who cannot travel, we do offer housecalls.  We can perform physical examinations and basic diagnostics in the confines of the home.  We do not perform xrays or surgical procedures in the home but we can provide transportation if these become necessary.  We do request that the patient reside within 20 and at most 30 minutes from the clinic.  End of life care is also provided in the home setting.


Ultrasound and Electrocardiography

We do offer ultrasound and echocardiography within our clinic via mobile ultrasonographers that provide this service for us twice a month.  This is convenient and a cost savings over referral to a large facility and also allows the attending doctor to be present for the ultrasound and receive direct medical advice from the board certified internists performing the procedure.  This is a priceless benefit to having the procedure done within our clinic. 


Orthopedic Surgery

We can provide orthopedic surgery such as cruciate repair in the setting of our clinic.  The surgery is performed by our mobile board certified orthopedic surgeon Dr. Dennis Ting, who will meet with you at our facility before any procedure is scheduled, and then perform the procedure again with our excellent technical nurses to monitor anesthesia and good attention to state of the art pain management.  There are significant cost and comfort advantages to the patient having these procedures done in a small and familiar facility with excellent supervision and a team with which the patient is already familiar.


Our doctors have had specific training for pain management and are well versed in the combinations of medications that work best to alleviate pain safely.  We will strive for each patient to find the combination of medications that keeps that patient as comfortable as possible for their specific type of pain.  We are well versed in the newest developments in this fast moving field including newer transdermal and long acting injectable modalities.  

Pain Management


Behavior

We can and will provide assessment of behavior difficulties such as chronic anxiety or inappropriate urination and give good strategies on how to address these that include environmental changes, often food therapy, and pharmacological interventions wirth supplements and medications.  When necessary we will provide referrals to behavior specialists we trust to add an additional layer of support.  


Poison Consultation Service

Access to a National Database to assess how to handle ingestion of possible toxins so the right treatment plan is initiated. We also offer Clevor which is a painless eye drop to effectively induce vomiting in dogs when appropriate.