Advanced Medicine and Surgery

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Orthopedic surgery represents advanced surgery most notably. At MPH, we have been performing advanced orthopedic surgery for many years. We work and train with specialists and we have acquired the skill, knowledge and experience to excel with many orthopedic surgeries. We have the ability to collaborate with our staff as well as outside orthopedic specialists. The TPLO surgery represents this concept most commonly. The bottom line is that we have been performing orthopedic surgery for many years and we are very experienced with rehabilitation. Orthopedic surgery at MPH includes all rehabilitation appointments at no extra charge.

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Soft tissue and abdominal surgery are less glamorous, but equally significant. Collaboration is really key. Camaraderie amongst the staff makes a big difference, but even more, being a general practice allows us to consult with multiple specialists from multiple areas. This diversity is different from a typical specialty practice because we are more connected to multiple specialists with multiple opinions. We can then collaborate the multiple opinions into a more balanced and comprehensive plan.

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Advanced medicine works the same way. We have been trained and influenced by multiple specialists and therefore represent a collaboration of multiple medical opinions. We have focused heavily on imaging, especially ultrasound of the abdomen and thorax, including heart disease. Once again, specialization has advanced the level of medicine, but specialized practices have fragmented the care for the overall picture, or the patient. A general practice that has the desire and ability to collaborate and execute both medicine and surgery has a distinct ability to care for the entire patient, your pet.

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Advanced Pain Management

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We are increasingly using “balanced anesthesia”, which incorporates pain management through multiple mechanisms. Multiple drugs at smaller doses are more effective and safer than a single drug at a big dose. Additionally, local anesthesia (local block) can help reduce the amount general anesthesia needed. MPH is now using Nocita, a local anesthetic that can last up to three days!

 

Nocita reduces the need for general anesthesia and post-op pain meds. It’s ideal for many surgery sites, and is even helpful in healing naturally occurring wounds. Risks are minimal, but can include irritation or infection at the surgery site. But Nocita also helps reduce the risk of infection, by eliminating pain that may otherwise cause your pet to lick or traumatize an incision.

 

The charge for Nocita is included with the cost for dental surgery, spay and neuter surgery, and cruciate surgery.

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Abdominal and Cardiac Ultrasound

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We have focused intensely on ultrasound for more than ten years. Ultrasound of the abdomen and chest requires a lot of skill and experience. Integrating ultrasound with our general practice provides a tremendous benefit with managing illness in the abdomen, chest, and heart.

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Oncology

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We have been working with oncology specialists for more than fifteen years. As a general practice, we have the benefit of being able to get influence from many specialists, from the Bay Area as well as national and international veterinarians. All of our chemotherapy is under the guidance of Drs Tony Moore and Angela Frimberger at Veterinary Oncology Consults. They have been leaders in the oncology community for more than twenty years.

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Dentistry

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Dentistry represents the progress of veterinary medicine more than anything else. A dental used to be simply cleaning the crown of each tooth and removing exceptionally loose or infected teeth. We now have increased awareness that dental disease can affect the rest of an animal’s health, through systemic infection and chronic immune system activation. Now a dental includes a thorough assessment of each tooth, the surrounding gum, and the underlying bone. This includes x-ray evaluation of the bony socket and the integrity of the tooth and the pulp canal. We now routinely clean portions of the root (root planing) as well as the crown. We also routinely identify cavity lesions and deep bone infection, even when the crown of the tooth looks perfectly normal.

 

We are committed to performing dentistry in a careful and thorough fashion. Our dentistry includes full charting and assessment of the entire mouth as well as any necessary x-rays. We have digital dental x-ray equipment, so even full mouth x-rays take only a matter of minutes, with minimal radiation exposure. If oral surgery or extractions are necessary, we use more advanced techniques that include surgically cutting teeth into sections before removal, primary closure of sockets, and surgical advancement flaps.

 

General anesthesia is necessary for thorough dentistry. General anesthesia has also evolved. For monitoring, not only do we use advanced equipment, but more importantly we assign a specific nurse to oversee the anesthetic monitoring. Individual skill and careful monitoring are essential with general anesthesia. ​

 

We are increasingly using “balanced anesthesia”, which incorporates pain management through multiple mechanisms. Multiple drugs at smaller doses are more effective and safer than a single drug at a big dose. Additionally, local anesthesia (local block) can help reduce the amount of general anesthesia needed. MPH is now using Nocita, a local anesthetic that can last up to three days!

 

Nocita reduces the need for general anesthesia and post-op pain meds. It’s ideal for many surgery sites, and is even helpful in healing naturally occurring wounds. Risks are minimal, but can include irritation or infection at the surgery site. But Nocita also helps reduce the risk of infection, by eliminating pain that may otherwise cause your pet to lick or traumatize an incision. The charge for Nocita is included with the cost for dental surgery, spay and neuter surgery, and cruciate surgery.

 

We classify dentistry into four categories. We try to anticipate which category a dental will be, but since a lot of the dental disease is under the gums, it is not uncommon to have the dental category change once a thorough assessment has been made under anesthesia. Following is an ESTIMATED list of categories.

 

Every category includes: Anesthesia, IV Fluids, Dental Radiographs, Cleaning and Polishing of the teeth and any medications.

 

Level 1: no extractions 

 

Level 2: few simple non-surgical extractions, and no advancement flap closure 

 

Level 3: few surgical extractions and/or an advancement flap closure 

 

Level 4: multiple surgical extractions or a very advanced and involved surgical extraction, or multiple advancement flap closures

 

 

 

 

Critical and Emergency Care

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During office hours, our hospital is well equipped to handle emergency care for our existing clients at a very high level.  We are confident and experienced in providing urgent care diagnostics, treatments, and surgery.  Our hospitalized patients have overnight care from some our most experienced technicians.  With consistency in mind, the treatments are dictated and overseen by our veterinary staff.

 

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Preventative Care

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Dog Vaccines

Basic vaccination guidelines for puppies include a single rabies vaccine given at 16 weeks of age or later, and 2 or 3 DAP (distemper, adenovirus (aka canine hepatitis), parvovirus) vaccines given at 3-4 week intervals, typically started at 8 or 9 weeks of age. The last DAP vaccine must be given at 12 weeks of age or older.

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The rabies and DAP vaccines are known as "core vaccines" as they are recommended for all dogs. They should be administered again after one year, and thereafter, every 3 years for rabies, and every 4 years for DAP.

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Additional vaccinations, such as bordetella, leptospirosis, and lyme disease, may also be given. Vaccine recommendations are based on an individual assessment of each dog’s need, based on a conversation between the veterinarian and the owner. Rabies vaccination is required for all dogs by law.

 

Canine Influenza​ - The canine influenza epidemic is significant and real. This is a link to the official information from the AVMA:

https://www.avma.org/KB/Resources/Reference/Pages/Canine-Influenza-Backgrounder.aspx

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If your dog has a sudden onset of coughing, please CALL us. If your dog is coughing, it may be highly contagious. Please DO NOT simply bring your dog to Mission Pet Hospital and do not expose it to other dogs.

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​Cat Vaccines

For cats, core vaccines are the basic distemper shot (FVRCP). Some authorities consider the rabies vaccine to be a core vaccine,

but due to the fact that many cats that we see almost never go outside, we often do not give it. However, if you consider the consequences of rabies exposure (which can certainly happen indoors) and the legal consequences of owning a biting animal (what happens to the animal generally is dependent on its vaccine status), it is not hard to see why this vaccine is important. Additional vaccines for cats include feline leukemia virus (FeLV).