Our commitment to compassionate patient care is framed by our practice core values. These values guide us as we provide an exceptional level of nursing care for every patient who visits our hospital ward. Our facility is staffed 24/7 with veterinarians and a nursing team who provide compassionate care around the clock. While our surgeons and medical team are at rest, the doctors and medical team of the Animal Emergency Clinic of Cary are in our facility caring for our patients under the direction of our attending surgeons. Our surgeons are “on call” to aid with any surgical care that may be required by the Animal Emergency Clinic of Cary patients after our regular office hours. This relationship enables us to ensure the highest level of care is maintained consistently for all of our guests throughout their visit to VSRP. We recognize and appreciate the commitment and trust our visitors and referring veterinarians place in our team.

Our Core Values

• trust
• responsibility
• personalized service
• specialization
• compassion
• professionalism
• individualized attention
• progressive environment
• practical leadership and vision
• high standard for excellence
• challenges are opportunities
• medical expertise
• cohesive team

Before an animal is hospitalized, a written estimate of the anticipated cost of treatment, along with a consent form for anesthesia / sedation, if applicable, is prepared and thoroughly explained to the client.

A deposit equal to one-half of the total estimate provided is required at the time of admission for surgery or other treatment. Payment in full of any balance due is required prior to the discharge of any pet. No extension of credit is available.

The human anterior cruciate ligament (ACL) is analogous to the canine and feline cranial cruciate ligament (CCL). Once torn, the CCL will generally degrade and become nonfunctional over time, resulting in knee instability and arthritis. This results in a pelvic limb (back leg) lameness. Various surgeries can be done to passively or dynamically stabilize the knee with this injury. At VSRP, we believe that the tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA) procedures generally achieve the best and most consistent results in dogs. However, we are trained in and do perform other procedures for this injury (fibular head transposition, extracapsular stabilization), though on a selective basis. We infrequently recommend the extracapsular “fishing line” stabilization technique, as its results tend to be inconsistent. We do not recommend the TightRope technique, as its mode of failure is similar to the 'fishing line' technique but at a higher cost. In fact, our most common 'revision' knee surgery is for those dogs that have had a prior TightRope procedure at other facilities.

Elbow dysplasia is a general term for the genetic abnormalities which affect the canine elbow. It includes the more discrete problems we recognize, such as fragmented coronoid processes (FCP), osteochondrosis dissecans (OCD), and ununited anconeal processes (UAP). The term is also used to describe elbow incongruity, asynchronous growth of the bones which articulate in the elbow, and radial head subluxation. These problems result in lameness in the forelimb (front leg, analogous to the human arm).

Fractures occur when your pet has had some type of trauma, whether it be a fall from the bed at night or being hit-by-car on the street. Fracture repair combines the art and science of orthopedics. Each bone has a different mode of bearing weight, and these fracture forces are what surgeons study to determine the best type of repair. Bone fractures are like puzzles in a way, as we need ‘to put the pieces back together’ in a manner which allows the body to heal over time (2-5 months!). Surgeons utilize many types of surgical grade implants to stabilize fractures. The best repair of a fracture may require pins (positive or negative threaded), plates and screws (stainless steel, titanium), external fixators, composite rods, ring fixators, synthetic bone graft products, and the list goes on. This requires a large implant and equipment inventory, especially when considering we repair broken bones on breeds ranging from teacup poodles to English Mastiffs!

Hip dysplasia is a genetic disease which can result in lameness and arthritis over time. Hip evaluation includes the radiographic evaluation of hip conformation, as well as palpation of the hip joints. Hip conformation can be assessed using the hip-extended (OFA type) radiographic view and also the PennHip technique. Both large and small breed dogs have hip dysplasia. Each individual animal, dog or cat, will have varying degrees of lameness attributable to their hip problem. Some dogs with severe hip arthritis do not limp or show signs of discomfort, while other animals with minimal arthritis are extremely painful and have difficulty walking. Thus, a clinical evaluation is important to determine the course of treatment. Conservative and medical management of hip discomfort is very common, though hip surgery retains an important role in managing hip discomfort and improving hip function. Our more common hip surgeries include the triple pelvic osteotomy (TPO; younger dogs), femoral head/neck ostectomy (FHO, FHNO; generally smaller less active dogs), and total hip replacement (THR, cemented and cementless; generally any size active dog, large sedentary dog, or cat). We will also consider the JPS procedure (juvenile pubic symphysiodesis) in 16-20 week old puppies.

Dogs and cats have joints that flex and extend (ex. hips, shoulders and elbows). They also have some joint surfaces which do not flex and extend (ex. some carpal and tarsal bones). Traumatic injuries, and even immune-mediated diseases (for instance, Lupus) can damage joints such that they do not function as intended. Joints can dislocate, partially dislocate, breakdown, become deranged, lose their smooth cartilage surfaces, become fused, and become nonfunctional. The joints which tend to dislocate most often due to trauma are the hip, shoulder, elbow, carpus (wrist), and tarsus (ankle). Sometimes these luxations can be reduced without surgery. If the trauma is more severe, surgery may be necessary to realign the joint and restore stability.

Patella luxations occur in small and large breed dogs, as well as cats. The patella (kneecap) can dislocate (luxate) medially or laterally, and the limb conformation often dictates which type is present. Bowlegged breeds tend to have medial patella luxations (MPL), whereas postlegged breeds tend to have lateral patella luxations. Essentially, the genetic conformation of the pelvic limb dictates the alignment of the limb, and can predispose to this problem.

OFA: (Orthopedic Foundation for Animals) This screening for hip and elbow dysplasia and patella luxation can be done at VSRP easily. We submit images digitally and directly to OFA which expedites the turnaround for results. OFA also offers certification for eyes, thyroid function and many other congenital abnormalities.
Printable Submission Forms:
Hip and Elbow Dysplasia
Patellar Luxation
Additional OFA Submission Forms

PennHIP is the most accurate hip screening method available and can be safely performed on dogs as young as 16 weeks of age. VSRP will submit the images digitally and directly to PennHIP which expedites the turnaround for results.
For more information take a moment to read the PennHIP brochure.
You can see a video clip with one of the orthopedic surgeons from Penn State discussing the PennHIP method.
PennHIP submission form

We are in the process of adding this exciting new joint replacement technology at VSRP.

There are a variety of conformational malalignments which affect our pets, particularly dogs rather than cats. Some breeds are naturally 'crooked' in their limb structure, whether they be 'toed out', 'bowlegged', 'pigeon toed', or 'cow-hocked.' In these breeds, your pet's appearance is symmetrical (i.e. the right forelimb looks the same as the left forelimb). As long as your pet's 'normally abnormal' structure does not result in lameness, all is acceptable. However, there are occasions when abnormal growth of a bone, secondary to an injury or disease, can severely alter the function of a limb. Your pet's limb appearance will not be symmetrical in these instances, and often surgical intervention can improve the comfort and function of that particular limb. Some genetic conformations predispose to other acquired conditions, such as medial/lateral patella luxations and even cranial cruciate ligament injury.

Mandibular (jaw) and maxillary fractures occur in traumatized pets, and often require surgical repair to allow normal occlusion and normal closure of the mouth. Tumors of the oral cavity are common, and surgical removal is often the initial treatment recommendation. TMJ luxation is also recognized and can require surgical intervention.

Abdominal surgery typically is focused on a particular organ or system which is found to be abnormal via radiographs or ultrasound. If your pet is vomiting, having diarrhea, or abdominal pain, then their stomach and intestines may be the focus of surgery. Bloody urine or inability to urinate may be a sign of bladder or urethral‘stones’ or blockage. Anemia and blood in the abdomen can result from a bleeding tumor of the spleen or liver. Animals that have been traumatized can develop diaphragmatic or abdominal hernias. Small animal surgeons are trained in the treatment of a variety of abdominal diseases.

Airway surgery, simply stated, is used to improve breathing. A common surgery for brachycephalic breeds (for example, Bulldogs) is surgical treatment of their stenotic nares and elongated soft palate; at times tonsillectomy and laryngeal fold resection are necessary. Older Labradors that have difficulty breathing secondary to laryngeal paralysis can benefit from a 'tie-back' procedure (cricoarytenoid laryngoplasty). Small breed dogs with tracheal collapse can often be managed medically but placement of stents can become necessary.

Surgical procedures can be of benefit in the management of chronic ear infections and removal of ear tumors or polyps. With mild intermittent otitis, sometimes 'opening' the ear canal with a Zepp procedure can reduce the frequency of infections. In more severe cases, say a Cocker Spaniel with a longstanding otitis which no longer responds to oral or topical medications, complete removal of the ear canal is necessary (total ear canal ablation with bulla osteotomy). This surgery will resolve their ear pain and headaches. Cats can develop ear infections secondary to polyps in their middle ear, and these can be removed via another type of ear surgery (ventral bulla osteotomy).

Fortunately, many pets are spayed or neutered at an appropriately young age. However, intact female and male dogs and cats can develop infections (pyometra, prostatitis) or cancers (testicular, mammary ) of their reproductive organs. The urinary system tends to require surgery due to congenital abnormalities (ectopic ureters), cancer (kidney and bladder), and formation of 'stones' (kidney, ureteral, bladder, and urethral). Urinary obstruction in dogs and male cats is very common, and can be life-threatening.

Oncologic surgery encompasses many types of cancers in many locations throughout the body. Many types of cancer require some type of surgical procedure as a primary treatment. Cancers which are primarily treated with chemotherapy, such as lymphosarcoma, may only require surgery in the form of a needle biopsy or lymph node excisional biopsy. Other soft tissue tumors, such as sarcomas (of muscle, spleen, liver, intestinal, stomach) and carcinomas (of anal gland, adrenal, lung, pancreas, thyroid), can be amenable to complete surgical resection. Successful surgical resection of tumors can require the use of specific muscle flaps and skin grafts. In other instances, amputation of a digit or limb (bone tumor) is recommended. Treatment recommendations may include surgical tumor removal along with additional chemotherapy or radiation therapy.

Plastic and skin reconstruction surgery in pets is usually done for a medical benefit, rather than as an elective 'cosmetic' procedure. Breeds with excessive skin folds can have chronic skin infections which can become difficult to manage medically, especially on the face or surrounding a 'corkscrew tail'. Although surgical reduction in these folds can change the 'look' of your pet, it will help manage their pyoderma. The treatment of large wounds (induced by trauma, snakebites) can often include the use of skin flaps or grafts. The surgical resection of tumors may require these specialized techniques for a more successful outcome.

Thoracic surgery involves treatment for abnormalities of the esophagus, heart, mediastinum, lung lobes, thoracic duct, and thoracic wall (rib cage). Congenital and developmental disorders such as patent ductus arteriosus (PDA) and vascular ring anomalies (persistent right aortic arch (PRAA) as an example) can be treated with interventional techniques or surgery. Pericardial effusion can be managed with a pericardectomy. Pleural cavity diseases such as pyothorax, pneumothorax, and chylothorax can be managed with the aid of surgical intervention. Lung lobectomy (for lung tumors) and diaphragmatic hernia repair (traumatic or congenital peritoneopericardial) are common reasons for your pet to have thoracic surgery.

October 14- 20, 2012 is the 20th anniversary of National Veterinary Technician Week, the celebration of the contributions to the healthcare of animals made by veterinary technicians. Often called 'nurses', these licensed professionals practice under the supervision of licensed veterinarians. Our veterinary technicians induce and maintain anesthesia, acquire and process lab samples, prepare and give medications as ordered by the veterinarian, take x-rays, and assist with medical and surgical procedures. Most importantly, they are critical members of the team caring for our hospitalized guests. If you have ever had a human hospital visit, you understand the invaluable role the nursing team members play in the quality of your healthcare.
We are proud to include six highly trained Registered Veterinary Technicians (RVTs) as an empowered part of our medical team at VSRP. Our ratio of RVT’s per veterinarian (2:1) is well above the national average (0.4:1). The consistently high standard of patient care delivered 24/7 at VSRP separates our practice from others who may offer the services of a visiting/traveling surgical specialist. Our team focuses on each patient’s individual needs and offers a patient experience unique to our practice. VSRP RVT’s are absolutely critical to our daily operation and mission achievement. We would like to celebrate the excellent work of our RVT’s and thank them for delivering the gold standard of individualized patient care that every patient deserves when they visit VSRP.

This diagnosis refers to a spinal disorder which is commonly referred to as "Wobbler Syndrome." It is generally an acquired malformation and malarticulation of the cervical vertebrae, thought to be caused by a developmental bone disorder called osteochondrosis. Younger dogs tend to develop a stenosis (narrowing) of their spinal canal, while older dogs develop degenerative joint disease in their spine. This results in compression of the spinal cord, and thus a degree of paralysis. Hence, these pets can begin to 'wobble' in their pelvic limbs. Affected breeds include Great Danes, rottweilers, and Doberman pinschers. Diagnosis and treatment options will depend upon the results of radiographs and a spinal MRI.

Intervertebral discs are 'cushions' of tissue between the bones of the spine (vertebrae). They absorb the compressive forces which occur within the spine. Their extrusion or protrusion can damage the spinal cord and its nerve roots, resulting in back pain, partial paralysis, or complete paralysis. Disc herniations can occur in any breed, more commonly in the chondrodystrophic breeds (Pekingese, dachshund, bulldog, beagle, Welsh corgi, basset hound). These herniations also occur in cats.

This is a narrowing of the spinal canal at the lumbosacral junction. The narrowing is secondary to malformation and malarticulation of the vertebrae, which can also lead to a disc prolapse. Essentially, the spinal nerve roots in the low-back are pinched and compressed by the thickened ligaments and joint capsules of the vertebrae, along with bone spurs between the vertebrae (spondylosis). Fractures of the vertebrae, infections of the disc (discospondylitis), and spinal or pelvic bone tumors also can cause neurologic impairment localized to the lumbosacral spine.

Tumors occur within the brain, spinal cord, and peripheral nerves; they also occur within the vertebrae. Clinical signs can include weakness, paralysis, headaches, pain, and lameness. Diagnosis and treatment options will depend upon the results of noninvasive (radiographs, MRI) and invasive (biopsy, spinal tap) results

Fractures of the spine are generally surgical emergencies, although not all types of spinal fractures will require surgical intervention. Some fractures will heal relatively well with conservative treatment, which includes strict cage rest and a body cast. Spinal radiographs, MRI, and/or CT are useful tests, as well as knowledge of vertebral biomechanics.

This condition is also known as caudal occipital malformation syndrome (COMS). It results in a plethora of signs, and is seen predominantly in toy and small breeds, particularly the Cavalier King Charles spaniels and Brussels griffon. Common clinical signs include neck or back pain, persistent scratching, seizures, and loss of balance. It is a condition in which part of the brain (cerebellum) compresses the spinal cord, altering the flow of cerebral spinal fluid (CSF). Conservative (nonsurgical) and surgical treatments have been recommended.

This is a congenital condition in which there is instability between the first (atlas) and second (axis) cervical vertebrae. Miniature and toy breeds are most commonly affected. These dogs can exhibit neck pain, a reluctance to petting on their head, partial paralysis, wobbliness, or complete paralysis.

This is a nonsurgical condition. Degenerative myelopathy results in progressive deterioration of the spinal cord, and as such progressive paralysis. Large dog breeds are more commonly affected, such as the German shepherd, boxer, and Bernese mountain dog; the Pembroke Welsh corgi may have a similar condition.

Platelet Rich Plasma Therapy, PRP, is composed of two of the four main components of whole blood; plasma and platelets. The benefit of PRP has to do with the lesser known functions of platelets. Beside their familiar role in hemostasis, platelets also play a critical part in the tissue healing process by closing down the initial inflammatory phase of healing and providing a host of biochemical mediators (growth factors) that recruit healing cells, unlock the healing potential of cells already present, and stimulate the development of a new blood supply in damaged tissue environments. PRP has proven itself as a valuable treatment modality for humans with ligament, tendon, and muscle injuries, complicated fractures and arthritis. Horses were the first veterinary patients to benefit and now this treatment method is coming to our companion animal patients as well.