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Pet Specialists of Monterey

Minimally Invasive Medicine

Minimally Invasive Medicine (MIM), the standard in human medical diagnostics and therapy, is now available for pets. MIM allows our hospital to complete important procedures without an incision and with minimal or no sedation or anesthesia. Less invasive methods allow pets to recover faster and most go home the same day.

Benefits of MIM include:

  • Improved visualization of internal structures
  • Decreased need for sedation and anesthesia
  • Reduced pain and discomfort

Pet Specialists of Monterey offers a wide variety of MIM procedures, such as ultrasound guided sampling and therapy; endoscopic evaluation of the gastrointestinal, respiratory, lower urinary, and reproductive tracts, capsule endoscopy of the gastrointestinal tract and stenting procedures.

Ultrasound-Guided Diagnostics and Therapy

Brown dog

Ultrasound is a non-invasive imaging method that uses sound waves to examine the inside of a pet’s body. With ultrasound, we can see the shape and internal anatomy and evaluate for presence of masses or fluid in abnormal areas. We also use ultrasound to visualize and direct a sampling needle for collection of cells, biopsies, and fluids for analysis. Most samples can be collected with little or no sedation.

Ultrasound-guided diagnostic techniques include:

  • Fine needle aspirate: Sampling of groups of individual cells from internal organs such as the liver, kidney, or spleen, masses, or from abnormal fluid in body cavities. The needle used is similar in size to a vaccination needle. Most of these samples are collected without any sedation or anesthesia. After collection, tissue samples are evaluated on a microscope and fluid samples are chemically evaluated and visually examined on the microscope. Some sample evaluation can be completed at Pet Specialists of Monterey, then the slides and samples are sent to a board-certified pathologist for confirmation.
  • Needle biopsy: Collection of small tissue samples that show not just individual cells but also architecture of an organ or mass. The needle is about the size of a ballpoint pen tip. Needle biopsy generally requires brief sedation or injectable anesthesia. After collection sample is preserved in formalin, it is sent for microscopic evaluation by a board-certified pathologist.
  • Cystocentesis: Collection of urine from the urinary bladder for routine analysis and urine culture for bacteria. This is the most common ultrasound-guided procedure. Sedation is not needed for a well-behaved pet.

Ultrasound-guided therapy procedures include:

  • Thoracocentesis: Collection of fluid from the chest cavity around the lungs to improve breathing and for diagnostic analysis.
  • Pericardiocentesis: Collection of fluid from the sac that surrounds the heart to improve heart function and blood flow, as well as for diagnostic analysis.
  • Abdominocentesis: Collection of fluid from the abdominal cavity to reduce discomfort and distension and for diagnostic analysis.

Endoscopy Diagnostics and Therapy

Endoscopy is the use of a long, slender, flexible digital camera for non-invasive examination of internal organs via a natural opening (mouth, nose, throat, anus, urethra). Diagnostic samples are collected with the guidance of the endoscope; in some cases, foreign bodies can be removed as well. Samples are often collected and sent to a board-certified pathologist for examination.

Your pet’s safety and comfort are our top priority. All our endoscopic procedures are non-invasive, meaning that no incision is necessary, and performed by a veterinary internal medicine specialist. Your pet is fully anesthetized and monitored before, after and throughout the entire procedure.

Common diagnostic endoscopic procedures include:

  • Gastroscopy and duodenoscopy: Examination of the upper gastrointestinal tract (esophagus, stomach, and upper small intestine) and collection of biopsy samples.
  • Colonoscopy and ileocolonoscopy: Examination of the lower gastrointestinal tract (the large bowel and lower small intestine) and collection of biopsy samples.
  • Rhinoscopy and nasopharyngoscopy: Examination of the nasal passages and and throat. Biopsies and/or fluid samples and swabs may be collected for evaluation.
  • Tracheobronchoscopy: Examination of the trachea (windpipe), bronchi, and lungs. Generally, after the visual exam, a small amount of sterile saline is flushed into the airway then suctioned out for examination on a microscope and for bacterial culture. This procedure is called a Bronchoalveolar Lavage (BAL). Small biopsies may also be collected.
  • Cystoscopy: Examination of the urinary bladder and urethra. Biopsies may be collected for microscopic and bacterial evaluation.

Common therapeutic endoscopic procedures include:

Therapeutic endoscopic procedures include removal of foreign objects from the gastrointestinal and respiratory systems, dilation of strictures, and placement of feeding tubes.

  • Retrieval of objects that are eaten or inhaled that are causing trauma and or obstruction of the nose, throat, trachea (windpipe) or stomach. Our internal medicine specialists are on call to provide emergency endoscopy 24-hours a day, including weekends and all holidays.
  • Stretching an injured section of throat, esophagus, or colon to relieve obstruction where a narrowing has occurred due to past injury and scar tissue.
  • Specialized feeding tubes can be placed to allow pumping of liquid nutrition directly into the stomach or small intestine.


Medical stenting is the placement of a mesh tube to expand a passage where disease or injury has caused narrowing and dysfunction. We offer stenting of the trachea, colon, ureter, and urethra. Stenting requires the patient to be under general anesthesia. However, no incision is involved for placement of the stent. The patient is typically discharged from the hospital the following day.

Stenting is used for serious health conditions that may otherwise be life threatening, such as:

  • Tracheal collapse
  • Urethral tumors
  • Colonic tumors

Referrals and Appointments

Pets undergoing these minimally invasive procedures require evaluation by a board-certified specialist in internal medicine. Please consult your family veterinarian to determine whether minimally invasive or non-invasive procedures are appropriate for your pet.