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Internal medicine for dogs

A specialist service in Sydney

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What is veterinary internal medicine?

Internal medicine is a specialist field of veterinary medicine.  Specialists complete a three-year residency including specialised training and examinations, and are certified Fellows of the Australian and New Zealand College of Veterinary Scientists (FANZCVS) or Diplomates of the European or American College of Veterinary Internal Medicine (DipECVIM, DipACVIM). Internal Medicine specialists typically see referred cases that are difficult to diagnose or manage, using advanced, non-surgical diagnostic tools such as imaging and laboratory testing.

Your regular vet may refer you and your dog to the University Veterinary Teaching Hospital Sydney to diagnose their complex condition. These conditions can include long-term vomiting or diarrhoea, unexpected weight loss or gain, increasing or decreasing appetite, increased urination or drinking, unexplained fever or lack of energy.

Our referral clinicians have advanced clinical training and expertise in all areas of internal medicine, including gastroenterology, endocrinology, urology, respiratory disease and infectious diseases.

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Refer a case

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Only for veterinarians

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(02) 9351 3437

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Internal medicine service

We can investigate and treat cardiovascular and respiratory diseases using our diagnostic facilities. Cardiorespiratory investigations often include thoracic radiographs, fluoroscopy, ECG, echocardiography with spectral colour Doppler imaging and bronchoscopy.

Our facilities include specialised oxygen cages for patients who require intensive care and oxygen supplementation.

Endocrine disorders can present with an array of clinical signs such as increased thirst and drinking (PU/PD), increased appetite (polyphagia), weight gain or loss, alopecia and skin changes. The diagnosis and treatment of some endocrine diseases can be challenging. Our referral clinicians have expertise in the diagnosis and management of a wide range of common and rare endocrine diseases, including Cushing's disease, Diabetes mellitus, thyroid disorders (hyperthyroidism, hypothyroidism), and disorders of electrolyte or mineral regulation (e.g., hypercalcaemia, hypoglycaemia).

We also provide care for critically ill patients with diabetic ketoacidosis.  

Published research from our team:

Cheung, C., Giori, L., Griebsch, C., Courtman, N., Podadera, J., & Thompson, M. (2025). Case Report: Trilostane therapy in a dog with recurrent adrenocortical carcinoma producing an array of steroid hormones. Frontiers in Veterinary Science, 12, 1632432. https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2025.1632432/full

Griebsch, C., Lehnert, C., Williams, G. J., Failing, K., & Neiger, R. (2014). Effect of Trilostane on Hormone and Serum Electrolyte Concentrations in Dogs with Pituitary- Dependent Hyperadrenocorticism. Journal of Veterinary Internal Medicine, 28(1), 160-165. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.12268

Griebsch C. “Canine hyperadrenocorticism – diagnosis.” Small Animal Continuing Education. Veterinary Ireland Journal Volume 8 Number 9, pages 543-548

Griebsch C. “Canine hyperadrenocorticism – management.” Small Animal Continuing Education. Veterinary Ireland Journal Volume 8 Number 10, pages 594-599

Problems of the gastrointestinal tract, pancreas, and liver and gallbladder are common in dogs. We investigate these problems using specialised diagnostic procedures such as fluoroscopy for disorders of swallowing and investigation of regurgitation, ultrasound for gastric, intestinal, hepatic, or pancreatic diseases, and endoscopy for investigation of the gastrointestinal tract.

Published research from our team:

Cheung, C., Rigling, J., Stang, B. and Ruaux, C., 2025. The effect of dietary tryptophan supplementation, and an oral tryptophan challenge, on urinary excretion of 5-hydroxyindoleacetic acid in domestic dogs. Frontiers in Veterinary Science, 12, p.1634940.

Yu, J., Ruaux, C., Griebsch, C., Boland, L., Wong, N., Bennett, P., & Wasinger, V. C. (2023). Serum proteome of dogs with chronic enteropathy. Journal of Veterinary Internal Medicine, 37(3), 925-935. https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.16682

Griebsch, C., Whitney, J., Angles, J., & Bennett, P. (2019). Acute liver failure in two dogs following ingestion of cheese tree (Glochidion ferdinandi) roots. Journal of Veterinary Emergency and Critical Care, 29(2), 190-200. https://onlinelibrary.wiley.com/doi/abs/10.1111/vec.12790

Jaffey, J. A., Pavlick, M., Webster, C., Moore, G. E., McDaniel, K., Blois, S. L., . . . Hostnik, E. T. (2019). Effect of clinical signs, endocrinopathies, timing of surgery, hyperlipidemia, and hyperbilirubinemia on outcome in dogs with gallbladder mucocele. The Veterinary Journal, 251, 105350. https://www.sciencedirect.com/science/article/abs/pii/S1090023319300838

Haematology focuses on diseases of blood cells (red blood cells, white blood cells, blood platelets) such as anaemia, thrombocytopaenia and leukopaenia as well as bleeding disorders. For investigation of bleeding disorders, we have a specialised equipment called the TEG machine (Thromboelastography (TEG) which is a point-of-care diagnostic device used to measure the entire process of blood clot formation, strengthening, and breakdown (fibrinolysis) in real-time.

 We also have an in-house blood bank for dogs and cats in case blood and/or plasma transfusions are needed.

Published research from our team:

Zhong, M., Hall, E., Glanemann, B., Jih, S.H., Korman, R.M., Langhorn, R., Leshinsky, J., Lingard, A.E., Roels, E., van Boeijen, M. and Boland, L.A., 2026. Treatment outcomes and prognostic indicators of primary immune thrombocytopenia in 31 cats: a multicenter retrospective study (2000-2023). Journal of Veterinary Internal Medicine, 40(1), p.aalaf038.

Chapman, S., Angles, J.M., Griebsch, C. and Yu, J., 2026. Hyperbilirubinemia and neurologic signs in dogs with non-associative immune-mediated hemolytic anemia: 81 cases (2015–2024). Journal of Veterinary Internal Medicine, 40(1), p.aalaf034.

Griebsch, C., Hall, E., & Barrs, V. (2022). Effectiveness of aspirin vs. clopidogrel in dogs with immune mediated haemolytic anaemia evaluated by serial thromboelastography and platelet mapping. The Veterinary Journal, 287, 105882.  https://www.sciencedirect.com/science/article/abs/pii/S1090023322000971

Mooney, E., Agostini, G., Griebsch, C., & Hickey, M. (2020). Intravenous vitamin K1 normalises prothrombin time in 1 hour in dogs with anticoagulant rodenticide toxicosis. Australian veterinary journal, 98(6), 225-231.  https://onlinelibrary.wiley.com/doi/abs/10.1111/avj.12931

Griebsch, C., Arndt, G., & Kohn, B. (2010). [Evaluation of different prognostic markers in dogs with primary immune-mediated hemolytic anemia]. Berl Munch Tierarztl Wochenschr, 123(3-4), 160-168.  https://www.ncbi.nlm.nih.gov/pubmed/20329649

Griebsch, C., Arndt, G., Raila, J., Schweigert, F. J., & Kohn, B. (2009). C-reactive protein concentration in dogs with primary immune-mediated hemolytic anemia. Veterinary clinical pathology, 38(4), 421-425.  https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1939-165X.2009.00146.x

Immune mediated diseases occur when the immune system targets tissue in the body. Affected organ systems include blood cells (immune mediated anaemia, thrombocytopaenia or neutropaenia), joints (immune mediated polyarthritis) or the central nervous system (steroid responsive meningitis arteritis (SRMA), meningoencephalitis of unknown origin (MUO). The diagnosis is established after a thorough workup , including infectious disease testing and imaging, and treatment is targeted at immunosuppression. (link to publications).

Published research from our team:

Zhong, M., Hall, E., Glanemann, B., Jih, S.H., Korman, R.M., Langhorn, R., Leshinsky, J., Lingard, A.E., Roels, E., van Boeijen, M. and Boland, L.A., 2026. Treatment outcomes and prognostic indicators of primary immune thrombocytopenia in 31 cats: a multicenter retrospective study (2000-2023). Journal of Veterinary Internal Medicine, 40(1), p.aalaf038.

Chapman, S., Angles, J.M., Griebsch, C. and Yu, J., 2026. Hyperbilirubinemia and neurologic signs in dogs with non-associative immune-mediated hemolytic anemia: 81 cases (2015–2024). Journal of Veterinary Internal Medicine, 40(1), p.aalaf034.

Griebsch, C., Hall, E., & Barrs, V. (2022). Effectiveness of aspirin vs. clopidogrel in dogs with immune mediated haemolytic anaemia evaluated by serial thromboelastography and platelet mapping. The Veterinary Journal, 287, 105882.  https://www.sciencedirect.com/science/article/abs/pii/S1090023322000971

Griebsch, C., Arndt, G., & Kohn, B. (2010). [Evaluation of different prognostic markers in dogs with primary immune-mediated hemolytic anemia]. Berl Munch Tierarztl Wochenschr, 123(3-4), 160-168.  https://www.ncbi.nlm.nih.gov/pubmed/20329649

Griebsch, C., Arndt, G., Raila, J., Schweigert, F. J., & Kohn, B. (2009). C-reactive protein concentration in dogs with primary immune-mediated hemolytic anemia. Veterinary clinical pathology, 38(4), 421-425.  https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1939-165X.2009.00146.x

Infectious diseases can affect multiple organ systems, including the central nervous system (CNS), and include parasitic, bacterial, viral, fungal and protozoal diseases. At the University of Sydney, we have been conducting extensive research on canine leptospirosis and novel treatment options for feline infectious peritonitis (FIP) in recent years. Our research has led to the development of a new leptospirosis vaccine and has significantly improved outcomes in cats with FIP, which is now considered a treatable disease. 

Published research from our team:

Cheung C, Shilton C, Danesi P, Simpson C, Shinozaki E, Miranda L, Krockenberger M, Harvey AM, Malik R. From plants to animals: Pythium, Lagenidium, Aphanomyces, and other oomycete pathogens of animals seen through a one-health lens. Aust Vet J. 2026 Jan-Feb;104(1-2):3-17. doi: 10.1111/avj.70054. https://onlinelibrary.wiley.com/doi/10.1111/avj.70054

Lu, X., Griebsch C., Norris, J.M. and Ward, M.P., 2025. Canine leptospirosis and environmental risk factors in coastal New South Wales, Australia (2021–2023). Preventive Veterinary Medicine, p.106748.

Griebsch, C., Norris, J., & Ward, M. P. (2025). Emerging human and canine leptospirosis in New South Wales: insights from a One Health geospatial study. Science in One Health, 100126
 https://www.sciencedirect.com/science/article/pii/S294970432500023X

Griebsch, C., Kirkwood, N., Ward, M. P., & Norris, J. M. (2025). Vaccination with monovalent Leptospira interrogans Serovar Copenhageni and its implication for the diagnosis of natural infection in dogs. Comparative Immunology, Microbiology and Infectious Diseases, 102418. https://www.sciencedirect.com/science/article/pii/S0147957125001262?casa_token=X_il0Io4g8gAAAAA:U4853rGhLNHmLqvWi68DteIt2Uqs_n5GX2RHnoBle2TF0SlnkoxLcT0V52wUhjOHiU8Vzwnw

Griebsch, C., Kirkwood, N., Norris, J., & Ward, M. (2025). A comparison of risk factors for canine leptospirosis and seropositivity in New South Wales, Australia. Australian veterinary journal, 103(3), 106-111. https://doi.org/10.1111/avj.13411

Griebsch, C., Kirkwood, N., Ward, M., & Norris, J. (2024) Serovar Australis replaces serovar Copenhageni as the most common cause of canine leptospirosis in New South Wales, Australia. Australian veterinary journal. 103(3), 94-105. https://onlinelibrary.wiley.com/doi/abs/10.1111/avj.13401

Griebsch, C., Kirkwood, N., Ward, M., & Norris, J. (2024). Serological evidence of exposure of healthy dogs to Leptospira in Sydney, New South Wales, Australia. Australian veterinary journal, 102(4), 215-221. https://onlinelibrary.wiley.com/doi/abs/10.1111/avj.13315

Lu, X., Westman, M. E., Mizzi, R., Griebsch, C., Norris, J. M., Jenkins, C., & Ward, M. P. (2024). Are Pathogenic Leptospira Species Ubiquitous in Urban Recreational Parks in Sydney, Australia? Tropical Medicine and Infectious Disease, 9(6), 128. https://www.mdpi.com/2414-6366/9/6/128

Lu, X., Griebsch, C., Norris, J. M., & Ward, M. P. (2023). Landscape, Socioeconomic, and Meteorological Risk Factors for Canine Leptospirosis in Urban Sydney (2017–2023): A Spatial and Temporal Study. Veterinary Sciences, 10(12), 697. https://www.mdpi.com/2306-7381/10/12/697

Gong, J., Griebsch, C., Kirkwood, N., Norris, J. M., & Ward, M. P. (2022). Emerging canine leptospirosis in Sydney and the role of population demographics. Transbound Emerg Dis, 69(5), e2485-e2494. doi:10.1111/tbed.14591 https://onlinelibrary.wiley.com/doi/full/10.1111/tbed.14591

Griebsch C, Kirkwood N, Ward MP, So W, Weerakoon L, Donahoe S, Norris JM (2022) Emerging leptospirosis in urban Sydney dogs – a case series (2017-2020). Australian Veterinary Journal doi:10.1111/avj.13148 https://onlinelibrary.wiley.com/doi/abs/10.1111/avj.13148

Griebsch C, Ward MP, Norris JM (2022) Canine Leptospirosis – global distribution, diagnosis and treatment. Advances in Small Animal Care 3(1), 177-22 https://www.advancesinsmallanimalcare.com/article/S2666-450X(22)00011-6/fulltext

Skinner, V., Ward, M., & Griebsch, C. (2026). Risk of infection in dogs in contact with clinical canine leptospirosis casesAustralian veterinary journalhttps://onlinelibrary.wiley.com/doi/full/10.1111/avj.70069

Urology and urogenital conditions involve the urinary system (kidneys, bladder and urethra) as well as the reproductive organs. Renal disease refers specifically to conditions affecting the kidneys, which play a vital role in filtering waste, maintaining hydration, and supporting overall health. Our veterinary team provides diagnosis and care for these conditions to help keep your pet healthy and comfortable.

Published research from our team:

Jones E, Alawneh J, Thompson M, Allavena R. Association between case signalment and disease diagnosis in urinary bladder disease in Australian cats and dogs. May 2021, Journal of Veterinary Diagnostic Investigation, 33(3), p.498-505, SAGE Publications. Association between case signalment and disease diagnosis in urinary bladder disease in Australian cats and dogs - Emily Jones, John Alawneh, Mary Thompson, Rachel Allavena, 2021

Thompson MF. Furthering our understanding of positive urine cultures in dogs. Jan 2017. The Veterinary Journal 219:42-43, Elsevier. DOI: 10.1016/j.tvjl.2016.11.018

Thompson MF, Litster AL, Platell JL, Trott DJ. Canine bacterial urinary tract infections: New developments in old pathogens. Oct 2011. The Veterinary Journal, 190(1) 22-27, Elsevier DOI: 10.1016/j.tvjl.2010.11.013

Thompson MF, Schembri MA, Mills PC, Trott DJ. A modified three-dose protocol for colonisation of the canine urinary tract with the asymptomatic bacteriuria Escherichia coli strain 83972, Aug 2012. Veterinary Microbiology. 158(3-4):446-450, Elsevier DOI: 10.1016/j.vetmic.2012.03.012

Internal medicine for dogs FAQs

Yes, you will need a referral from a general practice veterinarian to our internal medicine specialists. Once you have your referral, you can then book an appointment. Your veterinarian will send through your dog's full history and information regarding their condition will the referral. 

Top three symptoms include increased thirst and urination, increased appetite but weight loss, lethargy or reduced energy

Leptospirosis is a potentially fatal zoonotic disease caused by Leptospira bacteria. Rodents are the most common source of infection and transmission occurs through direct or indirect contact with infected urine or contaminated environments. In dogs leptospirosis most commonly causes acute kidney failure and liver injury. There have been cases of leptospirosis in dogs in Sydney in recent years and we therefore recommend vaccination especially in dogs with at risk behaviour such as rodent hunting.

See our Diagnostic imaging page for a full run of all our imaging resources available to our veterinary hospitals.