Specialty FAQs:

What is a veterinary specialist?

What is a veterinary specialist? In veterinary medicine, as in human medicine, some doctors choose to specialize in an area of interest. A veterinary specialist is a veterinarian who has undergone years of advanced education and training in a certain field or discipline and earned board certification.

To earn the designation of “board-certified specialist” veterinarians must attend undergraduate school, attend veterinary school, complete an internship (1-2 years), and complete a residency (2-4 years) in their chosen field. These residency programs require veterinarians to meet specific training and caseload requirements, perform research in their specialty field, and have that research published. They must also pass a set of rigorous examinations administered by the board of the specialty college. It is only after the completion of all prior steps does a veterinarian earn the title of “Veterinary Diplomate” and become a board-certified veterinary specialist.

Why am I being referred to a board-certified specialist for my pet’s care?

At SAGE, we speak of a “triad” of caregivers: you, your pet’s primary veterinarian, and our veterinary specialist. You and your primary veterinarian are the first line of care in your pet’s health and well-being. In some complex cases, your primary veterinarian may refer your pet to a specialist who has the advanced training, expertise, and equipment needed to continue to provide the best possible care for your pet. When a referral is indicated, your primary veterinarian will discuss this process with you and then provide us with all pertinent information regarding your pet’s history and current medical problem. Often they will call one of our specialists to discuss the case being referred. They may also fax or email medical records to us, send your pet’s imaging studies, or even ask you to bring x-rays or radiographs to your pet’s consultation. To maintain the triad of care, our specialists will keep you and your primary veterinarian informed of your pet’s progress after your initial consultation and any subsequent appointments. This continuity between specialist and primary veterinarian ensures the best possible outcome for your pet.

What should I expect from my consultation with a board-certified specialist?

Our specialist will review medical records from your primary veterinarian, as well as any x-rays/radiographs or lab results sent prior to your appointment. When you bring your pet in for the consultation, you will be asked to provide a thorough history of your pet’s medical problem. Your consulting specialist will also perform a physical examination on your pet. After reviewing all of this information, your specialist will discuss a treatment plan with you, which could involve further diagnostic tests, a surgical recommendation, and/or detailed home-care instructions. After you approve a treatment plan, your doctor will create a detailed financial estimate for your pet’s care. Your specialist can sometimes perform diagnostic tests or procedures the day of your consultation, so in general we request that you have your pet fast for the appointment. Diabetic patients, however, should never be fasted unless specifically requested to do so by the doctor or nursing staff. Please call us before your consultation if you have any questions about withholding food from your pet.

Why does my pet need to be fasted before the appointment?

Many procedures and blood work require a minimum of a 12 hour fast. It is at the doctor’s discretion to allow a patient to have food and/or water before the appointment. When scheduling the appointment, you may be asked to fast your pet; if you have concerns about this, the Client Service Coordinator (CSC) can discuss these concerns with the doctor and their team. A member of the clinical team will communicate with you before your scheduled appointment to discuss your concerns.

When do specialty medicine diagnostics or medical procedures take place?

Most specialty doctors have either consultation and recheck appointments scheduled in the mornings and medical and surgical procedures scheduled in the afternoons, or vice versa. While we strive to accommodate our clients’ and patients’ needs the same day as their consultation appointment, there may be times when an unforeseen urgent patient care issue occurs in the hospital resulting in rescheduling of stable patient procedures. We will update you if your pet’s procedure is delayed and work with you to provide continued care during the delay.

What are my options for medical care?

The specialty doctors at SAGE include specialists in alternative medicine, cardiology, internal medicine, neurology, surgery and oncology and work during the daytime, Monday through Saturday. Our emergency and critical care team work closely with the specialists, and they are scheduled to be at SAGE 24 hours a day, 365 days a year.

The doctors meet as a group for patient rounds in the morning and evening to discuss cases and collaborate together to meet the needs of the patients in the hospital. If your pet was hospitalized through the emergency department, the emergency doctor will include an estimate for the first 12 hours of your pet’s care and may recommend transferring your pet’s care to one of the specialists. We will communicate options and our recommendations to you and your pet’s primary veterinarian.

Emergency doctors, specialists, and your primary veterinarian all have you and your pet’s best interest at heart and will work together to provide the best care possible.

If the recommended medical plan is not the right choice for you or your pet, please discuss this with your SAGE doctor and your primary care veterinarian, and we can work together to discuss the best course of action. You may choose to follow-up with your primary veterinarian for continued care.




Emergency FAQs:

Can you give me medical advice for my pet over the phone?

We cannot give specific medical advice for your pet without an exam by our doctors. If you are not sure if you should have your pet seen by a doctor, please contact us for us to discuss with you.

My pet just ate something potentially poisonous, what do I do?

If you are concerned that your pet may have ingested a possible toxin, we recommend calling the ASPCA Animal Poison Control Center at (888) 426-4435 for specific information about the potential toxin. There is a nominal fee for their services, payable by credit card. If Poison Control instructs you to bring your pet to the hospital for treatment, they will provide you with a case number that will allow our veterinarians to contact them for further information about treatment. Please bring this case number with you to the hospital.

What if my pet has an emergency situation?

Emergency services are available at all of our facilities, 24 hours a day, 7 days a week, 365 days a year. We are open during all major holidays.

If your pet is experiencing an emergency during regular office hours, please call your primary veterinarian. If they feel that a referral to one of our emergency departments or specialists is warranted, they will call the closest facility directly and set up that transfer as an immediate referral. If you do not have a primary veterinarian, please call the closest SAGE facility to you. Regardless of the time or day, it’s always best to call ahead if you can so that we’re prepared for your arrival.
Your pet does not need an appointment or a referral to be seen at any SAGE Center emergency department. Your pet will be seen in order of treatment based on the degree of urgency to wounds or illnesses. This may mean we must attend to animals not in their order of arrival, but in their order of need. We are committed to helping your sick pet and any delay in seeing you may be related to the doctor’s belief that another animal must be seen first. We ask for your patience in this process if it occurs during your visit.

I just brought my pet in to Emergency. What is happening with my pet in the treatment area?

The emergency doctor and clinical staff will be assessing the nature of the emergency and examining your pet’s condition, taking vital signs, and starting their medical chart and care. We have the necessary equipment in our treatment rooms to begin therapy quickly if needed.

My pet was admitted in to Emergency. When will I know something? Or, what is taking so long?

We strive to communicate and update you as soon as we can so that you have some information on your pet’s condition. There may be other patients being seen and the doctors will triage to care for the most sick or injured first. After the doctor examines your pet, they will speak with you regarding their findings and their recommended course of action.

Why is my pet being “Transferred”?

The emergency doctors and different specialists provide care in distinct areas of veterinary medicine, all to give your pet the highest quality medical care. While the medical care is ‘transferred’ between doctors, your pet stays in the same place and gets input from several different doctors.

How long will my pet stay in the hospital?

The doctor will discuss the estimated time your pet will need to remain in the hospital. Some patients are able to have a workup and procedures performed the same day as the consultation. Overnight hospitalization is common for patients that undergo surgery. During their hospital stay, they will receive 24-hour care from our qualified nursing staff. Our nurses will make sure that your pet receives appropriate treatments and the best possible nursing care. If your pet requires hospitalization, we will update you at least once a day regarding your pet’s progress. Your doctor will also call you to discuss any changes in treatment plans during your pet’s hospitalization.

May I come and visit my pet staying in the hospital?

Of course you are welcome to visit! We ask that you call first to arrange a time when the hospital staff can accommodate your visit. If your pet is medically stable, you may be able to visit in an exam room or our Quiet Room to provide you with privacy with your pet, in a comfortably furnished setting. If your pet is in oxygen or is not stable enough to leave the Critical Care Unit (CCU), we may need to limit the visit to a brief one by their side (max 15 minutes), in order for us to provide the medical care that your pet needs during his or her hospitalization. Please be aware that while we will do everything possible to adhere to scheduled visits, unforeseen urgent patient care issues occurring in the hospital may cause delays or shortened visits.

When may I bring my pet home?

When your pet is ready to go home or be transferred to their primary veterinarian, we will schedule an appointment time with you so we can review homecare instructions and medications. Your pet’s complete medical record will then be faxed or emailed to your family veterinarian.

If your pet is receiving chemotherapy or an anesthetic procedure, you should expect your pet to stay for the majority of the day.



FAQs After Surgery
We understand that the first days after surgery can be quite challenging for both pets and their caretakers. In addition to your pet’s personalized aftercare instructions, we would like to provide you with information regarding some of the more common questions and concerns that arise once pets are at home.

 

My pet is restless, unable to get comfortable, is whimpering and/or sleeping poorly…

This is not unusual, especially during the first hours to days following release from the hospital. A number of factors are likely contributing to these behaviors, including the recent hospital experience, low grade pain, and changes in their usual home environment and/or with their daily routine. If your pet calms down when you are directly engaging their attention (by talking to them, sitting with them, or petting them), inadequate pain control is not likely the cause of their actions.

You can often help this situation by letting your pet know you are nearby, placing familiar items (dog bed, favorite toy) in your pet’s new enclosure, and–if it was dispensed by the surgeon–the administration of a sedative. If these measures are unsuccessful, it is possible that your pet is experiencing a side effect of some of the pain medications they’re receiving or that their pain is not yet adequately controlled. If you believe this to be the case, please contact SAGE for further instructions.

My pet was using the operated leg well, but has suddenly stopped doing so…

This sometimes occurs after a support bandage is removed. A pet grows accustomed to having extra support for the operated limb, and using the limb without that support may feel awkward for a while. This may also occur with overuse of the limb. As your pet begins to feel more comfortable using the leg, they may not “remember” that the leg is still healing and somewhat fragile. They may forget to step lightly on the limb to protect it as you might after an injury or surgery. Additionally, the normal release of adhesions (immature scar tissue) with greater limb use following surgery may cause transitory pain. It is rare that any permanent setback occurs if your pet has been adequately confined and their exercise limited appropriately.

If your pet stops using the operated leg well, and in the absence of evident pain or deformity of the limb, try strictly limiting their exercise for the next 24-48 hours. If the surgeon dispensed an oral analgesic such as Torbugesic in VAL syrup or non-steroidal anti-inflammatory tablet (Rimadyl, Etogesic), you may administer them as directed on the label. The surgical site may also be warm compressed by using a dampened towel that is warm–but not too hot–to the touch for 10-minute sessions, 2-3 times daily. If there isn’t a return to the previous level of limb use within a day or two, or if you believe that your pet may have done more significant damage to the surgical repair, then contact SAGE for further advice.

My pet’s eating and elimination habits are abnormal…

Eating patterns may be altered by surgery for a number of reasons. The combination of recent anesthesia, pain medication, environmental change, and decrease in normal exercise can sometimes cause a decrease in food intake. If your pet has no special dietary requirements/orders from the surgeon, it is acceptable to entice them with a special food (like boiled chicken and rice) in small quantities. This should be offered in combination with your pet’s normal diet. Please avoid foods that have significant fat or are considered to be “rich”, since the last thing your recovering companion needs is gastrointestinal upset.


Miscellaneous FAQs:

Is SAGE a corporation?

SAGE is a San Francisco Bay area locally-owned partnership, owned by 14 partners who all practice in each of our 4 facilities. Though we are large in size and offerings, we are cognizant of remaining local and community based. Our management team has corporate experience, and we have benefited from their experience with growing the organization and streamlining our processes, however by design, our culture is such that we are flat-management based with little to no hierarchies. Everyone at SAGE has an important role to fill regardless of their title.

What does SAGE stand for?

The SAGE name is not an acronym and was chosen due to a variety of reasons. First, the definition of the word “sage” is someone who is wise and venerated for their possession of wisdom, judgment and experience. We feel our team exemplifies this description and shares their knowledge for the greater good. Second, a sage plant is an aromatic herb plant native to California which identifies our presence in the San Francisco Bay area.

What does your Logo stand for?

The SAGE logo is comprised of a shield to stand for protection, a paw print to identify our commitment to small companion animals, a leaf to illustrate the sage plant (and our name), and the colors of sage green and brown to represent our ‘down to earth’ CA presence.

Is there parking at the practice?

Yes! Our hospital parking lot is right next to our facility. If you need assistance with bringing your pet in, please call upon your arrival, and we’ll have a staff member come out to meet you to assist.

Can SAGE be my regular veterinarian?

We do not offer routine preventive care such as wellness exams, vaccines, dental cleanings, and spays and neuters. Our doctors act as an extension of your primary veterinarian to ensure the best veterinary care for you and your family.

Do you offer euthanasia and cremation services?

Yes, in the unfortunate event that your pet does not survive his or her current illness or accident, we offer painless euthanasia services 24 hours per day. You may choose to be with your pet at the end if you wish. If your pet passes away at home, you may bring them to SAGE as we provide communal or private cremation options for your pet’s remains. Our staff will explain all of the options available to you at the hospital, so you can make the best choice for your family. SAGE provides a free Pet Loss Support Group to our clients as a safe place to help with grief.


Payment FAQs:

Can I get a specific quote over the phone?

Each estimate is based on your individual pet’s needs. It’s best to meet with the specialist for a specific estimate, as they will have a better idea of what tests or treatments your pet will need. By coming in to have our doctors meet with you and your pet, you will learn more about your pet’s health yet are not obligated or committed to any course of treatment.

What are some costs of services?

For specialty appointments: The initial specialty consultation fee is $140 and a recheck fee is $80. If your pet needs to be seen on an urgent or emergency basis, there may be an additional $50 emergency fee. If your pet requires an additional specialist to consult on your pet’s condition, there may be an additional specialist consult fee.

For emergency visits: If coming through our emergency department, there is an emergency fee of $50 and an exam fee is $55.

Diagnostics, medical procedures and hospitalization costs are additional charges on top of the above fee(s). We will provide and discuss the initial estimate for the cost of your pet’s care. An initial payment of the low end of the estimate is due when your pet is admitted to our hospital. We strive to keep the costs within this estimate range.

If your pet’s condition changes, we will call you with an updated treatment plan and an updated estimate which will include any recommended tests and treatments. We will review the updated estimate in whatever format will allow you to ask any questions and gain understanding whether in person, email, or fax based on your needs. Upon your approval and consent to begin treatment, a pre-payment will be requested for any additional services.

How do I pay for services provided by SAGE?

An initial payment of the low end of the estimate for services is required with payment in full due when your pet is released to your care. We accept cash, checks, Discover, MasterCard, and VISA. We understand that veterinary expenditures often are unplanned, so we offer the option of CareCredit, a convenient payment plan that allows you to make installment payments at competitive interest rates. Applying for CareCredit is quick and easy. Please ask our Client Service Coordinators at the front desk how to apply. The application form takes a few minutes to complete, and you will receive notification of your approval quickly. Or, you may apply online at www.carecredit.com prior to your appointment.

Do you accept pet insurance?

Yes we do. Please bring in your insurance company’s claim form for the doctor to complete. You may need to submit your claim form with itemized invoices to your insurance company within a set amount of time from your treatment date.

Alternative Medicine FAQs:

What is an acupuncture meridian?

A meridian is a channel that circulates “qi,” (pronounced chee) or the body’s vital energy. From a Western perspective, these “qi” pathways are closely associated with blood vessels, the lymphatic system, muscles, and the nervous system. The superficial meridians, located just underneath the skin, are accessible to acupuncturists and connect with inner meridians that serve the internal organs. Acupuncture points are located at specific points along these meridians and are areas that when examined microscopically are found to contain high concentrations of nerve endings and small blood vessels. By treating points on the meridians, an acupuncturist can have a local effect (treating pain or increasing circulation for example), a distant effect (to areas located along the same meridian), or in some cases, affect internal organs.

How will my pet sit still for acupuncture needles?

Many people are surprised to see how well most pets tolerate acupuncture needles. Usually the first needle placed is a calming point (also called a “permission point”), which helps the pet relax. The needles are very small gauge, and most pets lie quietly with them in place. They can lay down if they wish to, and can also move around some if they want to – they don’t have to be absolutely still. For those few patients that don’t tolerate needle placement, other options are available like using a cold laser to stimulate the points without needles.

How is a cold laser used in an acupuncture session?

The cold laser is a tool frequently used in rehab (for both people and pets). It can be used to gently stimulate acupuncture points and meridians in patients who don’t tolerate needle placement well or who can’t sit still for a prolonged acupuncture session.