A Different Breed of Medicine

A Different Breed of Medicine
Kelson Danielson, a resident in small animal surgery at the UW’s Veterinary Medical Teaching Hospital, holds Clarabelle.

Emergencies aren’t convenient. No one plans for their dog to get sick in the middle of the night or for their cat to need a blood transfusion on Memorial Day. But when these crises happen—and they do—Madison has a fleet of veterinarians ready to help at any hour of any day.

Emergency medicine is a different way of practicing veterinary care. It’s more than nontraditional hours and complex equipment. These vets see animals at their most gravely ill or injured, as well as pet owners who didn’t anticipate rushing their dog or cat to the hospital. And sometimes, these vets are a last resort for animals that have run out of options.

Emergency and specialty clinics began multiplying around the country—and in Madison—a decade ago as pet owners sought more sophisticated care for their animals, from cancer treatments to organ transplants to orthopedic surgery. But the recent recession has forced several clinics to close or reduce services.

It’s not a life for every vet. And providing such care continues to have its challenges. But the four organizations in Madison that offer emergency and specialty services have no intentions of stopping.

When Mark A. Koeppl started doing emergency work near Boston in the 1980s, the area of veterinary medicine wasn’t popular. “No one wanted to work nights, weekends and holidays, facing down the hardest cases in the worst possible scenarios, be they financial, emotional or logistical,” he says. At the time, most clinics took a “Band-Aid” approach of patching up animals till their regular vets could see them.

Yet one aspect of critical care appealed to Koeppl and has stayed with him working at Exceptional Care for Animals. “You could do something right now and make a difference,” he says.

Originally called Emergency Clinic for Animals when it opened in 1980, ECA was Madison’s first animal ER and today provides twenty-four-hour urgent and critical care with an in-house laboratory and blood bank and the ability to perform surgery, endoscopy, laparoscopy, radiology and ultrasounds.

The clinic opened a second location in Sun Prairie in early 2007, but closed it last June following the economic downturn. The business’s four shareholders decided to refocus on one central location—with one core staff of twenty-five employees and one set of equipment. “One of our founding missions was community service,” Koeppl says, adding that being accessible is a big part of that goal.

And they’ve remained busy: The clinic sees thousands of sick and hurt pets each year. “There is no such thing as an average day,” Koeppl says. “I’ve never seen a case twice in twenty-five years.”

ECA also caters to wildlife. From the start, Koeppl felt a responsibility to create a place where anyone could bring an injured animal to be treated free of charge. “It seemed like all of those animals were hurt because of [humans],” he says. “Any wildlife that’s injured, it’s on us to help them.”

229 W. Beltline Hwy. 274-7772

While the UW School of Veterinary Medicine and its Veterinary Medical Teaching Hospital have been around since 1983, the hospital began offering around-the-clock emergency services only in late 2008.

“We’re the new kid on the block for emergency,” says Jonathan Bach, a clinical assistant professor at the vet school and section head of emergency critical care at the hospital.

Providing 24/7 emergency care benefits more than area pets and their owners. It also aids vet school graduates looking to specialize. Participants in a highly selective, yearlong internship program—260 vets recently applied for four spots—staff the hospital, which sees roughly 140 emergency cases a month. The heavy caseload allows interns to gain valuable experience before moving on to a residency or practice.

That’s a good thing, says Bach. The ability to handle oneself in a crisis is a crucial skill for any vet. “General
practitioners are faced with emergencies,” he says. “Nobody plans for an accident.”

The hospital also boasts fifty-one board-certified veterinary specialists, the most in the state. Cardiologists, dermatologists, oncologists and more see patients at the hospital and are often on call for specialized cases. And they teach and conduct research within the vet school, too.

Altogether, the hospital’s vets are prepared for nearly any emergency involving a dog or cat. “We do everything,” Bach says. “We’ll take pretty much any case, whenever.”

2015 Linden Dr. 263-7600

David Wirth worked in both general practice and emergency medicine before opening his Veterinary Emergency Service in Middleton in 2003. A native of Madison and graduate of the UW vet school, he saw the opportunity to bring a clinic to the area that would emphasize patient interaction, the imporance of which he learned in day practice.

He opened a second branch in 2007 on the east side, which expands from night and weekend service to twenty-four-hour care starting May 1. Wirth has found that operating around the clock is most useful to patients. Often, on weeknights and weekends owners have more time to observe their pet, and this is when they notice something is wrong.

“In general, animals try to mask their illness as long as they possibly can,” Wirth says. When dog or cats show any signs of abnormality, they probably are sick, he adds. And it’s time to bring them to a vet.

Working in critical care takes a toll on vets and their staff, as most of their patients are in bad shape. “We don’t see puppies coming in to get their shots,” Wirth says. “We see more animals pass away or put to sleep. It’s hard.”

The unexpected nature of emergencies can also be hard on the pets’ owners, a situation sometimes compounded by the cost of care. Wirth and his staff work to keep costs down for their patients, but emergency services are simply more expensive than standard vet visits—due to staffing all hours of the day and night and maintaining a blood bank as well as a variety of medical devices.

“In an emergency, we have to have the equipment to do everything,” he says. “We can’t afford to have it not working.”

1612 N. High Point Rd., Suite 100, Middleton. 831-1101
4902 E. Broadway. 222-2455


Veterinary Specialty & Emergency Care started out in 1999 as Surgical Options, a practice centering on orthopedic and soft-tissue surgeries. But the name and focus changed in 2005 when John Silbernagel joined. The surgical specialist and CEO added other specialties and all-hours emergency services on the principle that the two areas of veterinary medicine go hand in hand. He also believes they complement the work of general practice veterinarians. “It’s an extension of services,” he says.

The practice moved to a 23,000-square-foot, eco-friendly building in early 2007, but the slow economy prompted the closing of its emergency services in 2009, which reduced its staff to fifteen. It’s a decision Silbernagel regrets—and is working to reverse. He plans to have emergency services back up and running as soon as possible.

Currently, VSEC employs specialists in surgery, internal medicine and ophthalmology. “We are the only group in town with board-certified specialists other than the vet school,” Silbernagel says. Some pet owners don’t realize the significance of board certification. Those doctors have graduated from vet school, completed a yearlong internship and three- or four-year residency in their area of expertise and passed a rigorous set of exams. “Practitioners who do surgery are not surgeons,” he adds.

Specialty services can be costly, but Silbernagel tries to educate his clients about the range of options available for their pets, and then provide the best outcomes possible. “Value is the perfect way to put it,” he says.

1848 Waldorf Blvd. 845-0002

Katie Vaughn is associate editor of Madison Magazine.