Advanced Veterinary Internal Medicine

Don’t ever use Advanced Veterinary Internal Medicine (AVIM) in Tustin! We were referred to this place by our vet (Cypress Dog & Cat Hospital — love them!) as an ultrasound was ordered for our Chloe. $$$ later, we were told that her lab results would be available on Wednesday, June 29^th, however, the Dr. that performed the tests & ultrasounds would be off that day so it would be delayed until today.
After waiting until 11:40 I called them. Dr was out again today. If I consented, they could have another Dr. call me with the results. Duh! Of course! If I hadn’t called, they would not have bothered to call me! They indicated that the Dr. would call me after the morning rounds. It’s now after 2PM and still no call. Of course I’ve been calling them to see when I will be called. I finally told them to email me the tests results. And yes, I still want the Dr to call me.
While they may do these kinds of tests day in & day out, I don’t. This is our beloved Chloe. The lack of empathy as well as professionalism blows my mind. In jobs that I have worked, if I was’t going to b there on a day where action was needed in my absence, it was assigned to someone else. Work doesn’t stop just because you took a day off. Not if you want your operations to run smoothly.
My heart aches & because of my familarity in medical tests, I need to see & read what the actual diagnosis is. It may be one of my shortcomings, but I paid for it — give me the damn results!

I cannot say enough about the compassion and quality of care at Advanced Veterinary Internal Medicine.
My adorable, loving cockapoo, Buster, was viciously attacked by a St. Bernard. I rushed him there and they immediately scooped him up and went to work on him. Dr. Duesberg and Dr. Cambridge cared for him night and day. He had to have a second surgery a couple of days later. Everyone from Ari and Dani at reception to all of the doctors and techs were loving and compassionate. I never had to worry about his care. When the time came that he could no longer fight, they were honest and let me know. I held Buster in my arms while they put him to sleep. They tried so hard to make my friends who were there with me and me comfortable during the process. I received a call that afternoon from Dr. Cambridge and a card from all of the techs.
If you have a pet emergency, this is the place you want to be. If I could give them 10 stars, I would.

Thank you so much for being so patient and kind to Creamie and our family. we had to make the difficult decision to let her go as she is and will always be «our forever baby» being that she’s a small little bundle of joy.
Your staff and doctors are wonderful and the facility is so clean and nice. It helps to be surrounded by kindness and understanding people. It would have been an aweful experience if the staff were mean, emotionless, and irritable… which I have seen before in other offices.
I would like to share a video that my sister DT Pham did yesterday… to show our happy last moments with our baby Creamie. She had a wonderful 17 years with us.

I couldnt be more grateful to Dr. Duesberg, Short, Cieplucha, and Vorathavorn. WIthout them and there fantastic staff I wouldn’t have my pet by my side. Me and Munki will always be thankful for all your kindness.

After a recent scare with our beloved Buddy, our regular Vet (the AWESOME Dr. Roellinger at Irvine Pet Complex) referred us to an Internal Medicine CRITICALIST at AVIM. They got us a same-​day appointment (within hours), and emailed me the paperwork so that I could email it back and not spend time filling it out in the office. They got all of Buddy’s medical records from our primary vet, and were ready to assess him when we arrived. Dr. Short was FABULOUS! So loving, attentive and THOROUGH. She obviously cares deeply for her patients, and checked all possible scenarios (checking for back pain issues, although we initially assumed stomach pain, since the two can be closely related). The office /​reception area was clean, they asked whether we preferred to wait in the reception area or in an exam room, and had a variety of complimentary beverages available, should you want one.
After additional tests and recommendations, we were sent home (Buddy had started to perk up a little, after all of the examinations /​prodding). Both Dr. Short and the office staff called several times to follow-​up on Buddy’s status over the next WEEK.
I hope we don’t require another emergency internal medicine specialist, but if we do, I’m glad to know they are around the corner, and can be reached ²⁴⁄₇!

AVM pet hospital is simply the best in caring for s pet. I brought my rat terrier in when he was in crisis. The competent Vets saved his life and he is now recovering. I am forever grateful and will refer my friends and family.

These people are THE experts. They find things and fix things average Dr’s can’t and don’t. If you want the best, for a difficult to diagnose dog or cat, Cindy Duesberg is the competent answer. For ortho surgery, Tony Cambridge is tops. These people are serious Dr’s that put others in their respective fields to shame. I have never recommended them to anyone who was not blown away by what they can do. I am convinced they have saved two of my dogs over the years when it was clear after repeated visits and worsening conditions, that regular local vets were out of their leagues. Pay more and get the best and know that you have done everything possible.

I have been a client of AVM for almost two years, and have had a very sick pup on my hands throughout that time. I have a few up front thoughts to share about the process of seeing a specialist generally, and then will go into a review of AVM specifically. This is a long post but I hope my experiences will be helpful for you.
First, a few things to keep in mind if you are seeking out specialist care for your animal:
1) Cost — going to any vet specialty group is akin to seeing a specialist physician for humans. If you don’t have pet insurance its going to be expensive. Bottom line: if your pet has a condition that requires a specialist get ready for big bills. Doesn’t matter what specialist you see.
2) Be Proactive — Be your pet’s (and your pocket book’s) advocate. Ask lots of questions. Research your pet’s condition/​s and develop a working knowledge of it. Ask the vet questions about what you’re hearing from them and make sure you understand what they are saying. Get to know all the doctors in the practice and go with one you like and trust. Rapport is really important. Also, get a second opinion if you can. Bottom line: don’t be a passive patient. Be involved.
3) Emotion — If you can, bring someone with you to appointments so if you freak out there is someone to ‘hear’ what the vet is saying. If you love your pet as much as I do, you will likely shut down a bit in the face of bad news. Bottom line: Have someone on hand to be your eyes and ears.
So, on to AVM. My pup, Jax came to AVM with some sort of muscle degeneration issue. Possibly genetic, possibly due to something ingested. We never found out. But, Dr. Duesberg, with whom I worked closely, did about every test imaginable to figure out what was up with Jax and we were able to start a treatment course that gave him and I many months of good health and fun times together before we had to put him to sleep.
I found Dr. Duesberg very accommodating and the more involved I was in learning about what was up with Jax the better result I had at AVM all around, and I think this goes back to #s 2 & 3 above — I tried as much as possible to ask questions, listen, learn and stay calm even when my dog was very, very sick and I was feeling desperate to save him. I should note there were several check ups where I simply couldn’t afford the tests that should have been done like bloodwork and xrays. I knew they were warranted, but Dr. Duesberg was really good about helping me prioritize based on what I had been seeing with Jax at home (energy level, appetite, etc.) and what I could afford.
I saw Dr. Duesberg, Dr. V, and Dr Chung at AVM. I liked them all, but clicked best with Dr. Duesberg. She is calm, forthright, and clear-​headed in her explanations. She is also compassionate but not overly so (if you’re looking for melodrama in your vet she’s not your gal). I liked her no-B.S. bedside manner especially when Jax was at his sickest. She is a damn smart diagnostician, although not dispassionate: she cares about her patients 24/​7, not just during business hours. I received several calls from her regarding Jax’s food and meds aside from our appts and I spent quite a bit of time on the phone with her vet tech, Tina, figuring out feeding issues and licensing issues as Jax could not be vaccinated. In fact, Tina filled out all the county licensing paperwork for me, mailed it to my house, and then followed up with me and the county when the county flaked out. One of my favorite AVM stories: I dropped by unannounced, for an unscheduled weigh in for Jax and the team was looking for his (very thick) chart, only to realize that Dr. Duesberg had taken it home with her the previous evening to review, and it was still with her. Not my type of riveting bedside reading, but I’m pleased it was hers!
Overall, I had a very positive experience with AVM, even though I had to put Jax to sleep a few weeks ago. His condition was never going to be curable, sadly, and putting a pet to sleep is awful. The decision was made much easier because of the extensive work AVM did on our behalf. We kept Jax pain-​free and happy for many more months than he would have been otherwise.
I also received a lovely note from a non-​profit called the Animal Health Foundation (AHF) yesterday. AVM contacted my primary vet and together they both made a sizable donation to AHF in Jax’s name. AHF helps all sorts of people with medical bills for their pets — people who otherwise couldn’t afford to keep their pets such as seniors, people on fixed incomes, etc. I loved that gesture so much. So much.
So…long post, I know. In closing, I would highly suggest Dr. Duesberg and everyone at AVM if you’re looking for a specialty vet group. Please do keep in mind #s 1 – 3 above, and most of all: good luck!

The doctors at AVIM killed both of my dogs within 6 months!
I really don’t have any positive feedback to give but to say I thought my dogs were under the best of care. We were seeing Dr. Chung for about 4 years to help keep my dog’s Cushings’ Disease under control. Turns out it wasn’t the Cushing’s that killed my dog. Dr. Chung’s explanation for my dog’s condition (which she didn’t give me a concrete diagnosis) was it’s part of the breed (chihuahuas). After spending thousands of dollars, I feel that is not a good explanation for her condition. She gave me the same explanation of my other dog’s condition who passed about 5 months earlier, that it is part of the breed (chihuahua). Really?
Here are my lists of CONS:
1) Quarterly visits:
When I would go in to get my dog’s quarterly tests done to determine whether her cortisol levels were in the therapeutic range, I never got to see Dr. Chung. It was always the vet tech. The only time I did get to talk to her was over the phone to tell me the test results. There is no good patient/​pet to doctor relationship. And I had to call for the test results. My dog was on trylastene.
2) Poor communication between staff and doctors:
There were many experiences, but the one that stands out is this one. At one point when my dog was in dire help/​support, I thought I could reach out to my specialty vet, and all she could do was discourage me from bringing my dying dog in to the office. I needed their help in trying to get my dog to eat as she was not eating for days. Dr. Ciepulha (filling in for Dr. Chung that day) said, «You know your dog the best». So in other words, you can figure out how to get her to eat… very frustrating at the time, since I had all the trust and hope in the world that these vets could help and that is the advice she could give me…
3) Unfriendly Staff (NO CUSTOMER SERVICE — don’t expect Nordstrom service like you do at VCG and VSG)
With an exception of 2 female staff and the fill in staff (Adam at VCG), the staff here are very unfriendly and not patient oriented at all. Never received a welcoming feeling here. Not like at VCG (Veterinary Cancer Group) and VSG (Veterinary Specialty Group) next door.
4) Vet Expertise/​trained staff:
I feel Dr. Chung should have operated on my dog at the time where we noticed considerable change, but she opted not to, thus helping to increase the likelihood that we would lose my dog. We were reluctant, but felt we had no choice but to get a second opinion, a month later, which was too late as that vet did operate to find some issues contributing to my dogs disease and at that time my dog was too ill to recover from it. As a result of getting the second opinion, I never heard back from Dr. Chung and didn’t even get a condolence note in their card to me.
I, too, feel with my other dog and his abrupt death, a transfusion was ordered. I called an hour early to see how he was doing from the transfusion, Everything was going well up until an hour later, they said he was having a difficult time breathing… Not sure how trained the techs are, but was told with a transfusion, the pet must be closely monitored throughout the process. Was he?
5) Refund Dispute:
In writing I was given the amount refunded to me, and then the office sent me by mail half the refund amount with no explanation. When I called the office, all they could say was, didn’t someone call you to explain the charges.(poor communication again) Very disappointing after losing not only one dog, but two within 6 months care with AVIM. I asked to see in writing the amount they feel was not charged and they sent me a bogus invoice. The invoice date was made up (I wasn’t there to receive vet service at the time), and the itemization was ridiculous charging dollars and pennies to equal the refund amount sent to me. Looking back at my records, It was also astonishing to discover I was charged 3 night stay ($ 3,000) and a 1 night stay ($ 3,000) — same cost… The explanation for the deposit was that the office was having issues with the computer and I wasn’t charged enough, so they deducted half from my written refund.
6) Lastly, after 6 months from the passing of my last dog, I received an email from AVIM and their service/​YELP/​Etc. wanting their patient input. I asked to be taken off the email contact list. They had the audacity to call me and ask why??? DUH!!! Need I say more???
I DON’T RECOMMEND THIS SPECIALTY VET OFFICE to ANYONE!!!

We took our beagle in because he broke into his hidden food storage bin while we were running errands and ate what I can only assume was his weight in food. He was experiencing signs of bloat. The staff was nothing but friendly on the phone as well as in person. They never even suggested it was our fault or made us feel like we’d done something wrong, as I think you always feel when you have to rush your dog to the vet. The facilities were clean and welcoming and everyone we dealt with was nothing but friendly and helpful. We were there for a couple of hours as they took care of our pup, but the time went by relatively fast. I hope we never have to take him back, but if there was ever another episode that required immediate attention I would not hesitate to take our boy here. Thanks to the staff for being diligent and taking good care of him.

I took my dog, Linus, to AVIM from May 2013 through March 2014. When Linus was found to have liver disease, my regular vet had a real laid back attitude, as if they expected him to die. I took him to AVIM and I was able to have 9 more months with him. Drs. Chung & Duesberg as well as the overnight vets were professional, informed, compassionate and helped me know that I did everything I could for my little guy. Yes, they are expensive. Specialists always are. They have the extra training, expertise and equipment. They try to help offset the costs with a program that, while it costs to join, I know I saved a lot of money using it.
The vets were very good about calling me about Linus’ tests and follow-​up. No, they didn’t always call as early as I wanted, but I had to remember there were other animals who needed their attention too. If it had been an emergency, I have no doubt they would be on the phone to me in an instant. Often they called just to check on how he was doing at home.
The bottom line for me was my 3 year old pup. For a while, he responded to treatment but then pancreatitis on top of the liver disease took its toll. The doctors and staff helped me do hospice at home with him, keeping him as comfortable as possible. I would go back in a minute if Linus’ sister Lucy gets sick.

Love them all. They saved my dogs life!

Verdict: Avoid AVIM at all cost (as it WILL cost you dearly). It’s difficult to tell if the people who work at AVIM actually do it because they love animals, because from the way they act, they’re only there to make money off of your pets. There are better emergency animal hospitals out there.
PRO: Dr. Sebastian, from the Veterinary Surgical Specialists located next door, saved our dog’s life last fall. He is a total professional and really the only person in the whole hospital complex who gave us realistic information. Dr. Chung was overly optimistic about our pet’s chances for survival and Dr. Deusberg didn’t think that after 3 days post-​op in the hospital was enough, or that our home round-​the-​clock post-​op care would be better for our dog.
CONS:
–Be prepared to pay exorbitant prices. We’ve spent about $ 10k at AVIM. They know they can charge a lot because they know pet owners love their pets because they’re our family members. They exploit this and there’s no kind of oversight that checks this price gouging at all.
–At the same time, be prepared for terrible customer service. Despite having spent so much already, if you don’t keep spending money at the hospital (and go back to your local vet), they could not care if your dog’s medication runs out and dies. Also, no one who works there seems to know how to crack a smile.
–Appointments don’t count: they will keep you waiting for AT LEAST 45 minutes of your scheduled appointment time if you’re not there for an emergency. Aside from our initial visit, all follow-​up appointments have lasted 2 hours each time due to long wait times.
–They never call — YOU have do all the follow-​up. During post-​op, we expected the doctors to call with a report every morning since they promised they would. Silly us, we usually never heard until the late afternoons, and that was only because we’d called several times earlier in the day to get a status report.
–Unnecessary diagnostics: For follow up exams, they give your pet a physical as well as a specific urinary test… even though you’re getting a blood test as well. Why? My dog doesn’t need a urinary test. Answer: because AVIM says it’s required.
–Cleanliness: On one of her visits, my dog pooped on the waiting room floor. I picked it up with a baggie and threw it out. But when I asked one of the front desk assistants if they had any antibacterial wipes or bleach so I can wipe that area, she just stared blankly at me. I can only wonder how they clean up the rest of their clinic…
–Post-​op care/​the back room: Yes the care is round-​the-​clock, but your pets are kept in cages and the lights are on ²⁴⁄₇. It’s not a quiet space for your pet to recuperate — people are shuffling about and other dogs are whiny/​barking/​etc. As soon as your pet is able to go home, TAKE THEM HOME — it’ll get better rest and care there and it won’t cost you a fortune.

We had taken a couple of dogs to AVIM quite a few years ago and had an excellent internal meds specialist. So when we found out in 2012 that one of our dogs had a nasal tumor, we decided to go back to AVIM. We live on the central coast, so it’s a 3 ½ hour drive for us; but there really aren’t any vets around us with the expertise and equipment that is available at the specialty vet medicine campus in Tustin. Before we made the drive, we have a phone consult with Dr. Duesberg; I don’t remember if we were charged for it or not. Anyway, we decided to take our dog to the Tustin specialists, starting with Dr. Duesberg. There were only 2 internal meds specialists at the time, so they were extremely busy; however, Dr. Duesberg, the vet techs and the office staff were wonderful about accommodating our schedule because of the travel time.
We think Dr. Duesberg is one of the very best internal meds specialists around. She was very thorough with several diagnostic tests to be sure our dog could go thru treatment for the nasal tumor before she referred us to a wonderful oncologist (Dr. Bommarito) and a wonderful surgeon (Dr. Cambridge) to try to save our dog’s life. She was very straightforward about our dog’s prognosis; she didn’t try to sugar coat it. She routinely tracked our dogs progress and condition and worked with the oncologist and surgeon.
We don’t think our dog could have gotten better care anywhere. Yes, it is very expensive; but we’d rather spend our money on trying to save a beloved pet than anything else in the world. We feel very lucky we had the money to pay the vet bills and that our dog had such great care.

I am so grateful to AVIM for the wonderful care that my dog, Josie, has received from Dr. Cieplucha and the whole staff at the hospital. We were looking at a possibility of bladder cancer. Dr. C was very thorough and, luckily, the diagnosis was not cancer. Dr. C worked closely with my regular vet. I can’t say enough about AVIM. Not cheap but I would recommend Pet Insurance to anyone. Thanks again AVIM and Dr. Cieplucha.

It is expensive, but they are very thorough. Hopefully if you are reading this review you have pet insurance… otherwise ‘ouch.’ Our pup is doing a lot better after a 2 day stay, they are the best specialists in OC.

I will say that Dr. Duesberg and Dr. Chung played a hand in saving Gideon’s life when he was a pup, but that being said the recent care we received was not of the same caliber in my estimation. Gideon developed breathing issues and Dr. Chung determined that it was asthma and took him off his inhaler and put him on a nebulizer. Gideon’s breathing worsened on the new treatment and every time I called to talk Dr. Chung (five times) my calls were either not returned or I was told by a vet tech or receptionist that the only option was a $ 3000 nasal scope. It also took them several days to call in a refill for his nebulizer. When i got a second opinion I found out that the nebulizers medication Albuterol, is not usually used daily due to it restricting the airways when used on a daily basis which explains why Gideon was doing worse on the new medication. Needless to say I am angry. Though I liked most of the support staff, there were issues. They scheduled me for appointments on different days than we agreed upon and at times the hospital was unorganized. One of my routine appointments kept me there for over four hours. Yikes!

They killed my cat!
She was being very finicky about food and was losing weight, but there are lots of other options to get food into them besides feeding tubes.
She had a «stroke?» coming out of anesthesia. She could barely move when we went to see her.
She died.
Dr. Chung, the one who performed the operation, never even called me to say «sorry for your loss». No flowers, no card, nothing!
Dr. Deusberg was nice, though. She called me to tell me at 3:45 in the morning and sounded apropiately saddened.
It cost me over $ 6.000 for them to kill my cat over 3 days. Horribly traumatic.
Don’t go there if you have other options.

I have been taking my BullMastiff ‘Tootsie’ there for almost 6 months now. I have always had great, compassionate service from the staff and from Dr. Chung. They have always been very professional and willing to help, and they explain procedures in detail. It is an hour drive each way from my home to their office, and I have never waited more than 5 – 10 minutes for my appointment. We were originally referred from our ‘normal G/​P’ Vet for further diagnose… we are very grateful to have been referred to such fantastic Specialists in their field that have been able to help out Tootsie!

We ended up here as a referral from the surgical center in the same building.
Pros:
The vet was thorough in their testing and we were able to find out that our cat had a serious infection that two other vets failed to discover. The staff was also friendly.
The place is clean and the vet is very knowledgeable and thorough.
Cons:
It’s very expensive to the point that our pet insurance had to re-​negotiate the reasonable rates and we ended up out of pocket way more than we expected.
Some of the other frustrations were that they told us they would follow up on certain things, and ever did. We had to send several emails and call to get resolution on items. When we expressed that we were frustrated that we had not heard from our vet or anyone, we didn’t receive a response.
The main problem is communication with the vet after the fact and getting answers and follow up.