Internal Medicine

Internal Medicine

Internal Medicine

Peak Veterinary Referral Center’s Internal Medicine Department provides specialty care, diagnostics and treatment of medical diseases in dogs and cats. Our board-certified internists, Dr. Marielle Goossens offers a variety of referral-based services for pets with complex diseases, multiple diseases, and diseases requiring intensive care. The knowledge and expertise gained during their years of advanced training allow them to diagnose and treat complicated and chronic diseases as quickly and efficiently as possible. Peak Veterinary Referral Center offers a complete internal medicine service including evaluation and treatment of referral cases in endocrinology, gastroenterology, hepatology, nephrology, urology and pulmonology. Together with our cardiologist and oncologist, Peak Veterinary Referral center offers the highest level of expertise in internal medicine in the state of Vermont and northern New England.

By referring your pet to a specialist, your veterinarian demonstrates a high level of care for the well-being of your pet. Patients are often referred for advanced diagnostics and treatment unavailable to your veterinarian, or for an experienced second opinion on difficult or unusual cases. Due to the complex and chronic nature of many of our cases, we promptly communicate with your veterinarian, allowing a smooth transition of the continued care of your pet. The internists, referring veterinarians and owners work as a team to optimize care.


New patient and recheck appointments are available Monday through Friday. Emergency referral is also available on these days, and our internists are available 7 days a week for the care of hospitalized patients in our 24-hour state-of-the-art facility. In-house consultation with the Internal Medicine Department is also available when your pet is seeing another specialist at our hospital.

The initial consultation, including a thorough medical history, physical examination and discussion of diagnostic and therapeutic options, generally takes one hour. Following this, consultation, diagnostics and procedures will be performed. Procedures can often be performed on the same day as the consultation, when medically appropriate.  To facilitate this, please withhold food on the morning of the appointment (unless your pet is diabetic, very young, or food cannot be withheld for medical reasons). Water should always be available to your pet. Medications should be administered as previously directed on the day of the appointment unless directed otherwise.

To avoid delays on the day of the consultation, please ask your veterinarian’s office to fax medical records for your pet before the end of the business day on the day prior to your pet’s visit. In addition, bringing all x-rays, medications and prescription diets with you on the day of your consultation will facilitate our evaluation of your pet.

The forms below may be downloaded and faxed or e-mailed ( prior to your appointment, or you may complete them in advance and bring them with you on the day of the appointment. If you wish to complete these forms on the day of your consultation, please arrive 20 minutes early to allow time for completion.


Common procedures performed include:

  • Bone marrow aspirate and/or biopsy
  • Endotracheal wash
  • Arthrocentesis (joint taps)
  • Upper and/or lower gastrointestinal endoscopy and biopsy
  • Rhinoscopy and biopsy
  • Foreign body removal (esophageal and gastric)
  • Feeding tube placement (nasal, esophageal and PEG tube)
  • Bronchoscopy
  • Fine needle aspirates
  • Urinary endoscopy (cystoscopy)

Client Registration Form

Internal Medicine History Form

Meet our Specialist:


Marielle Goossens, DVM
Diplomate American College of Veterinary Internal Medicine

Dr. Marielle Goossens was born and raised in the Netherlands and received her DVM degree from the Utrecht University in 1993. She completed her small animal internal medicine residency and board certification in 1997 at the University of California in Davis. She practiced in the San Francisco Bay area for 8 years, before moving to the East Coast and practicing small animal internal medicine in New Hampshire and in Vermont for the past 10 years.

Dr. Goossens loves all aspects of internal medicine and has a special interest in endocrinology and critical care patients, particularly delivering care to pre- and post-operative patients.