Frequently Asked Questions

For an idea of appointment flow, VeterinarySpecialists.com has a summary of a typical appointment (written by our own Dr. Luisana):  A Comprehensive Walkthrough of a Nutritionist Consultation  

We work with dogs and cats of all kinds! Nutrition appointments can be for both healthy and ill pets. Most patients fall into one of the following categories:

• Pets that have multiple medical needs and therefore have complicated nutritional considerations.
• Pets that eat a non-traditional diet such as a homemade diet. These require precise analysis to avoid nutrient deficiencies or excesses.
• Pets that have difficulty losing weight and may risk nutrient deficiency if they continue caloric restriction without diet analysis.
• Pets with owners that wish to have detailed conversations about their pet’s nutrition that may be outside the scope of a primary care veterinarian or a specialist in another area of veterinary medicine.
•  Please note that all recommendations provided are advisory in nature, with ultimate clinical decision-making deferred to the attending veterinarian.  

• Acute and chronic enteropathies/ gastrointestinal disease
  • Chronic/ intermittent vomiting, diarrhea, constipation, etc.
  • Protein-losing enteropathy
• Acute kidney injury
• Anorexia/ dysrexia/ hyporexia
• Canine cognitive dysfunction
• Cardiovascular disease
• Chronic kidney disease
• Diet-responsive/ food allergic disease
  • Dermatologic and GI manifestations
• Electrolyte abnormalities involving:
  • Calcium
  • Potassium
  • Sodium
• Feline lower urinary tract disease (FLUTD)
• Hyperlipidemia
  • Includes managing elevated triglycerides, cholesterol, and/or chylomicrons
• Hypertension
• Liver disease
  • Including acute and chronic liver issues, portosystemic shunts and liver failure
• Megaesophagus
  • Other motility disorders
• Neoplasia/ cancer
• Obesity
• Orthopedic disease
  • Including osteoarthritis and developmental disease
• Pancreatic disease
  • Includes pancreatitis and exocrine pancreatic insufficiency
• Proteinuria
• Uro/ cysto/ nephrolithiasis (urinary stones)

We are happy to create homemade diet plans for our patients! Although it is common to cook for ourselves, creating balanced, healthy meals for our pets is a different challenge, even more so if you have a pet with special health needs. 

Nutritional deficiencies and excesses may not show obvious clinical signs for months or even years but can prevent our pets from being in their best health. Our Clinical Nutrition team reviews patient records, meets with owners to discuss their pet’s needs, and creates recipes based on health needs and owner/patient preferences. All recipes will be examined for 40+ nutritional components to ensure it meets our recommendations and avoid deficiencies/excesses. Please note that homemade diets carry additional fees as they take additional time to tailor. 

1) Please fill out the Pet Owner Interest form found under 'Pet Owners'.

2) Reach out to your veterinarian for a referral. 

3) After we receive your form, we will reach out with scheduling and deposit information. Kindly note that prepayment for an initial appointment is required in order to schedule. See below for cancellation policy. 

Please note that we operate only on a referral basis and cannot give medical/dietary advice to pets that we have not been established as a patient. 

Our goal is to provide simple, transparent pricing. Prices for add-on services vary depending on the complexity of the service requested. See 'Pet Owners' tab for pricing. 

We understand that schedules can change and strive to be as accommodating as possible. To ensure fairness and availability for all clients, we have the following cancellation policy for the initial appointment:

• More than 14 days prior to your appointment:
  You will receive a full refund, minus a $50 administrative/processing fee.
• Within 7-14 days of your appointment:
  You will receive a 50% refund of the appointment fee.
• Within 7 days of your appointment or missed appointments:
  No refund will be issued, but the appointment can be rescheduled. 

If you need to cancel or reschedule your appointment, please contact us as soon as possible.

Please fill out a Referral Form and have patient records sent to us. 

If you are seeking assisted feeding plans (such as e-tubes) or vet-to-vet consults, please fill out a Hospital Establishment form first and contact us to finalize your account. 

The following are included in a typical initial appointment:

• Record review: Included with each appointment is a review of recent/pertinent records (typically the last 12 months). We recognize that patients may have several care providers and some may have extensive records. If there is something that you want to ensure we review, please discuss this during your appointment. 
• Nurse intake call: To ensure we have all needed information, review goals, and maximize time with the doctor, our nurse team will call you 1-2 weeks prior to your initial appointment. 
• Appointment time with the doctor: We will discuss our best nutritional recommendations for your pet. For new clients, these last typically 30- 45 minutes. 
• Written write up: Typically, within 1 week following your appointment you will receive a written summary of recommendations (minor delays may be seen if additional information/research is needed or due to holidays). Prescriptions or links for recommended diets can be provided. 
• Immediate follow up: Our staff will call 1-2 weeks later to see if you have any questions or concerns. Reassessments of plans will be recommended to have as a recheck with a nurse or doctor. We have developed a PeakCare support program specifically for our ill patients or those starting a homemade diet. Please see on-going support options for more information. 
• All prices include taxes and processing fees. 

What may be an additional fee: While we advise as much as possible during an appointment, the following are additional services:

• Homemade diet formulations
• Diet reformulations
• In-depth diet or supplement analysis
• Record review outside the scope of recent diagnostics
• International fees
• Follow up appointments, lab work review and/or plan reassessments

We strive to provide as much information as possible during an appointment. However, homemade diets can involve significant analysis, especially those for complicated medical patients or with several ingredients/substitutions. Therefore, a simple, temporary homemade diet may be included with an appointment if medically indicated but additional charges apply for tailored/long-term homemade diets.

 We understand that a significant amount of information is discussed during an appointment as well as afterwards within your written nutrition plans. Our goal is to ensure you feel supported as you implement and adjust your pet’s care. Because nutrition care is often an iterative and evolving process, we’ve developed a structured approach to communication and follow-up.

Included with Initial Appointment:

• You will receive a written report 1-2 weeks after an appointment.
• When adjustments are needed, reassessments are recommended as a scheduled recheck with a nurse or doctor. 
• After our initial appointment, you can elect how you wish to pursue follow up, see below.

On-going support options: As our patients have varying levels of need, we have flexible support.

For stable patients: A la carte: Rechecks are charged as needed:

• Doctor or nurse rechecks: $366/hour, with a minimum of 30 minutes. 
• Appointment scheduling: Nurse rechecks typically available in 2-3 weeks. Doctor rechecks may book 4+ weeks in advance. 
• Emails: Turnaround time of up to 5 business days, please note if doctor input required, a recheck will be recommended. 
• Additional services: Services such as recipe reformulations are available for an additional fee.

For ill or special needs patients: PeakCare program: This program connects you with a dedicated nurse and allows for a higher level of support. These are ideal for acutely ill and/or complex medical patients, or those starting a homemade diet with us. We have developed this program as it is our preferred way to practice for ill patients- to make fewer changes at a time and have dedicated time to chart progress and review updates. 

• Appointments: You will have a standing appointment with your nurse twice monthly (typically 15-20 minutes every other week) to review patient updates, changes in diet, new labs, etc. If preferred over a recheck, bulleted point/longer emails can be sent/reviewed. (Includes up to 1 hour of nurse time via virtual visit or email). Priority rescheduling if needed. 
• Emails: Dedicated email address with expected turnaround time of 1-3 business days.
• Discount: You receive a 25% discount on all services. The above is included in the membership fee. If services beyond the above are requested (diet reformulations, additional appointments, etc.) the 25% discount extends to these as well.
• Monthly fee: $275/month. 
• PeakCare Premium Tier: If you have a high-needs pet that may require more care, we can tailor based on patient needs (e.g. direct to doctor time, including reformulations, etc). Please inquire if interested.  Packages starting at $1500/month. 

Notes: 

• Services are available during work hours. 
• Fees are charged at the beginning of the month and allow for 1 month of rollover (e.g. if you do not use a portion of your time, it will roll over to the next month). Plans started within a calendar month are pro-rated. Additional services are billed as requested. Program fees are nonrefundable but can be cancelled at any time with a one-week notice. 
• Doctor appointments or plans adjustments requiring doctor input (such as homemade diet reformulations) are not included in the membership but are discounted.  
• Enrollment dependent on availability and case details. Prices subject to change

We are happy to work with multiple pets in the same household.  Dietary recommendations are individualized for each patient and may not be appropriate for other pets in the household. If your goal is to feed the same or similar diet across multiple pets, we have some options to ensure recommendations are safe and appropriate. Unfortunately, we are unable to give advice for housemates that are not established as patients. 

Consultation Options:

Full Consultation for each pet: 

• Each pet requires a separate consultation. Appointments may be scheduled on the same day or separately.
• Standard consultation fees apply per pet

Full Consultation for one pet initially:  

• You may choose to begin with a consultation focused on one pet and expand to others later if needed.

Diet recommendations are made based on what is best for the individual pet and their household. We do not make agreements with pet food companies to endorse/recommend products or to prioritize one manufacturer over another. Our online pharmacy sells some diets as a convenience for owners. However, clients are under no obligation to purchase diets from PVS, and we encourage owners to purchase from a reputable source that is best for them. PVS nutritionists are available to manufacturers in an advisory or employment capacity, such as manufacturers that wish for input to improve their products. 

Peak Veterinary Specialists offers only virtual appointments, and we are lucky enough to have patients all over the world! 

Please note that additional fees may apply for international clients. 

Peak Veterinary Specialists does not recommend raw feeding; however, our nutritionists will work with clients who choose to do so unless medically contraindicated. 

Our specialists are not trained in herbal supplements and therefore defer to those who are. We recommend looking for a veterinarian who has advanced certification in herbal medicine.