Holistic, Integrative & Functional medicine house calls for Tampa Bay pets.
Email DrTruli@VetVMD.com or Text (813) 714-7863
Dr. Sandra Truli Springer, VMD, MS-TCVM, CVA, CVFT, CVTP, CVCH, CTCVMP, CTPEP, CVMMP
Veterinary Medical Doctor, University of Pennsylvania Ivy-League.
Master of Science- Traditional Chinese Veterinary Medicine.
Acupuncturist, Food Therapist,Tui-na (medical massage), Herbalist, Veterinary Medical Manipulation Practitioner.
Fellow of the American Academy of Veterinary Acupuncturists.
Human Animal Bond Certified.
Founding Member of the Nutrition Innovation Council.
Acupuncture can help dogs with dry eye syndrome
You can read more about the 4 branches of TCVM at Chi University.
Mini Schnauzer gets acupuncture to brighten the eyes
What is dry eye in dogs?
Dry eye is officially called keratoconjunctivitis sicca (pronounced carrot – o – con – junk – ti – viy – tiss – seekaa) or “KCS.” Basically, the tear glands do not produce a proper tear film on the corneal surface of the eye or eyes and they are not moisturized properly throughout the day. The eyes feel like they have sand in them and hurt. Also, eyes need a nice tear film to wash away irritants like dirt. When the tear film is not working, the surface of the eyes can get injured and develop sores like corneal ulcers.
In biomedical practice, it is thought that the tear glands are attacked by the body’s own immune system. KCS or dry eye is thought to be an autoimmune condition (most of the time.)
How is dry eye in dogs usually treated?
The medication is usually an immunosuppressant. (For example, Optimmune is a brand that is FDA-approved for use for dry eye in dogs.) Once the immune over-reaction calms down, the tear glands start producing better tear film.
Integrative Veterinary Care can help dry eye syndrome
What is dry eye in integrative medicine?
Dry eye is inflammation in the eyes causing the tear film to dry out, or not be made properly. The inflammation source is Liver dysfunction. The eyes are the opening to the Liver Channel. Herbal medicines are combined to nourish and soothe the Liver and to nourish and calm the eyes. They may be oral herbal formulas or topical.
There is a saying: “One disease, many patterns. Also many disease, one pattern.”
Dry eye is mostly an example of one disease with many possible underlying patterns. You likely will need an experienced herbalist to help diagnose what pattern your pet has. Then the herbalist can recommend herbs that treat that particular pattern that led to the problem for your pet. This is what is meant by “individual medicine.”
In the United States, medical care for pets is provided by doctors (called veterinarians) licensed by the individual State in which the doctor practices. Remote consults without meeting the practitioner in person can lead to misdiagnosis and unsatisfactory results. Remote consults may be illegal in some jurisdictions for this reason.
You can research at Chi University for a qualified herbalist-veterinarian. Another resource is the Veterinary Botanical Medical Association. These organizations each have international reach and active membership around the world.
Dr Truli is a licensed veterinarian certified in herbalism, nutrition, massage, acupuncture and palliative care.
What do you mean, many patterns can cause dry eye?
Blood Deficiency can lead to dry eye
For example, a pattern called Blood Deficiency can lead to dry eye. You can think of it as lack of sparkle in the Blood leading to malnourishment of the eyes. Vitamin D is one such “sparkle” component of the blood. Proper marine source omega 3 fish oils are others. Dr Truli offers routine Vitamin D and OmegaQuant red cell membrane testing.
Liver problems can lead to dry eye
Another pattern that leads to the same biomedical diagnosis called dry eye is Liver Heat Rising. In this pattern, the liver enzymes might be elevated and the gall bladder clogged. The liver may be congested and function is sluggish. This slow function can lead to build up of metabolic byproducts that trigger inflammation. This type of patient would possibly be made sicker by Blood tonics that would help the first patient!
Cold windy weather or a crate under the AC can lead to dry eye
There is even a type of dry eye caused by Wind Cold. This is the type that occurs when a sudden windy change in the weather (or indoor AC) brings cold air into the body. The whites of the eyes may become red and corneal ulcers could form. The neck will be super stiff. Humans would complain of a headache. Obviously, this is not a deficiency or an excess Heat condition. It is really quite the opposite and the herbal prescription would be opposite of the Liver Heat Rising type of patient.
We can help dry eye with herbal medicine, food therapy and acupuncture
Shorty Jack Russell cutie gets acupuncture to brighten the eyes. Can you spot the (2) silver needles?
Herbal formulas to target the pattern of dry eye
A qualified herbalist can prescribe herbal formulas that are likely to help the dry eye. All major medical herbal traditions can handle this task. They may use different types of herbals, but they should all be prescribed based on your individual needs. There should not be – nor is there – one successful herbal “for dry eye.” They are for dry eye in…each different type of patient.
Dr Truli is a certified herbalist for pets.
Food therapy can help dry eye
Certain foods may brighten or nourish the eyes. There are many. Some are also found in herbal remedies. They can be food or medicine. There are many. You can consult an herbalist, a local healer, or a talented elder to guide you about local and appropriate choices. Dr Truli is certified in food therapy.
Acupuncture can help dry eye
Acupuncture has been researched in many countries for the treatment of dry eye. Cookbook acupuncture- where needles are placed local to the eyes or at points to help the eyes – can be effective. Dr Truli prefers acupuncture based on each individual patient’s pattern diagnosis and consideration of all other challenges and issues facing the patient so that the acupuncture treatment may synergize to help the whole body.
Dr Truli is Certified in Veterinary Acupuncture (CVA).
Integrative care may be combined with biomedical care
A wonderful feature of Integrative care is you can continue biomedical treatments that are working, affordable, helpful, fun and add to or alter your protocols with herbals, foods, or acupuncture where those treatments can bring even more quality to you and your pet’s life.
If you live in the Tampa Bay area or can travel here, Dr Truli may have availability to bring all of this care to your home or hotel. Email, call or text with your name, contact info and address and a brief statement of urgency/goal/or what issue your pet is facing & Dr Truli will respond (usually well within 24 hours.)
Dr Truli
Email DrTruli@VetVMD.com
Call (877) 378-7854
Text (813) 714-7863
Insufficient or Deficient Vitamin D3 Hinders 75% of Dogs in the United States
Dogs & cats need adequate vitamin D3 to be healthy
What is Vitamin D?
D3 is a fat-soluble vitamin that acts as a hormone in the body. Whole food sources include oily fish, eggs and liver. Humans can make D3 from the sun through skin exposure, our companion animal dogs and cats cannot. Cats and dogs can only obtain D3 from food sources.
How likely is my pet to have low Vitamin D?
Vitamin D3 is commonly added to pet foods as part of making the food complete and balanced. And yet, for reasons not yet understood (as of 2021), 75% of pet dogs in the US have insufficient or deficient D3.
What Happens if My Dog or Cat has Low Vitamin D3?
Broadly, insufficient Vitamin D3 causes the body to be in an inflammatory state, promoting allergic tendencies. Low D3 is also found in pets diagnosed with cancer. Conditions such as protein-losing enteropathy and protein-losing nephropathy have a worse outcome if D3 levels in your pet are not addressed. Pets taking steroids, non-steroidal anti-inflammatory drugs like certain painkillers, older pets, and neutered or spayed pets are known to have reduced Vitamin D3 levels compared to young, healthy pets.
“Why not just supplement my dog with Vitamin D3?” you may ask.
Excess D3 causes kidney failure and death. As a fat-soluble vitamin, excess D3 builds up in the body and causes Vitamin D poisoning and eventual death. A top reason for a pet food recall is excess Vitamin D. Home cooked diets are often critically low in Vitamin D, especially if they have not been designed with the help of a veterinary nutritionist.
What Can be Done About Vitamin D3 for my Dog or Cat?
You can fix the Vitamin D3 level with your veterinarian’s help. There are underlying diseases and medications that cause a pet to use more Vitamin D than expected and there are cofactors needed for proper absorption of the Vitamin D3. Your veterinarian can help guide you to a proper dose and monitoring of the dose to make sure your pet stays at an optimal level. Veterinarians and intrigued pet owners can read more about the science and details at VDIlab.com.
How Do I Get the Vitamin D3 Test for my Cat or Dog?
Dr Truli Routinely Performs Vitamin D3, Magnesium & Omega-3 Fatty Acid Level Testing
If you are accepted as a registered client with Dr Truli, you will be offered Vitamin D3 and Magnesium level testing routinely as needed depending on your pet’s underlying health status. In addition, Dr Truli recommends OmegaQuant Omega-3 Fatty Acid testing for Dogs. These tests can often help your pet even more than a routine CBC-Chem with actionable information to make positive changes in your pet’s management at home.
Reach Out Today
If you live in- or travel- to the Tampa Bay, Florida area, you are welcome to contact Dr Truli about becoming a registered client. You can text (813) 714-7863, call (877) 378-7854, or email DrTruli@VetVMD.com. Please include your name, address, your pet’s name and the urgency and nature of the need for services.
Dr Sandra Truli Springer , aka Dr Truli, is an ivy-league veterinarian licensed in Florida and several other US states to practice medicine for animals. In addition to university and 4 additional years of medical veterinary training, she has undergone 5 years of Master’s of Traditional Chinese Veterinary Medicine training and earned the Master’s Degree. She has been practicing veterinary medicine since May 17, 1999. Dr Truli has been practicing exclusively house call integrative medicine since 2015.
Big doggy smile during acupuncture!
Food Allergy Elimination Diets Can be Tricky
As anyone who has suspected their dog has a food allergy can attest, we wish there were accurate saliva or blood tests to make the food allergy diagnosis easy. However, the interpretation of these tests is unreliable. Saliva or blood tests for food allergies may not be as helpful as we would like.
The gold standard for dog food allergy testing is an allergy elimination diet. You can learn a step-by-step allergy elimination protocol here.
5 Common reasons a “perfect” dog food allergy elimination diet trial fails
The usual reasons a food allergy elimination trial fails:
- lack of committment from everyone in the family
- food falling from the table, especially with little kids in the house
- dog steals cat food. or kitty “snax” out of the litter pan or the garden
- medication or supplements with unsuspected allergens, like “real beef flavor”
- neighbors/friends giving biscuits you do not know about
An unusual reason a dog food allergy elimination diet had to be restarted from the beginning
My friend Benji
Let me introduce Benji. Benji is a much beloved mixed breed long-haired blonde. He has every attention and care that a devoted human can provide. Three weeks into his eight week dog food allergy elimination trial diet, Dr Truli received a text unlike any other.
“Omg Benji ate a piece of styrofoam”
“He ate a whole one of these pieces”
Omg my dog ate a foam packing peanut
Doc Truli advised Benji’s mom to apply water to the foam packing peanut and see if it melted. It did!
The Good News and the Bad News
Good news: not a foreign body obstruction.
Bad news: possible break in Benji’s dog food allergy elimination diet.
Turns out, these packing peanuts are made of planet-friendly starch. They melt in water and do not add to landfills or waste disposal problems.
However, the starch comes usually from sorghum or from corn. We suspected Benji is allergic to corn! This little “snack” of packing material was a violation of Benji’s dog food allergy elimination diet protocol. We had to restart his 8-12 week “clean” diet in case the packing material was made of a starch that triggered his allergies.
Doc Truli Learned Yet Another Way a Dog Food Allergy Elimination Diet Can be Messed-Up
Turns out, environmentally-friendly packing peanuts can ruin a dog food allergy elimination trial! Let’s keep those packing “peanuts” away from your allergic dog.
Acknowledgement: Special thanks to Benji and his person Liz for the learning experience, beautiful pictures and permission to share this story. -Doc Truli September 1, 2021, Palm Harbor, Florida, USA. To schedule an appointment email DrTruli@VetVMD.com.
Dogs and Cats are Great in a House Call
It’s the Kids That Need Some Guidance
Happy Puppy in a holistic vet house call
Dr Truli can teach you how pain management can benefit your pet
Massage Therapy & E-stim acupuncture for a Yorkie
The International Academy of Veterinary Pain Management is an organization of health care practitioners including, veterinarians, medical doctors, veterinary technicians, and other licensed health care practitioners who have committed to practice, study and research non-human (animals’) pain management from an allopathic, rehabilitation and/or acupuncture and Traditional Chinese Medicine basis.
How Does Excellent Pain Management Help My Pet?
You would think this answer was obvious, wouldn’t you? We do not want any of our family members to be in pain- especially our animal family. We design and manage our pets’ lifestyles, including their food, exercise and entertainment. We could argue we have a special responsibility to be mindful and considerate when planning for our pets’ comfort and enjoyment.
Creative and forward-thinking pain management can help in ways we cannot intuit. For example, can we help our pets digest better and enjoy their food if they are not in pain? Can we help them live longer, need less surgeries, feel less itchy? Absolutely. If our pets are happy and energetic and relaxed, are we healthier and more relaxed? Absolutely. Attention to your pets’ happiness and health makes your whole family- pets and people- healthier.
What is New or Interesting About Pain Management?
Doc Truli perform Tui-na massage on Senior Boston Terrier
We can prescribe allopathic medications – like non-steroidal anti-inflammatory painkillers. We can prescribe herbal formulas. We can use electromagnetic devices like the Assisi Loop. We can perform hands on therapies like massage, laser treatment, acupuncture, osteopathy, medical manipulation (like chiropractic adjustments in humans.) We can ensure modern anesthetic protocols that minimize pain.
But what is new and interesting is the new specialty of palliative care medicine and the relatively new study of rehabilitation and physical therapy techniques for pets. The application of functional neurology, nutritional response testing and tui-na (pronounced twee-nah) medical massage for the benefit of our animal friends and companions is exciting and meaningful work. Your pet can benefit from these sciences and technologies, whether they are new or ancient.
Does My Pet Have to Be in Pain to Benefit from Pain Management?
This Olde English Bulldogge is a prime candidate for pain recognition training because she is rambunctious.
No! They do not.
You can learn pain management concepts and techniques to identify when and if your pet is in pain. You can learn how to manage small injuries and oops! to prevent chronic pain or weakening of knees, shoulders, hips and back. You can learn healthy lifestyle choices to keep your pet out of pain like what to feed, what to supplement and how to train for maximum fun and minimum injury. Your trusted neighborhood veterinary team should be available to help teach you and check in with you so you can manage your pets’ lifestyle for optimum pain avoidance.
Text (813) 714-7863 and share your name, number, email, address, pet’s name, and urgency of situation to request to become a client or for more information.
Commercial pet foods pulled due to FDA Aflatoxin concerns
Dutch Shepherds & a Black German Shepherd gather around before dinner.
If your pet feels sick, remember to provide your veterinarian with a complete history of what your pet eats. Symptoms such as sluggishness, loss of appetite, vomiting, yellow in the whites of the eyes, and/or diarrhea may be aflatoxin poisoning. In severe cases, aflatoxin poisoning can be fatal. In some cases, pets may suffer liver damage but not show any symptoms.
Some experts believe the aflatoxin is an especially worrisome for our pets who may be fed the same food consistently compared to our human families that eat a variety of foods. Please check out the list of recalled foods and the excellent summary article on the FDA’s website. Complete list here
Now May Be a Good Time to upgrade Your Pet’s Nutrition
Switching pet foods or even switching to organic, holistic-type brands does not mean you will avoid aflatoxin, salmonella, e coli, listeriosis, or the most common source of pet food recalls, hypervitaminosis D. You must think beyond the can and the box or bag. Your pet may be a candidate for home cooking. Check out BalanceIT to design healthy balanced meals for your normal, adult healthy dog or cat. Schedule a check up with your veterinarian to determine that your pet is indeed, as healthy as you think. If you already know your pet is not 100%, your veterinarian can help by designing a meal plan for you or by facilitating a nutrition specialist consultation. If your veterinarian is unfamiliar with this service, you might introduce them to some resources such as The American Association of Veterinary Nutritionists.
Dr. Truli provides veterinary nutrition services for clients in the Tampa Bay Florida area
If you live in Tampa Bay Florida, or can travel here with your pet, Dr. Truli can consult directly with you to design a delicious, balanced meal plan strategy. Email DrTruli@VetVMD.com to schedule an appointment anytime!
Professional Guidance for Canine Yeast Dermatitis
My poor itchy legs!
You know the smell. That yeasty, warm, sickly smell coming from your dog’s head or skin or their bed? The skin is red or bright pink. It is dry with flakes and itches like crazy. You have gone to the veterinarian 4-6 times in the past 2 years and you are frustrated with the money spent and the lack of results. You are researching holistic vets on the internet to find relief for your dog. You desperately need professional veterinary guidance.
Here’s What Goes Wrong with Chronic Dog Skin Infections
Which one are you?
Best Arthritis Treatments for Dogs
We want our dogs to play and swim for many years
Veterinary Orthopedic Exam at 16 Weeks Old
We need to keep our dogs limber and playful into old age. How do we do this? For starters, your veterinarian can examine your puppy carefully for any signs of pain. Puppies should not have pain. If your puppy shows pain or if your puppy has a “cute, weird, quirky, unique way of sitting, standing, walking, or running, you should be highly suspicious that your puppy needs intervention to stay as healthy as possible. Most osteoarthritis in dogs starts with hip dysplasia or elbow dysplasia. These are abnormalities of the shape and function of the elbows and hips that puppies may be born with. If they are detected in a very young puppy, there are several interventions to help them grow better and have less pain when they are older.
Puppies should not have pain. And a puppy who “sits quirky” or has other unique ways of moving may be compensating for elbow or hip dysplasia,” says Doc Truli.
Puppies Need to Slow Growth to Decrease Osteoarthritis When They are Older
Keep your puppies growing slowly, or they may suffocate their friends
Most importantly, puppies need to grow slowly. A dog expected to be over 44 pounds fully grown should eat large breed puppy food. They should absolutely not be fed adult food or be changed to adult food too early. Why? Because carbohydrates feed rapid growth and the adult food is proportionally less protein and more carbohydrates. Grain-free does not mean carbohydrate free. Novel carbohydrates like potatoes, chick peas, quinoa and green peas fill in for the grains to reach the carbohydrate requirements of the food. These still promote rapid growth and need to be a minimal proportion of the puppy food.
Dogs Have Less Arthritis When Walked 60 Minutes a Day
Dogs who had 60 minutes or more of exercise a day had less osteoarthritis problems than dogs with 20 minutes or less exercise a day. 2 nice 30 minute walks every day with a human companion is relaxing and healthy.
Ask your veterinary team if you need help designing a healthy exercise schedule that is not too much or too little. If your dog is arthritic, your veterinarian may be able to refer you for a consultation with veterinarian certified in Canine Sports Medicine and Rehabilitation. They have cavalettis and underwater treadmills and massage therapists and protocols for cookie-inspired stretch routines you can do at home.
Skinny Dogs Feel Better
Dogs will beg for food even when they are not hungry.
Dogs who have their meals portion controlled and are not allowed to become fat will have less arthritis problems than they otherwise would have had. And getting fat and then losing weight still means they deteriorate their cartilage during the fat months and years! Better to keep them lean their whole lives. Your veterinarian can teach you how.
Canine Osteoarthritis Newsletter Fall 2020
Dr Truli provides in home consultations and therapy to the Tampa Bay, Florida area. She can provide exams, physical therapy plans, acupuncture, laser therapy, herbal medicine, Rx medicines, blood work including a neat osteoarthritis screening panel. Dr Truli partners with local specialists for Sports Rehab. Orthopedic Surgery, and Neurology.
What Most Pet Parents Learn About Fish Oil Supplements
Let’s assume you are providing healthy daily amounts of omega fats for your dog or cat. You did your research. You know that there are lots of supplements on the market that contain ethyl esther forms of the omega fatty acids which are cheap substitute chemicals.
Tru Tip
Easy test: If you take a fatty acid supplement oil or take oil out of a capsule and let it sit in a styrofoam cup for about 15 minutes, if it is ethyl esters form, which you do not want, it will eat a hole in the cup.
You know that you can feed oily fish like mackerel, sardines and anchovies to provide omega 3’s without using a supplement. Or cooked egg yolks a few times a week. You know that heavy metals in the oceans such as mercury accumulate in the muscles and tissues of apex predators like salmon and other large, long-lived fish. You purchase only from trusted sources that have heavy metal tested the fish oil or you purchase krill or New Zealand perna mussel supplements. You may even have researched seaweed sources of omega fats and you wonder if you can keep your dog vegan or vegetarian with the rest of the family. (You can for DHA and shiny coat. You cannot if you want anti-inflammatory effects of omegas.)
More In Depth Fish Oil Supplementation Information
You may even be a veterinary technician, veterinarian, or pet parent who knows that their dog or cat needs at least 180 mg of EPA per 10 pounds (US) body weight to provide anti-inflammatory doses of EPA. And you know cats cannot convert plant sources of omega 3’s like flax and borage seed into any anti-inflammatory molecules in their body. You may even know that dogs covert only 2% of plant omegas into useful anti-inflammatory factors. You do your homework.
What Most Pet Parents Do Not Know About Fish Oil Supplementation
We Cannot Logic an Answer About How Much Omega Supplementation Your Pet Needs
Did you know that each individual dog or cat can vary wildly even from litter mates fed the same diet in their omega fatty acids composition of their red blood cell membranes? Did you know measuring the omega fats in the red blood cell membranes is considered the standard for measurement and it is a highly technical procedure fraught with opportunity for poor quality test results?
Valid, Accurate, Affordable, Simple Omega Fatty Acid Testing Now Available
Dr Truli now offers Omega Fatty Acids testing for her cat and dog patients. It takes 1-2 drops of blood and the laboratory is the premier human grade testing company, OmegaQuant. Recent research results (2017-present) have delineated arachidonic acid (AA) to eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) ratio levels that demand higher omega-3 supplementation or feeding to reach therapeutic benefits. Sometimes a pet needs four times the label dose of omega 3’s to feel the benefits for their hips, knees, joints, heart and kidneys!
Why Test?
Why not just give more omegas? The biggest reason is that omega fats can accumulate in the body to toxic levels. Too much is not better. Another reason is they may be difficult to digest for some pets. And of course, good quality supplements are not inexpensive. Testing and knowing saves money.
Why Not Just Give More Omega Fats to My Pet?
- Too much may be toxic
- Difficult to digest
- Expensive
Dr Truli can help registered patients with testing, protocols and options for effective, environmentally sound, and safest omega supplements to provide your fur family. Testing may be incorporated into discounted annual blood work packages, added on to Essential Vitamins D3, B6, B12 Testing, or run by itself. Contact Dr Truli today to find out how to schedule an appointment about omega-3 benefits and how to get your pet started off on the right paw.
Phone/Text 813-714-7863
Email: DrTruli@VetVMD.com
Further Reading:
If you are just starting learning the basics: Tufts University Petfoodology
Basic Benefits of Omega 3 Fatty Acids for Pets
Beneficial Effects on Kidneys when dogs are fed diets high in omega-3’s
Peer-reviewed research about omega-3 levels needed to alleviate osteoarthritis pain in dogs:
Increasing blood omega-3 levels helps relieve arthritis symptoms in older dogs
From the Desk of Dr Truli,
In this time of change and contemplation, I offer guidance and assistance. Veterinary medicine is an essential service. As an essential service provider, let me outline several ways I keep you and your family safe while helping your pets with their medical needs. Keep in mind I am an experienced surgeon trained in sterile technique and experienced in biosecurity practices.
As you know, private house call service is uniquely controllable. I am healthy and I am in contact only with my husband and my house call clients. We have no vet team to protect or to cause an inadvertent breach in Covid-19 susceptibility. If you are healthy and have not traveled in 20 days or been in contact with someone who has, and your pet is ill or in discomfort, we can reasonably provide house call medical services.
I have options if you are practicing 6-feet social distancing with absolutely everyone, as many people are. I can meet your dog outside your home and they can have an exam and acupuncture on your lanai or other outdoor space. The dogs really enjoy the fresh air and sunshine while getting their treatments!
The other in-person option is I bring your pet to my SUV and perform their exam and medical care in my vehicle. This is a little unsettling for some cats and a few dogs, but still more relaxing than hospital care. Most medium and large dogs love it and cooperate just fine.
Many heath issues can be resolved with a combination of remote and in-person care. We can schedule videos, pictures, and teleconferencing and if I can confidently diagnose the issue remotely, I can have medicine or herbals delivered to you.
As always, I am delivering supplements, medications or herbals to your door if it is a better option than by mail.
I can provide referrals for specialty care. Current waiting lists for many specialty services are clocking in at 3 to 4 weeks! Be advised I provide in-depth care such as ophthalmology, dermatology, orthopedic and neurological examinations. As a licensed veterinarian, I can access the critical care specialists on your behalf and fast-track your pet’s wait time in an emergency.
I’m committed to meeting your needs while keeping communities safe. More than ever, I believe in supporting health through partnership with Western Medicine, plant-based Medicine and whole food-based solutions.
Yours in health,
Doc Truli
Dr Sandra Truli Springer, VMD, MS-TCVM, CVA, CVFT, CVTP, CVCH, CTCVMP, CTPEP
