NEWS and events

ER Services Now Open!


Exciting News! Our ER is Officially Open! 

We are now Puget Sound Veterinary Specialty & Emergency (PSVSE)! Our new facility is located at 6565 Kimball Drive in Gig Harbor. As a reminder, we will initially offer 24/7 Emergency and Critical Care, Internal Medicine, Neurology, and Diagnostic Imaging. All other specialty services (Surgery, Ophthalmology, Dentistry and Oral Surgery) will remain at the Port Orchard location (1730 Pottery Ave) until our move is completed in early 2023. 


Gig Harbor, WA: Puget Sound Veterinary Specialists are starting the process of moving from Port Orchard to Gig Harbor and expanding to 24/7 Emergency Care beginning December 1. They will be changing their name to Puget Sound Veterinary Specialty & Emergency (PSVSE) when Emergency Care launches. The new facility, located at 6565 Kimball Drive in Gig Harbor, will initially offer 24/7 Emergency and Critical Care, Internal Medicine, Neurology, and Diagnostic Imaging.

All other specialty services (Surgery, Ophthalmology, Dentistry, and Oral Surgery) will remain at the Port Orchard location until the move is completed in early 2023.

This move and expansion will offer specialty and emergency veterinary care under one roof to pet owners of Gig Harbor, the Kitsap Peninsula, and beyond. The 21,000 square ft. space will be equipped with full imaging services, including an MRI and CT Scan, full surgery suites, dental suites, a neurology department, internal medicine, ophthalmology, advanced anesthesia, and critical care.

Puget Sound Veterinary Specialty & Emergency strives to be a valued partner and steward of positive change in the Gig Harbor community by providing the best care to their employees, referral partners, clients, and their pets. They believe that collaborative and exemplary care starts with caring for animals, their caregivers, and the veterinary community. Therefore, PSVSE’s top priority is to develop a
collaborative team with clients, staff, and local veterinarians to provide patients with the highest quality medical care and emotional support to their families.

Dr. Heather Knapp-Hoch and Dr. Shana O’Marra, are leading the team as the Medical Directors for the Specialty Team and Emergency Team, respectively. They have been veterinarians in the Pacific Northwest for over 5+ years and have been practicing medicine for over 30 years. Dr. Knapp-Hoch and Dr. O’Marra and their team partner with referral veterinarians to keep pets healthy and care for them as if
they are their own in times of illness. The team is dedicated to being there for pet owners when they need it most.


Puget Sound Veterinary Specialists is launching emergency services in early December!

 We will be opening the doors at our brand-new space for ER patients located at 6565 Kimball Drive, Gig Harbor, WA. We are excited soon offer 24-hour emergency care to the Gig Harbor community and beyond!


Did you know the most common cause of pain in the pelvic (hind) limbs in dogs is from a ruptured (torn) cruciate ligament? Learn more below as we answer some common questions about this disease.
Where is the cruciate ligament located?
The cruciate ligaments form an “X” in the stifle (knee) joint and attaches the femur (thigh bone) to the tibia (shin bone) to prevent abnormal motion and support the biomechanics of the dog’s gait.
What causes a cruciate ligament injury?
The exact cause of this disease process is poorly understood; however, the process is usually due to degeneration and inflammation over time of the cranial cruciate ligament. This is very different than in people who mostly tear their ACL’s from an acute injury. This disease process can happen in any dog breed at any age but is more common in medium-large breed middle-aged dogs. Diagnosis of this is based on an orthopedic exam and x-rays. A definitive diagnosis is confirmed with surgery, which can be done with arthroscopy (video camera inside the joint) or a small arthrotomy (incision into the joint).
How do you treat this disease?
Cranial cruciate ligament disease is considered a surgical disease for the best outcome. Some patients can have fair outcomes with medical management (weight loss, pain medications, physical therapy, joint supplements). The most common surgical procedure to address this problem is called a TPLO which stands for a tibial plateau leveling osteotomy.
Why is surgery needed?
Surgical intervention addresses the instability that is created when the cruciate ligament is torn. The instability is in part due to the anatomy of the dogs stifle joint. The tibia (shin bone) in dogs has a large slant off the back end, without that ligament, there is a lot of instability between the femur and the tibia. The femur slides off the top of the tibia, which can cause pain, dysfunction and inflammation/arthritis, and in some cases a meniscal tear. The TPLO surgery aims to flatten the tibia (shin bone), so the femur (thigh bone) has a nice, flat surface to bear down on when the dog walks which eliminates the need for the cranial cruciate ligament. The tibia (shin bone) is cut with a surgical bone saw and rotated. The pieces are then held together with a strong bone plate.
How successful is this surgery?
 The success rate of this surgery is around 94% and most dogs are back to normal activity and function within 12-16 weeks after surgery.


PSVS is thrilled to welcome Dr. Amanda Brenna to the team!
Originally hailing from Kirkland, Washington, Dr. Brenna is overjoyed to return to the Pacific Northwest and call the Kitsap Peninsula her home. Throughout her childhood, she accumulated a menagerie of rescued pets and injured wildlife and settled on a career as a veterinarian by the age of ten.
Dr. Brenna obtained her veterinary degree at Washington State University (GO COUGS!!!) where she quickly developed a reputation as “the neuro girl” amongst her classmates. After receiving her Doctor of Veterinary Medicine in 2013, she moved home to Seattle to complete a small animal rotating internship, and then to Dallas to complete a specialty internship in neurology at Center for Veterinary Specialty and Emergency Care. Her three-year residency in neurology and neurosurgery then took her to Auburn University in Alabama, where she got to spend every day honing her neuro diagnostic and neurosurgical skills and sharing her love of neurology with the veterinary students she taught. She then returned to Dallas, spending four years at the Center for Veterinary Specialty and Emergency Care as an associate neurologist. We are happy to welcome her back to the PNW as the newest Doctor on the PSVS team! Learn more on our Neurology page! 


Seal pup season is in full swing in the Pacific Northwest, and we had the pleasure to help our friends at World Vets by being available to lend a hand with advanced imaging diagnostics to seal pups in need. 
Our partnership with World Vets allows their team to access advanced medical equipment when needed. By having access to advanced imaging, the World Vets team can evaluate injuries and gain a complete picture of a pup’s health which can help with rehabilitation efforts. 
We are so thankful for the opportunity to work with them and be of service to the local wildlife!


Puget Sound’s own Nicole Pambianchi, VTS Anesthesia, will be spoke at the annual AVMA Convention!
She presented the following topics during the convention:
“Is That Normal? Common Adverse Effects of Anesthetic Drugs” and “Understanding Capnography.”
PSVS values their technicians and para-professional staff which is why they prioritize offering opportunities for Technician Advancement as well as resources to help them get exposure at a national level.
We are thrilled to have her represent PSVS at AVMA as a VTS in Anesthesia!
Delivering Happiness


Our journey in creating a culture that is centered around well-being is off to a great start! The PSVS team recently got an opportunity to participate in a “Delivering Happiness” initiative. During this Delivering Happiness session, our entire team was able to share and collaborate on personal and professional values, goals, and the stressors and rewards of working in the veterinary industry. The program is designed to strengthen connectedness, resilience, well-being, and share tools to actively engage in enhancing overall happiness. We are thrilled to have a team that is committed to change, sustainability and that truly exemplifies resiliency.  



Myasthenia gravis (MG) is an autoimmune disorder that disrupts the neuromuscular junction. It occurs when antibodies bind to and destroy acetylcholine receptors so that muscles cannot receive signals from the associated nerves. Signs include muscle weakness and fatigue, which improves after rest, depressed respiration, and regurgitation caused by esophageal weakness.  

A fast, expert response is critical because the condition can progress quickly, leading to tetraplegia, aspiration pneumonia, and respiratory arrest.   

So, when Bruno, a three-year-old male intact German Shepherd, arrived at Bridgetown Veterinary Emergency + Referral with severe weakness in the back legs, the ER team immediately brought in BVER’s co-medical director, neurologist Megan Steele DVM, DACVIM.  

According to the dog’s owners, the condition had appeared overnight. Then, two evenings before bringing the dog to Bridgetown, the owners observed a sudden onset of weakness in the back legs. The condition seemed to improve the following day, but when it recurred on the second evening, the owners sought BVER’s expertise.  

Dr. Steele observed that Bruno was weakly ambulatory, with a characteristic bunny-hop gait. “He looked like he was sitting but trying to walk, but he was happy, pain-free, and very much wanted to be active,” she observed.  

The neurologic examination was consistent with generalized lower motor neuron disease and not a myelopathy. Top differentials for Bruno included acquired myasthenia gravis, acute acquired polyradiculoneuritis, myositis, neuritis, tick paralysis, and botulism.  

With the first possibility most likely, Dr. Steele performed a neostigmine trial by administering a small dose of the intermediate-acting cholinesterase inhibitor. Typically, in cases of MG, the animal regains the ability to walk within minutes. However, in Bruno’s case, the results were dramatic, Dr. Steele recalled.   

With the trial supporting her preliminary diagnosis and with chest radiographs negative for pneumonia and megaesophagus, Dr. Steele was able to send Bruno home with pyridostigmine to treat his symptoms.  

The underlying autoimmune condition could be addressed only after the MG diagnosis was confirmed by an acetylcholine receptor antibody (AChR antibody) test. At present, processing the test can take a few weeks. Nevertheless, waiting for confirmation of the diagnosis was crucial.  

Rushing to treat the animal with immunosuppressants is inadvisable due to increased susceptibility to infection and various side effects. “These are not benign drugs,” Dr. Steele cautioned.  

Once the AChR test confirmed that Bruno was strongly positive for MG, pyridostigmine was supplemented with the immunosuppressant mycophenolate, and the dog was monitored regularly.   

Bruno enjoyed a speedy recovery. At three months, his titers were weakly positive but improving. At six months, the titers were negative, Bruno was free of clinical signs, and the drugs were gradually reduced.   

Today treatment has been discontinued, Bruno’s antibody test remains negative, and he has suffered no recurrence of signs.  

Bruno is a lucky dog, Dr. Steele said. Due to the pet owners’ attentiveness and the ability of Bridgetown Emergency + Referral Veterinary to immediately and seamlessly transfer the case from ER to neurology, a potentially dangerous condition was successfully resolved.  

If an animal exhibits signs of myasthenia gravis or generalized weakness of unknown origin, you may refer the patient to our neurologists by calling 503.489.9535.


Ultrasound-guided nerve blocks are advanced pain management techniques used to provide pain relief to a region of the body. A local anesthetic medication is injected near a nerve which causes a temporary block of sensation and sometimes movement in a region of the body. In other words, the pain signal can no longer travel toward the brain, and the pain cannot be felt. These techniques are commonly used to provide pain relief both during and after surgery. When compared with IV pain medications, nerve blocks contribute to shorter hospital stays and faster recoveries from surgery.
At Puget Sound Veterinary Specialists, we routinely utilize ultrasound-guided nerve blocks for our surgery patients. Using ultrasound for guidance allows for excellent visualization of the nerves that we are targeting to avoid both short and long-term complications that can occur when blocking a nerve. Most of the surgical procedures performed here benefit from nerve blocks and include surgeries of the forelimb, hindlimb, pelvis, ear, and abdomen.
This multimodal anesthetic approach allows us to use fewer/smaller doses of anesthetic medications and reduces anesthesia time. As a result, the patients are often pain-free for at least the first 24 hours, which is typically the most painful period following surgery. Most importantly, our patients are able to go home the same day of surgery to recover more comfortably at home!


We understand the fear and anxiety of your beloved pet being suddenly affected by a neurologic condition, such as paralysis and seizures. Prompt and sometimes emergent care is often necessary to ensure your pet’s best quality of life. This is where a veterinary neurologist comes in and can diagnose the following:
– Seizures
– Intervertebral disc disease
– Meningitis of unknown etiology (MUE)
– Diskospondylitis
– Brain, spinal cord, or nerve sheath tumors
– Congenital neurologic disease (such as hydrocephalus)
– Chiari-Like malformation and syringohydromyelia
– Cervical spondylomyelopathy (Wobbler syndrome)
– Infectious neurologic disease
– Muscle and nerve diseases such as myasthenia gravis and polyradiculoneuritis
Puget Sound Veterinary Specialists is excited to welcome their new neurologist in the beginning of August. Please call us or visit our website for additional information.


We had an absolute blast participating in the annual Maritime Gig Festival!

We want to thank all those who came to our booth. We are excited to provide emergency and specialty medicine to the pets of Gig Harbor. 
We can’t wait to open our new hospital doors and meet your furry family members this fall!


We are now offering CT Imaging!
Have you ever seen a CT scan of a snake? When our CT machine first arrived, we decided to test it out with different animals. Our Dentistry LVT, Rachel volunteered her female snake named Monty Python for a scan.
Snakes have very subtle personalities, but Monty Python really enjoys being held and being outside on sunny days. Here is our very own Dr. Knapp-Hoch’s daughter comforting the snake after the scan!


As veterinarians, we rely almost entirely on our physical exam skills to ensure our patients are healthy. However, every once in a while, we note an unusual finding (abnormality) on a physical exam that warrants investigation. That was the case with Rita.
Rita was adopted as a spayed female puppy from Mexico when she was one year old. She went to her regular veterinarian for a routine yearly exam when a foreign object (mass) was palpated in her abdomen. Her doctor decided to take an abdominal x-ray to investigate the mass. To everyone’s surprise, it was revealed that the mass was caused by a surgical sponge left in her abdomen by accident at the time of her spay, which was done elsewhere. This was great news for Rita as surgery to remove the mass and the sponge would be curative. Rita was referred to Puget Sound Veterinary Specialists, where she had surgery to remove the sponge. She recovered well and has not looked back!
Did you know? Retained surgical sponges, otherwise known as gossypibomas are a rare diagnosis in veterinary medicine. They are caused by the body’s own inflammatory reaction to a textile within the abdominal cavity. They can be found incidentally at a wellness exam or cause a pet not to feel well, which could prompt a sick visit to the veterinarian. The most common finding is a mass within the abdomen noted on abdominal palpation. Gossypibomas can be difficult to diagnose; however abdominal x –rays or abdominal ultrasound can help identify the cause of the mass, sometimes producing a tell-tale finding such as that noted on the x-rays below. We can see the radio-opaque (bright) material within the mass. The treatment for gossypibomas is the surgical removal of the sponge and associated mass.


Puget Sound Veterinary Specialists is pleased to announce that Shana O’ Marra, DVM, DACVECC has joined our team of specialists!
Dr. O’ Marra started her veterinary career as a technician; it was while working as an ICU technician at the Tufts veterinary teaching hospital that she fell in love with Emergency and Critical Care. Dr. O’ Marra will be working alongside our team of specialists to enhance our capabilities to care for fragile patients with complex disease processes. Her clinical and research interests include blood banking, cardiopulmonary resuscitation, thrombocytopenia and other hemostatic disorders as well as sepsis, fluid therapy and transfusion medicine. She has a strong interest in teaching and mentorship, specifically in the realm of building skills for sustainable practice in early-career veterinarians and technicians. 
She is currently laying the groundwork to build our new 24-hour emergency and critical care services for our new location opening this fall. We are very excited to have her on the team!


The day has arrived! Our CT Imaging Machine is officially ready for patients! If your pet has advanced imaging needs or a veterinary referral, please call our Veterinary Specialists Care Team ahead of time to ask about availability @ 360-871-9651.


What is a CT machine, and what can it do? CT stands for Computed Tomography. This is an advanced imaging technique that uses a series of x-rays and a computer to produce a 3-dimensional image of soft tissue or bone to detect diseases, injuries, and complex surgery planning.


Meet our fantastic Support Team! They are the heart and soul and the backbone of our multi-specialty practice. Our team provides support to our doctors across Surgery, Ophthalmology, Dentistry, Internal Medicine, Recovery, and General Specialty Care services. But, more importantly, they deliver empathy, compassion, and emotional support to our patients and their caregivers who come through our doors.  

Did you know we are hiring?! Yes, not only are we expanding into a 21,000 sq. ft. space in Gig Harbor, but we are also expanding our services to include Advanced Imaging, Neurology, Critical Care, and 24 HR Emergency. As a result, we will need more amazing team members to join the Puget Sound Veterinary Specialists family! Apply for one of our multi-specialty support positions today, and check out our careers page!


🛠️ Construction Update 🛠Every week, we are making progress toward bringing multi-specialty and 24-Hour Emergency services to Gig Harbor and beyond. In the past few weeks, we have seen walls torn down, new ones go up, insulation and floors installed, electrical wiring go in, and the arrival of our new CT Imaging machine! The framework of our space is slowly coming together piece by piece and will become a reality in the fall of this year. We hope you are as excited as we are! 


🚨Big Announcement! It’s here!🚨 

Our CT Imaging Machine has arrived, and this spring, we will start seeing patients with advanced imaging needs.  

What is a CT machine, and what can it do? CT stands for Computed Tomography. This is an advanced imaging technique that uses a series of x -rays and a computer to produce a 3-dimensional image of soft tissue or bone. It has become a valuable diagnostic tool in veterinary medicine for detecting diseases and injuries deep within the body and a tool for surgical planning in more complex cases.    

If your pet has advanced imaging needs or a veterinary referral, please call our Veterinary Specialists Care Team to get you scheduled this spring @ 360-871-9651. 


Meet Hazel!

This cute little four-month-old French Bulldog came in for a fracture after falling off a bed in the middle of the night (not those late-night scaries, we’ve all been there!). After a visit to her regular veterinarian for x-rays and bloodwork, it was determined that she would have to visit the surgery team at Puget Sound Veterinary Specialists to repair her fractured leg. 

Hazel was diagnosed with a Salter-Harris type 2 fracture to her right proximal tibia. Salter-Harris fractures are fractures that involve the growth plate in young growing animals. Dr. Knapp-Hoch and her surgery team were able to repair her leg with pins plus lots of puppy kisses! At her four-week check-in, Dr. Knapp-Hoch was delighted to see that she was healing well and displaying excellent mobility. No stopping her now! 

Puget Sound Veterinary Specialists Expanded Benefits


Sneak Peek!

Construction is well underway at our new 21,000 square ft. space. We are excited to bring full imaging services, including an MRI and CT Scan, full surgery services, dental services, neurology services, internal medicine, ophthalmology services, and advanced anesthesia, to the pets of the Olympic Peninsula. Plus, we will be offering 24/7 Emergency Care! And did you know we are hiring?! Yes! We have openings across all multi-specialty and para-professional positions. See our openings here!

Puget Sound Veterinary Specialists Opening to the Olympic Peninsula 2022


Get Excited! New Year, New Location!
Puget Sound Veterinary Specialists is moving from Port Orchard to Gig Harbor into a 21,000 square ft. space equipped with full imaging services, including an MRI and CT Scan, full surgery services, dental services, neurology services, internal medicine, ophthalmology services, and advanced anesthesia. We will also be expanding to offer 24/7 Emergency Care. 
Construction is well underway, and our team of specialists and veterinary care professionals are excited to bring compassionate care to the pets of the Olympic Peninsula during a time when it is needed most.
AND….we’re hiring! We have openings across all our departments!! We can’t wait to hear from you!! See our openings here!


contact US

Port Orchard

1730 Pottery Ave, Suite #120 Port Orchard, WA 98366


Sun–Fri: 7am–5pm
Sat: Closed

Gig Harbor

6565 Kimball Drive
Gig Harbor, WA 98335

• 24/7 Emergency
• 24/7 Critical Care

• Neurology
• Diagnostic Imaging


ER Only: Open 24/7
Tues–Fri: 8am–5pm