Metzere Bierlein DVM, MS, DACVIM

What sparked your passion to focus on two specialties – Internal Medicine and Nephrology/Urology?

My inclination towards problem-solving and the complexities of managing patients with multiple health issues drew me to internal medicine. The kidneys, with their intricate functions and the challenges in optimizing care for kidney disease, have always piqued my curiosity. Despite completing my internal medicine residency, numerous unanswered questions and desired advancements in procedures prompted me to pursue a specialized residency in urology and nephrology.

What are some of the biggest challenges in your area of expertise?

Chronic kidney disease is still often diagnosed very late in the disease or is minimally managed with diet alone. With newer biomarkers and therapies we can catch kidney injury earlier than before and we have more ways to treat the secondary consequences of kidney disease in order to prolong quality of life and lifespan. I think our biggest challenge as a new college will be encouraging referral to a veterinary nephrologist at all stages of kidney disease rather than waiting until animals are sick from their disease or have rapidly progressing disease.

Is there a particular case that has inspired you?

I really enjoy diagnosing systemic diseases that manifest primarily as kidney disease. For example, during my fellowship, we had a young German Shepherd whose vet diagnosed him with juvenile chronic kidney disease. But in fact, he had a systemic fungal disease that was attacking his kidneys and once we diagnosed the fungus and started treating it, his kidney values got significantly better and he is still alive and doing well over a year after diagnosis.

What do you like to do outside of work?

I enjoy running, hiking, cooking, and watching movies.