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Demand for advanced expertise in kidney and urinary diseases in dogs and cats is rising fast. Dr Dennis Woerde is helping fill that gap. By Shane Conroy
While kidney and urinary diseases are common in dogs and cats, it has long been an underserved area with limited access to specialised care and advanced procedures.
That landscape is beginning to shift. Dr Dennis Woerde is the first person in Australia to have passed specialty examinations with the American College of Veterinary Nephrology and Urology (ACVNU), and is now a Diplomate (specialist) in veterinary kidney and urinary medicine.
Dr Woerde’s achievement comes after five years of intensive training at the University of California, Davis (UC Davis) Veterinary Medical Teaching Hospital, including a dedicated fellowship in nephrology, interventional endourology, and extracorporeal therapies.
His recent return home to join MediPaws Veterinary Specialist Centre in Sydney is helping establish a new level of specialist support for general practitioners managing increasingly complex renal and urinary cases.
Where it all began
Dr Woerde’s path into veterinary medicine started long before university. He grew up on a small hobby farm outside Port Macquarie, and his experiences gave him an early sense of what the profession involved.
“We always had animals and that meant vets regularly coming out to the property,” recalls Dr Woerde. “That kind of constant exposure definitely set the direction for me.”
By the time he reached high school, he was already working weekends and afternoons as a kennel hand on Sydney’s Northern Beaches. That hands-on experience confirmed what he wanted to do with his life, and after graduating from the University of Sydney with first-class honours, he moved into mixed practice in Bacchus Marsh on the outskirts of Melbourne. The shift was immersive and often demanding, with a wide range of on-farm and after-hours cases.
“You really do get thrown into the deep end in that kind of job,” says Dr Woerde. “It taught me a lot, but I realised I was more drawn to the diagnostic side of medicine rather than large-animal work.”
That realisation brought him back to Sydney for a small-animal internal medicine internship at the Animal Referral Hospital. He found the transition into a specialist setting energising.
“There was much more emphasis on investigation and deeper workups,” he explains. “Seeing unusual and complex cases every day really opened my eyes to what specialised medicine could offer and confirmed this was the path I wanted.”
Training at the top
After completing his internship in internal medicine, Dr Woerde set his sights on pursuing advanced training that would give him the depth of expertise he felt his patients deserved. That led him to one of the most competitive and highly regarded veterinary hospitals in the world, UC Davis in California.
We used to be quicker to condemn patients. But now, with the right diagnostics and, when needed, interventions like stents or bypasses, a lot of these dogs and cats can go on to live good, normal lives.
Dr Dennis Woerde, internal medicine specialist, MediPaws
“It was almost like working in a tertiary referral centre,” he says. “We’d get referrals from other specialists, and the people teaching us were the ones writing the textbooks.”
During his three-year internal medicine residency, he was immersed in a caseload that ranged from rare disorders to the kinds of complicated workups that could only be managed with advanced diagnostics and specialist teams.
“We’d see things we’d never even heard of before; it was an amazing experience,” he says. “We were doing really high-end urinary work. Those skills were exactly what I wanted to bring home.”
The combination of kidney physiology, complex diagnostics, and the ability to provide treatments like dialysis and minimally invasive urinary procedures resonated deeply, and that interest led him to stay on at UC Davis for a two-year fellowship in nephrology, interventional endourology and extracorporeal therapies.
The fellowship was intensive. It included procedures such as dialysis, therapeutic plasma exchange for immune-mediated conditions and toxicities, and advanced interventional urology techniques like cystoscopic stent placement and laser ablation of ectopic ureters.
“It was a huge amount of work, but I feel very lucky to have trained in a place where so much of the cutting-edge research and innovation is happening. It’s given me the tools to come home and actually offer something meaningful to Australian patients.”
A new specialty emerges
Kidney and urinary diseases are common in dogs and cats, yet access to advanced procedures and specialist-level diagnostics has historically been limited. That gap became even more apparent to Dr Woerde during his residency and fellowship in the US.
“I think the caseload in America is just so much higher than in Australia,” he explains. “You see so many more of these cases during residency and fellowship, and you’re exposed to procedures that only a few places here are doing. And those procedures were an opportunity to build tangible skills. They really let you feel confident about troubleshooting cases where things aren’t straightforward.”
For Australian general practice vets, the emergence of this dedicated specialty represents a significant step forward in a clinical area that has often lacked structured support. Dr Woerde sees real value in offering deeper expertise where it matters most.
“Internal medicine is so broad that it makes sense to hone in,” he says. “It helps build on the strong base we already have as specialists and gives us extra tools to help patients.”
He also hopes the growing recognition of kidney and urinary disease as a distinct specialty will improve outcomes, particularly for animals who would once have had limited treatment options.
“We used to be quicker to condemn patients,” he says. “But now, with the right diagnostics and, when needed, interventions like stents or bypasses, a lot of these dogs and cats can go on to live good, normal lives.”
Closing the knowledge gap
As the first Australian Diplomate of the American College of Veterinary Nephrology and Urology, Dr Woerde is now focused on translating his training into practical support for general practice veterinarians. Much of that comes down to ensuring GPs know what is now possible in a field that has historically offered limited options.
“We’re still in an education phase,” says Dr Woerde. “There are new ways we can help get better outcomes, and not everyone is aware of what these subspecialties can offer yet.”
He sees that knowledge gap most clearly in the way acute kidney injuries were traditionally managed. In the past, a sudden rise in kidney values often carried a guarded prognosis, yet many of those cases are now known to be caused by ureteral obstructions that can be relieved through medical management or minimally invasive procedures.
He expects the diagnostic landscape to continue shifting as newer biomarkers become more widely developed and validated. Earlier detection of kidney injury could help vets identify patients at higher risk after events like anaesthesia or prolonged illness, long before changes appear on routine bloodwork.
“For me, that’s where I think the profession will go,” he says. “Better tools to pick up kidney injury earlier than we can now.”
Just as important is the collaborative relationship he wants to maintain with referring vets. Dr Woerde is clear that specialist medicine works best when communication is open and accessible.
“Even if a vet isn’t planning to refer, I’m more than happy to give advice if it’s something related to kidney or urinary disease,” he concludes. “We’re all colleagues. General practice vets and specialists should work together in a symbiotic relationship.”
