I found out that Dr. Karnia is just a regular vet no specialty whatsoever, however, her fees reflect specialist. We took our 17 year old kitty to North Scottsdale Animal hospital for a complete blood panel and check up as Dr. Robertson's office referred us to Dr. Josh Sosnow. OMG he was great. After reviewing everything he said she didn't need any of the medications she was put on. We took her off the 2 hypertension meds immediately and she is seems the same. He believes she simply has arthritis and is old. He said her blood work was excellent and even he was surprised! He said her meds obviously haven't hurt her at all and said it was up to us to continue with a little pain and the small dose of steroids. All the drama with Dr.Karnia and not to mention the $500.00 plus $1,000.00 for absolutely nothing but meds our cat didn't need. Don't be afraid of calling your vet out. We have been paying 100.00 a month and treating our cat with medications she didn't even need after going to a "cat specialist" who isn't a specialist!