I brought my dog in for a consultation. He had very advanced rheumatoid arthritis. Dr. Lirtzman could have just told me that my dog needed to have his knees and hip replaced and charged me a lot of money. He was very upfront about the problems that my dog would be facing if we did have surgery. I appreciate their honesty, no matter how hard it is to hear, and would trust them with any of my other dogs. Thank you.