CUVS' Pet Talent Contest

Enter CUVS' Pet Talent Contest!

Every one of us thinks that our pet is the most amazing animal ever - On National Pet Week, let’s give them a chance to shine!

Does your pet have a special or unusual talent? Send us a video to prove it. If your entry receives the most votes, your talented pet will be featured on our homepage and blog. And you’ll win a CUVS fleece. This contest isn’t limited to just cats and dogs, so get out your video camera or smart phone and capture your cat, fish, dog, horse, hamster, guinea pig or ferret doing something extraordinary!

All entries will be posted in our Most Talented Pet album on our Facebook page. The video that gathers the most “likes” will be the winner! You can email entries to smueller@cuvs.org, or send us a facebook message with your video as an attachment. Make sure to include a brief description so that we know what we’re looking at! Once your video is up, feel free to share it with your friends, family, coworkers and neighbors and encourage them to vote for your pet! We will accept entries until 5pm on Thursday, May 23rd and will announce the winner the next week.

Get those cameras rolling and let’s see what your pet can do!

April is National Heartworm Awareness Month!

Heartworm Awareness and a Very Special Update

April is National Heartworm Awareness month, and our cardiologist, Dr. Gretchen Singletary, DVM, DACVIM (Cardiology), has some information for all dog and cat owners about this dangerous, but highly preventable disease:

"Heartworm disease affects increasing numbers of dogs and cats in the US every year. The disease is transmitted by mosquitoes and is most prevalent in warm and humid climates. Peak transmission usually occurs during July and August, although pets in certain areas such as the Southeastern US may be at risk year-round. Heartworm disease is a serious, sometimes fatal condition which can be safely and easily prevented using a monthly heartworm preventative medication. Yearly testing for heartworm is recommended for all dogs.

Pets infected with heartworm can develop damage to their blood vessels, lungs and heart. Symptoms include coughing, difficulty breathing, decreased ability to exercise and weakness. Severe infections can result in heart failure or death. There are approved treatments for infected dogs - including injections of a medication to kill the worms and removal of the worms using a minimally-invasive surgical procedure. There are no approved treatments for heartworm infections in cats. Prevention is key when it comes to heartworm disease!"

--


 Dr. Gretchen Singletary, DVM, DACVIM (Cardiology)

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We at CUVS can't think of heartworm without also remembering Lucky. In 2011, we posted about Lucky, the mixed breed dog who was rescued in Los Angeles, and brought to CUVS by a New York rescue organization. When he was first brought to us, Lucky had suffered gunshot wounds to his legs, and needed several surgeries. While his injuries were already certainly enough for the scrappy dog to handle, it was discovered that Lucky was also suffering from a severe heartworm infection of his pulmonary artery. Fortunate for Lucky, our cardiologist was able to expertly remove the heartworms using flouroscopy and an incredibly steady hand. While heartworm extraction is a complex procedure with many risks involved, Lucky sailed through the procedure and after a night of recovery in CUVS' Intensive Care unit, went home heartworm free.




When Lucky was brought to CUVS, his injuries were severe.

 

Cardiologist Dr. Kleman was able to remove a sizable group of heartworms from Lucky's pulmonary artery.


Lucky then underwent surgery to repair the damage to his front and rear legs, caused by serious abuse before he was rescued. Thanks to the skill and care of CUVS' surgery department, Lucky's limbs were skillfully repaired and Lucky was able to regain full use of all his legs. At the end of Lucky's journey here, one of our staff members adopted him and provided Lucky with a happy ending in his new forever home. 

Lucky with Dr. Kleman, members of the nursing staff and his rescuers on his way home.


Lucky attended our Courageous Companions event in April, and CUVS staff had the opportunity to reunite with him and his supportive family. We're happy to say that he looks incredible, and along with his supportive family, enjoyed the spotlight with his colleagues.

Lucky attended the reunion looking better than ever!

Lucky was fortunate that his heartworm was discovered before it had progressed any further, and he serves as an example of why heartworm prevention is so vital to a pet's well-being. Speak to your primary care veterinarian about the prevention options available to you and take care of all those hearts that are so dear to yours!

PDA

Patent Ductus Arteriosus (PDA)

 Jamie was a 6 and a half week-old puppy when she was first brought to Dr. Chuck Noonan at Animal Doctors of Weston. She was acting normally and seemed to have had no issues in her first weeks of life. Dr. Noonan examined her and listened to her heart only to discover a significant heart murmur that was continuous throughout her heartbeat cycle. Dr. Noonan astutely recognized that this was likely a very significant heart defect that she was likely born with and recommended that Jamie’s mother take her to a veterinary cardiologist.

A week later, Jamie was seen by Dr. Mandi Kleman, a board-certified veterinary cardiologist at Cornell University Veterinary Specialists. Dr. Kleman performed an echocardiogram (ultrasound of the heart), which revealed a structural abnormality called a patent ductus arteriosus (PDA). A PDA is a congenital cardiac abnormality in which a connection exists between the aorta (the major systemic artery) and the pulmonary artery (the major vessel to the lungs). This abnormal connection results in the heart becoming overloaded by recirculating blood and typically results in heart failure within the first year of life. It was imperative, therefore, that we correct Jamie’s PDA.

There are 2 ways to correct PDAs. The first is via open chest surgery, to locate and ligate (tie off) the abnormal PDA vessel. This is the traditional method. The second option is to occlude (close off) the PDA vessel via an Interventional Radiology technique. Interventional Radiology is a method of surgery that uses video xrays (fluoroscopy) to allow the surgeon to see into the body and manipulate structures. This is a new technique in veterinary medicine, available at few academic and specialty institutions, including Cornell University Veterinary Specialists. The advantages of these techniques are that they are less invasive; there is no open surgery and thus, less pain and a faster recovery. For PDA correction via Interventional Radiology, an Amplatz ductal occluder or embolic coil can be inserted via a blood vessel until it is placed across the abnormal PDA vessel. The device then causes obstruction of blood flow across the PDA.

Here, at CUVS, both techniques are possible. In Jamie’s case, however, it was decided that surgery was her best option given her very small size. Dr Oli Morgan, staff surgeon at Cornell University Veterinary Specialists, performed the surgery - a left lateral thoracotomy via the 4th intercostal space. The PDA was carefully dissected and ligated, restoring normal blood flow. Jamie recovered smoothly in the Intensive Care Unit. Her heart murmur resolved. That evening she was already standing and eating! The next day, she was giving kisses and behaving like a puppy again. She was discharged to her owners care for at home recovery. After two weeks of exercise restriction she was healed. Her prognosis is excellent with a normal life expectancy.

Dr. Oli Morgan joins CUVS

CUVS Welcomes Dr. Oliver Morgan, VMD, DACVS, on board as our new staff surgeon!

As we bid a sad farewell to Dr. Alon Kramer, who has moved back to Portland with his family, we are excited to introduce Dr. Oliver “Oli” Morgan as the newest member of our medical team. We are so lucky to have found a surgeon of his calibur, and his communication skills and core values lend themselves very well to our atmosphere here. We're thrilled to have him on board, and he is undoubtedly a great match for our team here at CUVS!

We had a chance to catch him in the middle of a busy day here to ask him a few questions:

Q. Where are you coming from - where did you work before CUVS?

A. I am moving from Los Angeles, California where I worked at a large multispecialty referral hospital (Advanced Critical Care at the City of Angels Veterinary Specialty Center).  I am returning to Connecticut where I grew up with my wife and 1 year old son not only to work at CUVS, but also to be close to family.

Q. How have your first few days been here at CUVS?

A. My first few days at CUVS have been great with everyone being extremely welcoming.  The atmosphere within CUVS for both clients, patients, and new doctors is very similar it seems!

Q. How is CUVS different? What do you like about working here?
A. CUVS represents a new paradigm in veterinary medicine that is directed at providing a mix of the best of private practice with the best of academia.  I am so excited to be working in an environment with specialists that both love what they do and are excellent at what they do with a central dedication to client service and to our referring veterinarians.  The technicians and staff are excellent and also clearly have a deep-seated dedication to the care of our patients and that carries through in all their interactions with our patients.

We're so happy to have Dr. Morgan on board and are looking forward to a great future with him as part of the family. Welcome!

Pet Dangers During the Holidays!

All of us at CUVS wish you and your family a wonderful holiday season! Because we’re always looking out for your four-legged family members, we’d like to share some common dangers to avoid during this joyful, and sometimes chaotic, time.

High Fat Holiday Foods
Although it is tempting to let everyone sample grandma’s great cooking, holiday foods are not a good idea for your pet, even in small quantities. Meals with a high fat content are one of the most common causes of pancreatitis in dogs. Pancreatitis (inflammation of the pancreas) can result in a reduced appetite, severe abdominal pain, vomiting, and in severe cases, can be life-threatening. High fat foods and abrupt changes in the diet can lead to gastrointestinal problems, such as vomiting and diarrhea.

Chocolate
Most of us know that chocolate can be toxic to dogs; however, few know the reasons. Chocolate contains theobromine, a chemical compound of the cocoa bean which is a strong stimulant, closely related to caffeine. In large doses, theobromine and caffeine can cause excitation, cardiac arrhythmias (abnormal heart rhythm) and seizures. Dogs are particularly sensitive to the effect of theobromine and caffeine. Chocolate should be stored far from your pets’ reach, especially dark, semi-sweet, unsweetened chocolate and cocoa nibs, since these have higher concentrations of theobromine than white or milk chocolate.

Raisins & Grapes
Raisins and grapes are extremely dangerous for dogs, as they can cause severe kidney failure. Keep in mind that raisins are commonly found in holiday treats such as bread and desserts.

Alcohol
We all like to relax and enjoy the spirits of the season. Just keep in mind that even small amounts of an alcoholic beverage can significantly affect your pet. Pets, especially cats, are not as efficient at breaking-down alcohol, and could end up in an ethylic coma. Please avoid sharing your drink with Fluffy, and keep the booze out of reach at all times.

Household Plants
If you share your house with a dog or a cat, always investigate your indoor plant choices before you consider making them an integral part of your household. Keep this in mind when receiving flowers as a gift. Poinsettia, the Christmas flower, can cause mouth irritation and gastroenteritis, but is not considered lethal. Various types of lilies, however (Easter Lily, Day Lily, Tiger Lily) can be lethal. These lilies cause severe kidney failure when ingested, even in small quantities, by your feline companion.

Holiday Decorations
Nothing sets the holiday mood like decking the halls and dressing your tree. However, many of these decorations can be hazardous to your pets. Tinsel and other string-like decorations can be a tempting treat for your cat or dog. Sometimes, parts of these decorations can get caught around your pets’ tongue or elsewhere in the gastrointestinal system and cause life-threatening problems that require emergency surgery. The same goes for other non-string-like decorative items, which can get lodged in the stomach or intestines, causing a blockage. Electric cords (such as for lights) can also pose a problem if your cat or dog has a tendency to chew on things they are not supposed to. Because of the danger they pose, make sure to hang your tree ornaments and other decorations out of the reach of your pets.

Please keep your pets safe this holiday season. And keep an eye on them. If they are lethargic, not eating, acting abnormally or exhibiting vomiting or diarrhea – seek medical attention.

Alex Rousseau, DVM, DACVIM (Internal Medicine), DACVECC

Wrap up: "The First 24 Hours" Continuing Education Lectures & Labs

Dr. Kleman leads her lecture on heart failure emergencies.

 On Sunday, October 23rd, many of CUVS's specialists lectured at a one day continuing education seminar for veterinarians titled The First 24 Hours: A Multifaceted Approach To The Emergency Patient. Over one hundred veterinarians attended the six lectures which were held at the Hyatt in Old Greenwich, CT.  The lectures, which covered a broad range of emergency topics, were led by veterinary specialists from Cornell University Veterinary Specialists as well as the Cornell University College of Veterinary Medicine.

Following the lectures were two labs which allowed veterinarians to get hands-on experience with either CPR using a virtual model or emergency radiology of the thorax and abdomen using a computer-based laboratory.

Dr. Fletcher leads the CPR lab with a high-tech virtual dog model.

The feedback from the attending vets was very positive and we all enjoyed meeting up with local veterinarians face-to-face. Although the veterinary field is a small community, and we do refer cases back and forth, it is not often we can meet up as a group to get to know one another. It's nice to put faces to names so that we can forge stronger bonds with our referring veterinarians moving forward.

Dr. Forman lectures to a full house at his Endocrine Emergencies lecture.

Lectures presented at "The First 24 Hours" included:


• Critical Thinking in the Critical Patient: 30 Minutes to Save a Life (Dr. Sergi Serrano LV, DVM, DACVECC)

• Getting to the Heart of the Matter: The Emergency Heart Failure Patient (Dr. Mandi Kleman DVM, DACVIM (Cardiology)

• Hematology in the Emergency Setting (Dr. Deanna Schaefer DVM, MS, MT(ASCP), DACVP)

• Endocrine Emergencies: A Case-based Presentation (Dr. Marnin Forman DVM, DACVIM (Internal Medicine)

• Making the Cut: The Fine Line Between Urgent and Emergent Surgery (Dr. Alon Kramer DVM, DACVS)

• Breaking Myths: Teaching Old Dogmas New Tricks (Panel Discussion- Dr. Daniel Fletcher, Dr. Susan Hackner, Dr. Alex Rousseau, Dr. Sergi Serrano)


Labs presented at "The First 24 Hours" included:


• Cardiopulmonarycerebral Resuscitation (CPR) Using a Virtual Model (Dr. Daniel Fletcher DVM, PhD, DACVECC)

• Emergency Radiology of the Thorax and Abdomen (Dr. Margaret S. Thompson DVM, DACVR)

Q & A: Canine Influenza Virus

What is Canine Influenza? 

Canine Influenza Virus (CIV) is a respiratory virus of dogs. It has been identified in several states, including Connecticut and New York. A relatively small number of cases have been reported in Hartford, New London and Fairfield counties.
Influenza virus was first identified as an infectious disease of dogs in 2004. The first isolation of the virus was done at the Animal Health Diagnostic Center at Cornell University involving racing greyhounds. Within a year of the discovery, CIV was found in pet dogs in Florida and in the New York City area. Since that time the virus has been found in different areas of the US. CIV continues to move slowly through the canine population. It is highly contagious. Risk factors for the infection are having dogs in closely confined conditions such as in boarding kennels, day care setting and animal rescue shelters. Animals being relocated from the rescue shelters seem to be a main source of the movement of the virus to new locations.

How do I know if my dog has CIV? 

The clinical signs associated with the infection are indistinguishable from the traditionally defined “kennel cough”, now more appropriately referred to as acute respiratory disease. They include coughing, nasal discharge, fever and often inappetance. These symptoms are not unique to CIV, so it is important that the dog be thoroughly evaluated and tested. CIV infection compromises the normal defense mechanisms of the respiratory tract so that secondary bacterial infections (such as pneumonia) are common sequelae.

How is CIV diagnosed?

The diagnosis of CIV necessitates the identification of the virus in the acutely infected dog (via PCR testing) or demonstrating antibodies in the later stages of the clinical event (via serologic testing). Samples for PCR testing should be taken within 4 days of onset of clinical signs and the sample of choice is a nasal swab. For serologic testing, an acute and convalescent sample (10-14 days apart) are optimal, but in areas of low CIV prevalence, a single sample taken > 7 days after acute onset may be sufficient. Both PCR and serologic testing are performed by The Animal Health Diagnostic Center at Cornell University.

What is the prognosis for dogs with CIV? 

Since CIV is a relatively new (novel) disease, few dogs have natural immunity built up to protect them. As a result, a high proportion of dogs exposed to the virus become infected; approximately 80 percent develop symptoms, while another 20 percent do not become ill. Fortunately, most dogs recover within two weeks without any further health complications. However, some dogs progress to pneumonia, which is usually due to secondary bacterial infections. This is frequently curable with appropriate medical care. Dogs are generally free of CIV by 7 days post onset of clinical signs. They may cough for several weeks beyond this, but they are not contagious at this time.

Is my dog at risk?

The risk of infection is increased by exposure to other dogs. Dog shows, dog parks, kennels, grooming salons, dog day care centers, or anywhere dogs gather increase risk of CIV infection. Risk also depends on the prevalence of the virus in the area in which the dog lives or travels.

How do I prevent CIV infection?

CIV is best prevented by avoiding unnecessary contact with other dogs, particularly if your dog is particularly young or old, or has a compromised immune system. A vaccine is now available, that is effective in preventing CIV-related symptoms.

Should my dog be vaccinated against CIV?

The vaccine should be considered for dogs whose lifestyle puts them at greater risk (see above). Due the contagiousness of this virus, some kennels and grooming salons now require this vaccination to prevent an outbreak. Aside from these situations, the decision to vaccinate should be discussed with your primary care veterinarian, taking into consideration your dog's risks and the CIV prevalence in the area in which you live or to which you will be traveling.

Can humans or other pets get CIV?

In spite of monitoring by the CDC, the transmission of CIV to humans or to pets has never been demonstrated scientifically.

For more information on Canine Influenza Virus, please go to: http://ahdc.vet.cornell.edu/news/civ.cfm

-Susan G. Hackner, BVSc, MRCVS, DACVIM, DACVECC

Chief Medical Officer & Chief Operating Officer

CUVS Drs. Forman and Kramer Interviewed on Pet Talk TV Show

CUVS internist Dr. Marnin Forman and surgeon Dr. Alon Kramer, with host Lauren Collier, discuss the benefits of minimally invasive procedures on a recent episode of "Pet Talk."

April 10th Pet Health Education Sessions: CPCR and First Aid for Your Pet

Cornell University Veterinary Specialists is proud to provide pet health educational sessions for owners, starting with our first session:


Sunday, April 10, 2-3:30 PM
CPCR and First Aid for Your Pet, led by Debbie Glynn, BS, LVT

Do you know what to do if your pet has been hit by a car, suffers from heat stroke or gets stung by a bee? This class is designed to teach you the basics of first aid and Cardiopulmonary Cerebral Resuscitation (CPCR formerly known as CPR) for your pet. You will learn everything from at-home splints/bandages to chest compressions so that you can be the first responder for your pet.

If you are interested in attending any of these classes or learning more about our pet health educational sessions, please call us at 203-595-2777 or email us at info@cuvs.org. Space is limited and reservations are required for attendance. All classes are held at CUVS. Please check back often for session updates.

Sherman Gets a Pacemaker at CUVS

Sherman Tank is an 8-year-old, 66-pound male bulldog who was brought into CUVS in need of help. Sherman needed a pacemaker. Sherman’s owners brought him to their family veterinarian for an exam after noticing that sometimes he lacked his usual energy and was reluctant to climb stairs. Sherman’s veterinarian performed an electrocardiogram (diagnostic tool that measures the electrical activity of the heart) and found that Sherman had 3^rd degree atrioventricular block with a ventricular escape rhythm. In layman’s terms, this diagnosis means the normal electrical impulse which stimulates the heart to contract is blocked. Fortunately, the muscular portion of the heart has a back-up system which allows it to continue to beat in the absence of a normal electrical impulse. Unfortunately, this back-up system often fails over time, despite various medical therapies.  Previous veterinary studies have shown that dogs such as Sherman may experience episodes of collapse or even pass away suddenly at home. Sherman was then referred by his family veterinarian to Cornell University Veterinary Specialists to see our cardiologist, Dr. Mandi Kleman, for an evaluation for a pacemaker.

Upon examining Sherman, Dr. Kleman found Sherman to be bradycardic (possessing a heart rate that is too slow), consistent with his previous exam. In preparation for potential pacemaker implantation, she obtained a repeat ECG, an echocardiogram (an ultrasound of the heart), bloodwork, and a urinalysis. The ECG confirmed the continued presence of the 3^rd degree AV block and the echocardiogram showed mild volume overload of the left heart. After discussing the plan at length with the owners, Dr. Kleman scheduled a pacemaker implantation procedure for the following day.

Dr. Kleman surgically implanting Sherman's pacemaker

Sherman stayed at CUVS overnight for monitoring and at noon the following day, Dr. Kleman prepared and scrubbed for the surgery. During a short 90-minute procedure, Dr. Kleman implanted a Medtronic pacemaker device into Sherman’s heart via two small incisions in his neck.  The surgery was a complete success with no complications. The pacemaker was ideally working to control Sherman’s electrical heart rhythm. Sherman recovered in ICU overnight with attentive pain management and monitoring. 

 

Dr. Kleman evaluating Sherman's pacemaker with ECG the next day.

Dr. Kleman programming Sherman's pacemaker the next day.

The morning after the procedure, the pacemaker was functioning properly, Sherman was energetic, and he ate a can of dog food for breakfast. That day, Dr. Kleman performed a chest x-ray, another ECG, and programmed the pacemaker to optimize the settings.  To program the pacemaker, Dr. Kleman uses a specialized computer to evaluate the pacemaker’s function and if necessary, to adjust the settings of the pacemaker. Sherman was prescribed oral antibiotics and a mild tranquilizer to keep him calm and to allow him to heal properly. He was discharged to his owners at 4PM that day with a normal heart rate and a short little wagging tail.

Sherman at discharge with Dr. Kleman,DVM, DACVIM (Cardiology), Carrie Maskley BS, CVT, Sherman and his owners

–      Dr. Mandi Kleman, DVM, DACVIM (Cardiology)
–      Stephanie Phillips, BA, A.A.S, LVT                       

Learn more about pacemakers by clicking here.

Casey's Abdominal Surgery at CUVS

   Casey is a mixed-breed spayed female dog owned by Suzanne, who is the Senior Client Service Representative at Bull's Head Pet Hospital. Casey was referred to CUVS from Bull’s Head after Dr. Nolan Zeide diagnosed her with a large abdominal mass, hemo-abdomen and a fever.  Casey was admitted to CUVS for observation, supportive care and a further work up under the care of Dr. Rousseau, DVM, DACVIM, DACVECC.

An ultrasound at CUVS revealed a large mass potentially originating from the liver, an abnormal spleen and a probable left adrenal mass. Casey underwent abdominal exploratory surgery with Dr. Alon Kramer, DVM, DACVS, during which a large, ruptured splenic mass and a ruptured liver mass were found. A splenectomy, a liver lobectomy and an adrenal biopsy were performed. (Her spleen and part of her liver were removed.) Casey also received a blood transfusion during surgery, a routine part of splenectomies as it combats anemia.

Post surgery, Casey stayed in our ICU for four days for pain relief and continuous monitoring. Attentive post-surgical monitoring is important for splenectomy patients to make sure that there are no complications. Lab results came back showing liposarcoma of the intermediate grade in the spleen, hepatoma in the liver and suspected pheochromocytoma in the adrenal gland.

Once Casey was stable enough for travel, she was sent back to Bull’s Head so her regular veterinarian could continue caring for her. Casey was a lovely patient for us and although we are happy she was discharged from CUVS, we were sad to see her go!

CUVS Featured on Channel 12 CT's Pet Talk TV Show

Dr. Susan Hackner (CMO) and Dr. Mandi Kleman (Cardiology) are interviewed by Lauren Collier on Channel 12 CT's "Pet Talk" TV show about the opening of Cornell University Veterinary Specialists.

Cornell University Veterinary Specialists profiled in the Stamford Advocate

Check out this great article in the Stamford Advocate which covers CUVS, the services we offer, our high-tech equipment and skilled staff!

Cornell University Veterinary Specialists is open for business

We are proud to announce that Cornell University Veterinary Specialists is now open and currently treating patients at a brand-new facility in Stamford, CT.  CUVS opened its doors on January 14th! A crowded ribbon-cutting event was held during the final open house on January 12th, 2011. The ceremony was attended by the mayor of Stamford, Michael Packs, several K9 police officers, the media, animal lovers, and the friends and families of hospital staff.

From left to right: Carl Kuehner from BLT; Dr. Susan Hackner, CMO of CUVS; Dr. Michael Kotlikoff, Dean of the College of Veterinary Medicine of Cornell University; Stamford Mayor Michael Pavia; Daniel Gurvich, CFO of CUVS; and Paul Kuehner of BLT.

As the largest university-affiliated veterinary referral center in the country, CUVS is driven by the mission of bringing together the best of specialty private practice with the best of academia to benefit pets, the people who love them, and the veterinary profession. CUVS provides exceptional medical care by integrating the latest medical and scientific advances with personalized, collaborative and efficient service.

With a state-of-the-art facility and a convenient location close to I-95, downtown Stamford and the Stamford train station, CUVS promises to deliver the highest level of specialty care to animals in need. CUVS features an 24-hour emergency department serving walk-in animal emergencies all day and night. Referral-based appointments with specialty veterinarians are available in the following departments: Cardiology, Critical Care, Diagnostic Imaging, Internal Medicine, Interventional Radiology, Oncology, Orthopedic Surgery and Soft Tissue Surgery.

Driving directions to CUVS are available here or by calling (203) 595-2777. You may email Client Services at info@cuvs.org, follow CUVS on Twitter and "like" our page on Facebook.

Cornell University Veterinary Specialists

880 Canal Street

Stamford, CT 06902