Our puppy was in bad shape when we got her. Today, you could never tell. Dr. Roach took great precaution with our puppy (a 3lb yorkie) and made sure she was dewormed and her ear mites were gone. We take her in at least once a month and his prices are so reasonable we don't even have insurance. The facility is always clean and we are treated well. Most importantly, Dr. Roach is great on updates and communication. If never consider going anywhere else.