AVImark vs Cornerstone

These are the two systems most often compared when a US small-animal practice is weighing on-premise options. Both have long histories and large installed bases. AVImark is Covetrus, Cornerstone is IDEXX.

Side by side

The equipment question usually decides it

For most practices choosing between these, the deciding factor is which analysers and imaging are already in the building. Integration between a practice management system and in-house lab from the same portfolio is tighter, and that shows up many times a day. Reviewers confirm this from the other direction: connecting Cornerstone to non-IDEXX software is reported as time-intensive.

If you have not yet bought equipment, this works in reverse, and the two decisions are more connected than either vendor leads with.

The question behind the question

If you are comparing these two in 2026, it is worth asking whether you want to stay on-premise at all. Both answers are legitimate. Staying keeps data in the building and keeps you working through an outage. Leaving removes the server, the backups and the update cycle, and makes multi-site and remote work straightforward.

Practices that decide this deliberately tend to be content with the outcome. Practices that end up on-premise by default, because replacing the system felt like too much work, tend to be the ones describing the same frustrations three years later.

Worth noting that both sit inside large groups that also sell to your practice. If that is part of what you are weighing, see who owns your practice management system.

Ratings and recurring themes from AVImark on Capterra, Cornerstone on Capterra, checked August 2026. Ratings move; tell us if this is out of date.