Fair point. I apologize.
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I have taught owners how to administer medication intravenously.
I have also taught owners who lived in BFE and had horses with ERU how to do a fluoroscein stain of the eye before starting corticosteroid eye medication so they could get on top of it ASAP.
But the idea of teaching an owner how to rectal a colicky horse is not something I would even consider. It isn’t even therapeutic.
I do try to teach owners how to assess their horse before calling the DVM in order to provide as much information as possible–temperature, heart rate, respiratory rate, gut sounds, digital pulses, mucous membrane color/capillary refill.
Also, when possible amount and quality of manure, urine, appetite, changes in usual behavior, etc.
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The need for veterinarians is clear, and and even greater need is looming on the horizon. Given the importance of animals in the food industry, what if the government paid x amount towards training in the vet professions. It could negotiate with the vet schools for a fair, fixed rate. If students took on a part of the burden (but not all) they’d have skin in the game. The government tuition would be considered a loan, to be forgiven after so many years in practice in order to discourage dilettantes and those who start vet school and then transfer elsewhere.
I’m a graduate of an public health/ epidemiology program. Years ago I tried to get a vet school to join with a public health school to offer a joint program. I came this close, before the usual concerns got in the way: who gets the most tuition, who grants the degree, who will be in charge. To me, it seemed like a win for the vet school. With no increase in bricks and mortar, and public health students only attending the “dry” classes, it would increase their interested alumni and financial base with minimal administrative support. And I thought it would be a win for public health since animals are so often an indicator of environmental health and the source of disease that can infect humans. (This was years ago when I was told by a med school professor that no one should go into studying infectious diseases because they were essentially wiped out. Oops!)
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I remember as a kid the barn owners daughters horse was colicking severely. Vet came out, and tried to do a recital palpitation. Horse’s bowel was so distended that vet unintentionally of course perforated it. This was back in the 80’s so nearest surgery center was UF 3 + hours away. Euthanized the horse at the farm. Large malpractice settlement. I felt so sorry for the horse, the little girl and also for the vet. He was so upset. I still remember his name to this day.
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But what do you do when there is no DMV to call? I mean that as an honest question. A lot of people live like that and many more will be joining the unfortunate lot.
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That’s good to hear you’ve helped folks gain skills that you believe to benefit them and their critters!
I know when we were home shopping, I vetoed several prospective areas as they were too far removed from good veterinary services.
I have considered approaching the vet that lives 4 doors down from me about my IV dilemma but she’s semi retired and I’ve not been a client of hers before so it seems too forward.
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What are you proposing as an alternative?
Wholesale access to prescrition medication?
A DIY surgery kit?
I’ve been through more than one absolute shitshow of being called out only after an owner had tried unsuccessfully to treat their own animals–and often these are people with some medical training beyond the average owner.
The all too frequent result is prolonged suffering on the part of the animal which is ultimately euthanized or far worse off than it would have been if treated properly to begin with, a badly broken relationship with the owner, and usual local gossip about the mean DVM.
There is no quick fix, and the fact that we appear to be modelling veterinary health care on out very badly broken for profit human healthcare system makes me sad.
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We have a Vet in this area who was palping a mare and tore her up internally. He denied doing it, but told them that they needed to get her to the Vet Hospital (New Bolton). New Bolton figured out what he’d done, but they lost the mare. He got sued, but as he was so apologetic and sympathetic, the jury didn’t want to hurt him, so he basically got off.
You and I don’t see eye to eye on anything. You are an experienced progressional with a wealth of knowledge, I am a keyboard jockey who has just happened to see far more than most horse owners.
I am asking for an answer to a very scary situation, not from you personally, but from the veterinary community on the whole.
There is a vet shortage. We cannot easily fix that. So what are we animal owners supposed to do? Get rid of them all? Let our animals die and suffer? And before anyone says I’m being histrionic, I’ve already shared one pertinent personal experience I had with no vet.
I am not proposing that Sally in Ocala start doing her own vet work to save a few dollars. What I am saying is we need a solution for the thousands of owners in the areas with less animal density where vet access is evaporating.
Training well qualified people to do more could help. But we don’t agree on that and I completely respect and understand your professional opinion of why not.
I think we could combine telemed with that increased education to owners to relieve the burden. Especially if we could come up with a way to get prescriptions in the hands of owners only when they need them in an emergency without just putting them out there in general circulation (partnerships with human pharmacies? $$$ but just one idea, though still problematic in rural areas).
I think a lot of (very intelligent) people go, “if the horse is so bad it emergently needs the vet, there is nothing wrong with putting the horse down.” But these animals are our friends and partners and we have the knowledge and ability to save them: it is a step backwards for society to be euthanizing saveable animals because the education system and economy are no longer compatible with our veterinary medicine model.
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If there were a quick fix, it would already be in place.
The veterinary profession is reeling right now. The cost of an education is through the roof. In small animal medicine, private practices are routinely being absorbed by corportations which dictate medical/surgical protocols to maximize profits, and yet it is the DVM and staff who are left to deal with the fallout and cries of putting profit before compassion.
A clinc where one of my former students is now a DVM was slammed on social media recently because a client expected them to be able to eat a >$4000 treatment bill on her dog, and rather than euthanize, a staff member said they’d cover it if the dog were signed over.
The suicide rate is skyrocketing. I have lost good caring colleagues.
I don’t think training paraprofessionals is necesarily a bad idea, but given where we’re at right now with the financial issues, I don’t see it working–veterinary nurses/technicians barely make a living wage. Adding 2-4 years to their educational debt to make them something more than a tech but less than a vet and then paying them less than fully qualified DVMs is likely a non-starter.
And that’s not even looking at changing the veterinary practice acts state by state.
Hell, I spent years on the state VMA’s committee trying to get vet techs accredited/licensed here, and it still dies in the legislature every year.
I think loosening up the telemed thing would be incredibly useful. I am consistently amazed at what MDs “get away with” compared to what I’m allowed to do.
The problem with access to prescription medications is that you know it would end up as a free for all.
Even in areas where there are ambulatory DVMs, access to colic surgery, nevermind being able to cover the expense, is not a sure thing.
No; I don’t have ready answers.
I benefitted from a partial decrease in my tuition because I agreed to remain in the state to practice for 4 years after graduation.
There are states which give grants to veterinary students who agree to similar conditions–working in underserved areas, etc.
I think that should be expanded as much as possible.
But again, once they’ve put in 4 years of being the only large animal DVM in the county, they’re often burnt out.
People younger than I was when I entered vet school could be eligible to join the military and serve after graduation.
Again, I wish to hell I had the answers.
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As an owner and someone on the fringes, something I feel very frustrated about is how you, the vets, are bearing the brunt of this disaster while it seems like “everyone else” who is a player (legislators, pharmaceutical/industry folks who impact expenses, also education institutions to a lesser degree) throws their hands up and goes “aw shucks there is nothing we can do,” or “well we tried that and it didn’t work so we give up.”
Do you think that is a fair assessment?
I get angry at the situation because I feel like no one in a position to affect change is actively trying to solve the problem. I know there are no easy solutions. But the problem isn’t going to fix itself by maintaining the status quo.
I can throw 100 ideas out there to help. No, I don’t think those 100 ideas are solutions or even viable when I throw them out there- they are just ideas. But we (meaning all stakeholders involved) need to keep the conversation going instead of just going “nope, nope, nope” and continuing to do nothing.
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The reality is not all animals make it, even with the best veterinary care possible. Owners need to accept that at certain times, in certain situations, the most positive outcome is a humane death for the animal. We are rapidly approaching a point that the humane death may come at the hands of the owner, the way it was done before vets were readily available.
I live in a rural situation, within an hour and a half of the nearest equine veterinary hospital, which is just outside of their service area. If one of my horses needs treatment, they must be hauled there.
Every owner needs to have a plan. I personally will never be with a stock trailer. A safe way to transport a horse, that is easy to get them in and out of. While mine is not equipped with a ramp, it can be backed up to an embankment to potentially load a horse with soundness issues. I also own an LQ trailer with a ramp, but the stock trailer is the trailer of choice.
I owned horses for many years before having a trailer, and now it is something I would not be without. If it got to a point where I could not of own a trailer, I would get out of horses. You cannot depend on others in an emergency situation, and if you choose to do so, you will most likely be disappointed.
I keep drugs on hand for the basics, given to me by my vet at my request. I make sure they are within a reasonable amount of the expiration date. I can hopefully provide a decent amount of relief until I can either get a vet here or get the horse to a vet.
I have had people ask me to “share” drugs, which I will not do. You develop the relationship and level of trust with your vet, just like I did with mine. You learn how to give an injection properly. I know how and where to give shots because I made the effort to learn.
We are prepared here to euthanize any large animal on the property (we farm beef cattle) via bullet if necessary. We know exactly where to place the shot for each species we own. We have the proper weapon with the proper ammunition for the situation.
Many years ago, at least 20 plus, an equine magazine published an article about how to properly euthanize a horse in the event a veterinarian was not able to get to you. This article was published after severe flooding in the Midwest that left catastrophically injured animals inaccessible to veterinary help. The article provided diagrams and very specific instructions, and was very clear and concise in descriptions. This magazine received much criticism for having the audacity to publish the article.
But in my opinion, they were right to provide the information. As owners, we cannot make the mistake of assuming anyone will be able to help us save our horses, including veterinarians.
Losing any animal is never easy. I lost a dog this week. He was euthanized due to dementia, and it was hard as he could still get around and was eating well, but was mentally no longer present.
I waited with him in the vet’s waiting room for an hour and a half, as they had emergencies when we got there and there were no exam rooms available for us to wait in. My dog greeted other owners and animals as they came in, and let a couple little girls fuss over him while we waited. One of the hardest things I have ever done was sit there, knowing what was going to happen next. The receptionist kept apologizing for the situation, but there was no point in being upset with her as she had no control of the situation.
Such is life. Do we really ever have that much control???
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I know without a doubt that I would not have made it through the last two years and leaving for human medicine is one of the best choices I could have made.
No, that’s definitely not true and such a common talking point. Paying fair wages will not increase the cost of veterinary care just as it won’t increase the cost of your hamburger. When employers refuse to pay living wages, provide subpar health insurance, and very little if any paid time off, employees are being set up for failure. And then they tell us we are burned out or have compassion fatigue. After over a decade of watching employers chew through their veterinary staff, I decided I was done being blamed for something largely beyond my control.
We can and should demand fair compensation for our labor.
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One of my cats was just doing some risky behavior. I made him stop and told him we are NOT going to the emergency clinic today (assuming they are open today and still accepting clients).
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I think there is a miscommunication here. I have to be misunderstanding this.
Saying statements along the lines of “not all animals survive even with veterinary intervention” as a justification for what is currently happening is not acceptable.
Of course not all animals survive even when treated. Am I wrong in assuming that is so obvious it doesn’t even need to be said?
My problem is the fact that many life-threatening incidents can be treated or will resolve once the horse (or dog or cat) has been stabilized with the aid of pharmaceuticals and therapeutic measures. Most of these can’t be delivered by anyone but a veterinarian.
To remove that option for owners and instead leave us the only choices of humanely destroying “just in case it gets worse” or wait and see if it gets better sets us back to 50+ years in terms of animal welfare and medicine. That is not okay.
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I am blessed to have an amazing younger large animal vet in my area. (I’ve been in this semi rural area since 1995) She bought an older vets practice 10 or so years ago. That older vet one time talked to me about horse owners and being a large animal vet. Lots of clients only call when the proverbial shit has hit the fan on Christmas Eve at 2 am. The bread and butter that many small animal vets see …. Vaccinations, wellness exams, annual look see were really non existent in my area. Just another thought. I know we horse owners are largely more self sufficient than small animal owners when it comes to our equines. I do wonder if that has contributed to the lack of available equine DVMs. If you only get called once in a blue moon how do you pay your bills or have a normal life ??
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My late husband was an equine vet. His level of frustration w people who did all their own vaccines, etc., and then called him for emergencies on Christmas at 2:00 am was HUGE!
Even though I could do those myself, I don’t. It’s important to me to support those I need to come when I really need them.
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@ThreeWishes and @NaturallyHappy I think this is all part of the conversation in solving the vet crisis. How can vets make enough money to survive in the face of ever increasing costs to own animals?
There are grants to go into food animal medicine. But everyone I have heard of who goes after those grants can’t get them because farmers can’t afford to call the vet. You need to show XX% of your income from food animal veterinary work, but when the farmers only want your emergency services, you can never reach that earnings threshold.
At the same time, when I call out the vet for an abscess and he leaves me a $100 tub of hoof supplement he peddles at an inflated price so he can feed his family, that’s irritating all around.
I wish I knew the answers.
I think that, if you live outside of a significantly horsey area, you just have to own a trailer and know that you will be hauling in an emergency. Do I like that? No, but it’s reality. I’m an hour and a half from my vet (who, bless him, was here two weeks ago inseminating my mare ON HIS DAY OFF because that’s just the kind of guy he is - yes, I thanked him profusely). The clinic I use provides ambulatory services to my area, but not outside of business hours or in emergencies. For anything urgent, I need to haul to my vet, to the nearest vet school (2 hours), or to the next closest major equine hospital (2.5 hours, but an easier drive than the vet school). I knew that when I moved here. There are a couple of ambulatory “large animal” vets in the area I could probably get in a critical situation to stabilize a horse or to euthanize one, but I wouldn’t trust them for anything other than that. This is the future of equine medicine, I’m afraid, because it’s not economically sustainable for equine practices to operate any other way.
On the farm animal side, I’m seeing an interesting trend that is helping the situation. I work for our state’s Farmers Cooperative, and many of the larger Co-Ops are now hiring veterinarians to work for their stores. Initially, this was a response to the customers’ needs for prescriptions for medicated feed, but it has also turned out to be a win/win/win overall for the local livestock producers, the stores, and the young large animal vets. The risk of establishing a clinic is lowered through the vet’s relationship with the store, and the community has access to veterinary medicine that is subsidized, to a certain degree, by the portion of the vet’s salary that comes from the Co-Op.
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