SIRVSing in northern MN

Last weekend I had the opportunity to travel to northern MN with a University of Minnesota group called SIRVS: Student Initiative for Reservation Veterinary Services. We set up shop just outside the White Earth community in a town called Naytahwaush. Our purpose there was to provide free basic clinical care. Generally, we performed exams, administered vaccines, and made recommendations for longer-term care or more advanced care than we could deliver in two days. It’s a win-win situation: the clients, who often don’t have the economic wherewithal to afford veterinary care (or simply don’t have a veterinarian nearby), get basic health care for their animals and the students get experience examining animals, delivering care, and interacting with clients.

I’ve participated in vaccine clinics before, but I would say this was somewhat more advanced. While we were still quite limited, we had rudimentary diagnostic capabilities and a very limited pharmacy in order to diagnose and treat some problems. In vaccine clinics it’s been my experience that more often than not the exam is perfunctory – it’s point is simply to ensure the animal is sufficiently healthy to handle the vaccines – and there is no attempt to treat other issues.

Saturday morning started with a man with six dogs. Given the amount of paperwork we need to do, along with the relatively slow pace of a student exam compared to a longtime practicing veterinarian, that took my team quite a while. A few clients later, one of the supervising vets approached and asked if I wanted to help with a critical care case. After taking the history it became apparent that the dog was a likely candidate for parvovirus: the 5-month-old puppy was listless and uninterested in his surroundings, had just had a bout of hematochezia (bloody diarrhea) on our floor, and had a reported history of recent vomiting.

Unfortunately, successful treatment normally requires hospitalization, and we did not have the capability to provide 24-hour care. We were limited to administering fluids to combat dehydration along with antibiotics to ward off secondary infection and subsequent sepsis. We did provide this both Saturday all afternoon and Sunday all morning, so I suppose we gave the puppy a somewhat better chance than it had to begin with. Better care would have involved an antiemetic to reduce nausea along with different fluids than the LRS (Lactated Ringer’s Solution) that we had. Even with our efforts, the prognosis (assuming our presumptive diagnosis was correct) was not good; parvovirus is a particularly nasty, contagious, hardy killer of puppies. Fortunately, there is a vaccine available. Unfortunately, this puppy hadn’t gotten it. The rest of my Saturday was taken up with this dog due to his need for constant care. Also, the particularly contagious nature of parvovirus would have made it foolish for me to return to providing exams for other (probably non-vaccinated) dogs.

Sunday was full of little interesting details on examination: a dog that had gotten its head caught in a car door and damaged an eye, another with a large squishy mass under its cheek that defied aspiration no matter who tried, a chihuahua that lived up to its reputation by trying to eat my arm off, a mutt with a broken leg that was well on its way to healing, and a really cute puppy. Puppies are always nice.

This little patient on Sunday made my day.

The entire weekend was an interesting education experience when it came to clients. Just like clinics I’ve been in, they came in all stripes: some compliant, some not so much. Some with financial resources to provide our recommended additional care (like heartworm protection), some without. Some trusting of the vet care we were providing, and some not. For example, one client absolutely refused rabies vaccination for his animal because of concern that his animal and he might contract rabies from it. No attempt to educate or convince him on my part was going to have any impact, and, believe it or not, I understand his point of view: here’s some technology he doesn’t really understand but if there’s one thing he does know, it’s that rabies virus is a pretty horrible thing, so staying an arm’s length away from anything involving it probably seemed smart to him. He was wrong, of course; there’s zero chance of contracting rabies from the vaccination, but he didn’t know that or believe me. (Incidentally, I just read that the first MN canine rabies case of 2011 cropped up in western MN recently. Please vaccinate your pets.) There were also some cultural differences, and they made it a bit challenging to provide the best care possible. For example, down here in Minneapolis most animals are largely indoor pets. They may go to the dog park, or go outside to play during the day, but at night they’re inside. The animals we saw this weekend were, more often than not, the reverse: mostly or exclusively outdoor animals with only a few that spent the majority of the time inside. During one exam I asked a client what they fed their dog; the client looked at me and said “Feed? It hunts.” That’s not something you’ll encounter here in Minneapolis. Incidentally, that particular ‘hunting’ dog had the best body and coat condition of any I saw; I suspect strongly a neighbor feeds the dog without the client’s knowledge.

Our hosts were fantastic. In particular, a local conservation officer made food available to us all weekend. She also fried up fresh walleye filets on Sunday afternoon that had been locally netted a day or two ahead of our trip. I was struck by the level of effort that took, and the consideration that it demonstrated. I knew they were going to feed us, but frankly, I anticipated the bare minimum. I never expected to sit down to a meal of fry bread, corn on the cob, fresh walleye filets, a wild rice mixture, milk, and juice. It was humbling.

SIRVS intends to return, I believe, in the spring for a spay/neuter clinic along with a day of exams and vaccinations. I thought I heard talk of a winter trip for exams as well. I’m hopeful I’ll be able to participate in all of the future trips!

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