SAVMA PHCOC "Underserved Population Externship" stipend winner
Chelsea Reaves, CSU DVM Candidate Class of 2017
December 2013 at Animal Care Center
As my first semester of vet school came to an end, I packed up my suitcase with warm clothes, my stethoscope, coveralls, and boots and headed off to Hardin, MT. I was fortunate to have met Dr. Francis through family friends randomly, and we clicked right away, so I spoke with him about gaining some experience through his practice! Dr. Francis runs a mixed animal practice, Animal Care Center, in a rural area of Montana basically on the Crow Indian Reservation. Being a Tucson native, I knew this would be a great opportunity for me to be exposed to an area with a different level of personal animal care than you mostly see in larger cities like Tucson where everything is “their baby”.
In Hardin and the surrounding areas there are a ton of stray dogs, skinny horses, and feral cats that are kind of put outside to forage for food on their own with the occasional food tossed out to them. On the contrary, there are also the family pets, ranchers’ cattle, and 4-H animals. Hardin is a beautiful area if you really enjoy the outdoors, as the Bighorn River runs right through it and there are a lot of open spaces.
Being on the reservation, there are an immense amount of strays. Dr. Francis works closely with a rescue lady, Sheri. Sheri runs a non-profit organization called Rez Dog Rescue and basically drives all over Crow Agency, Lodge Grass, and Lame Deer finding abandoned, neglected, and stray “Rez” (reservation mutts) dogs. She brings them to Dr. Francis and he works with her at discounted prices to spay/neuter, treat, vaccinate, and deworm all these dogs. Dr. Francis works to provide low cost veterinary care to the underserved area and help alleviate the rampant problem of abandoned “rez dogs”. I got a lot of experience with spay and neuter surgeries, from sedation and anesthesia, to prepping the dogs on the surgery table, and assisting in surgery. Dr. Francis also sets up spay/neuter clinics with the tribes, although there was not one during the break while I was there.
There are many problems unbridled in the area from stray dogs roaming the area and breeding, a wide array of mange, malnutrition, neglect, and injuries from car accidents and mistreatment. Mange is a consistent problem. Many dogs that are owned by members of the tribe are not treated for their mange until it has reached a very severe state. This leaves the dogs with severe alopecia, secondary bacterial and fungal infections, and more since the immune system can become depressed. We would treat many of these dogs with dip baths, ivermectin, and antibiotics or antifungals. Part of the problem is that the population is so naïve to the proper hygiene and care for things like this, that even if they do bring a dog in to get treated, they do a poor job of checking other animals or cleaning the environment (beds, etc). So, re-infestations can be a common place.
Big Horn County has one of the highest unemployment rates in the state. This contributes to the fact that the members of the Crow Tribe most often don’t seek out health care for their animals until the disease or ailment has progressed to a severe state. One dog was brought in that had a GIANT mammary tumor, by far the biggest I had ever seen. The owners finally agreed to treat by removal. The surgery went for the most part well except for the fact that the tumor was so large that after having removed it, it was extremely difficult to close the skin back down, as a lot of skin had been removed with the tumor. This left the dog with a very taut suture line that would be prone to breakdown.
In communities like Hardin, in which veterinary care is very much a luxury, a lot of pre-op care, such as blood work, or fluids during surgery gets turned down by the owner due to lack of money. However, at least the patients brought in are able to get their main problem treated. Another incidence of letting a problem go on for too long, is when a dog came in with an embedded "collar" from a jeweled bracelet that had been placed around its neck as a puppy. It was so deep that the skin was morphed around it about an inch or more deep. We removed the jewelry and the puppy will be up for adoption from Rez Dog Rescue.
Common occurrences in the area also include dog fights, car accidents, poisoning (often from ingestion of rat poison or rotten food at the town dump where strays hang out), which all come naturally with lots of strays roaming and unkempt fences. We saw several cases during my externship in which we cleaned and debrided wounds and sutured up lacerations. We had a successful case in treating a dog that had ingested rat poison by inducing the dog to vomit and administering vitamin K. Unfortunately we also had an unsuccessful case in which the dog was brought in by the owners who hadn’t seen him come to eat in two days and finally found him laying somewhere out in the yard. I was able to perform a necropsy and there was diffuse bleeding throughout the body, and we suspected it was from the progression of ingesting of rat poison.
Although there are many problems consisting of the dog population on the reservation, the Crow Nation, as with many surrounding tribes, is also very involved with horses. They use horses for Indian Relay races, racing, and buying/selling. Since they like to travel with these horses to sales, competitions or races it is important that these horses follow state regulations relative to Coggins testing and health certificates. Dr. Francis is one of the very few veterinarians that serve this area and without him many of these horses would not receive this testing or proper paperwork. This could also lead to increased spread of disease when regulations aren’t followed with transportation of animals. So, this leads me to another adventure I had with Dr. Francis. We travelled out to the middle of Crow Agency to perform quite a few Coggins tests on horses that were going to a bucking horse sale. I want to emphasize those last three words once more… bucking horse sale. I have drawn blood on horses for Coggins tests before, but it was rather amusing to watch me trying to draw blood on these untamed horses, as the “chute” like apparatus that they were chasing these horses into was about five feet too wide and five feet too long. The client would then throw a rope around the horse’s neck and try to pull the horse closer to the fence for me. HA! Wild horses don’t like halters, people, needles, and surely aren’t calm after you wildly hoop and holler at them as you chase them into a wooden stall. Long story short I was very successful in that I managed to avoid breaking my arm as the horses kicked and reared with my arm reaching through the slits of the fence attempting to draw blood!
There area also many, way too skinny horses that you will see left to graze through a foot of snow which has almost no grass, let alone nutritious grass. It is a problem that coincides with the lack of employment and low income, and also a sense of ignorance. This population needs a better awareness of nutrition and care for their animals, as well as a better system enforcing proper treatment and care. It becomes a sticky situation since any complaints made about animal cruelty or neglect has to be enforced by people from the tribe since it is a sovereign nation. I believe it is a really important issue that will hopefully get resolved with education, awareness and somehow a change in the laws of enforcement as these animals deserve better than to starve.
There are also many viruses that are prevalent and somewhat endemic in the area. When you have a population of animals that doesn’t get a lot of preventative care (vaccines) and a lot of strays, you get rampant bouts of parvovirus, distemper, and rabies cases. A rabies positive case actually came into the clinic just a few days before I arrived for my externship. Due to this the clinic vaccinates for rabies on a 2-year schedule instead of 3-year. It is important to educate populations like these about the important of preventative care and vaccinations. Many of the animals in the area have never gotten a vaccine or maybe only got one and were never seen again for a booster.
My overall experience was amazing and I learned a lot. It was the perfect experience for me as a first year veterinary student to experience all types of medicine to various species. It is an entirely different environment of veterinary care than I am used to from my experiences working in small animal clinics in Tucson, Arizona, where I am from. The community has less disposable income to be spent on veterinary care, and also lacks the understanding of how important it is to the health and prosperity of the community. I believe strongly that Dr. Francis contributes tremendously to this underserved population through his clinic's service, and he is a tremendous mentor. He is so willing to help me learn and try things for myself. He will explain any case presented, and also let me attempt my own analysis before explaining to me why I am right or wrong or which steps are the next to take. I was able to make a presentation to local students at the middle school in Hardin about veterinary medicine, as Dr. Francis’ wife is a teacher. Many of the students did not realize there was so much that you could do with a veterinarian degree, so I hope I encouraged them to explore all options. As break flew by and came to an abrupt end, I packed up my stuff to head back to Fort Collins for my second semester. It was a great experience and I hope to work with Dr. Francis, and in Montana, more in the future.