Wednesday, December 23, 2009

What Makes a Good Vet?

I'm not completely sure that we've gotten to the bottom of what was bothering Noble, but at least he seems to be doing OK for now. Part of my dissatisfaction has to do with our vet visit yesterday. I wasn't completely happy with how that went, and it made me think about how important having a good vet is, and what it means (to me as a horse person) to be a good vet.

I thought, many years ago, about being a vet. I ended up doing other things instead. But I'm well aware of how difficult it is to become a vet. There aren't that many schools, they're hard to get into, and the course of study is long and rigorous. And then there's the large animal/small animal problem - fewer and fewer veterinary students are deciding to go into large animals - the work is harder, the working conditions are less comfortable and the pay is less - not a good combination. So I'd think that anyone who ends up doing equine veterinary work would be someone with a natural affinity for horses.

We use a veterinary practice out of southern Wisconsin for our regular and emergency vet care for most of the horses at our barn - a few people use other vets. Our regular vet until recently was a wonderful woman called Dr. Ana. She was a horseperson herself, and her caring for horses really shone through. Although she was always very busy to the point of overwork, she never rushed or was impatient. She truly cared about the horses, and would always take the time to talk to them and reassure them. She got things done and didn't pussy-foot around, but she always took the gentlest route and always considered how the horse would think about things. Even our most nervous horses were more cooperative for her, and most of them seemed to genuinely feel comfortable in her presence - which is quite an achievement for someone who often came with needles in hand! She also took time to listen to what the people attached to the horses had to say - she was a good listener and was thoughtful.

We also use another vet, Dr. Alice, who works on her own, for our chiropractic and some endocrine and nutritional matters - I've found that most traditional vets don't seem to do very well when it comes to nutrition and knowledge about it - perhaps the veterinary curriculum doesn't do as good a job on these issues. (I've found this to be a problem with human doctors as well.) But Dr. Alice lives a long way away and doesn't do emergency visits. We also have access if we need it to several very good veterinary clinics, one of which is affiliated with the University of Wisconsin.

But Dr. Ana has left veterinary practice to work with her husband, who is (I believe) a (human) chiropractor. It's a loss for us - she knew all of our horses as individuals and had been providing their care for a number of years. And I liked her and always enjoyed talking with her about horses.

Although I've had good luck with the vets we've had show up on emergency calls from time to time over the years, I wasn't particularly happy with how Noble's vet visit went yesterday. The vet was a younger woman who I'd met before. She seemed harried, impatient and irritable. Noble isn't the best patient even when sedated - he tends to be extremely nervous for the vet and particularly worried with people he doesn't know - but she was easily frustrated and her first impulse when he was uncooperative was to use force - she started to twist his nose. This sort of thing tends to upset Noble even more - when I got him he was extremely head shy and he still isn't that comfortable having his ears touched - it was pretty clear that he'd been hit in the face or head and had had his ears used as a control device (I wish I could get my hands on the people who did that and twist their ears!). I told her to stop doing that and she wasn't pleased. I held his head for her and she got the job done, but he wasn't happy about it. She also wasn't very considerate of him - banging his teeth with the water syringe.

So I wasn't very happy with all that. I've dealt with lots of vets over the years, and technical competence is important, but that said I think most vets just aren't all that good on things like subtle lameness, alternative treatments and nutrition/supplementation. It's a lot like the health care system for people in that way. I blame some of that on the veterinary education system. But even if a vet is competent, it's also important that they take the time to carefully look at the horse and talk to the owner, and to consider the needs and feelings of the horse. They need to be able to get the job done, but the best vets are able to do it with minimal or no coercion and the horses trust them because they project calm and competence. And rushing is not good - horses tend to be unhappy with that. I think I'll try to get in touch with Dr. Ana and see whom she would recommend we use as our regular vet from her old practice, or if there is another vet she would recommend. We'll still likely get luck of the draw for emergencies, but at least we should have a regular vet the horses and people are comfortable with.

What do you think is important to have in your vet?

12 comments:

  1. I know you've kept up with our ongoing vet adventures with Jaz, and how long it took to get a correct diagnosis. I want my vet to take the time to explain all treatment options and the cost, AND admit if/when he has no idea what's going on and recommend you get further testing by a specialist. Don't make me go through every test you have until you stumble on the answer. Fortunately, we have large specialty clinics at our disposal here. They are way too expensive for small timers like me to use regularly, but great to have around when needed.

    It's important that the vet not rush and that the horses are treated in such a way that they aren't caused even more stress than they're already under. My vet once had an assistant that was always abrupt and needlessly rough with the horses, and they acted up for him every time. He was very knowledgeable in terms of the science, but this guy just didn't have the rapport with the horses. I finally got the courage to step in and say something about it. When I held them or a different assistant held them, they were fine. BTW, that assistant is no longer there.

    I'm still working thru this one, but I want the vet to have LOCAL vets to cover if he's OOT. I don't want to have to trailer a horse more than 30 miles in an emergency situation, or wait however long it's going to take them to get to my place. And then charge me a bazillion $ for a farm call.

    Finally, I think it's important for us as horse (or other pets, for that matter) to be proactive in the care of our horses. Just as with human doctors, even the best one can't have all the answers all the time. Listen to your own gut instinct. If you think something is not quite right, it probably isn't. Develop a rapport with the vet so you are comfortable voicing your opinion. If you don't have that, switch vets for sure.

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  2. Oops, in that last paragraph, I mean to say as horse OWNERS we should be proactive. Sorry about that.

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  3. Kate;

    I concur with regards to most of what you said about vets. The type of individual that is attracted to six or more years of college followed by a residency often isn't the kind of individual who has a lot of people (or animal) skills.

    When we find one who has all three, we glom onto them like glue around here.

    You're also correct in your assumption that vets don't receive a lot of nutrition courses in college, and next to no alternative medicine type stuff. Given the multiple species treatment, diagnosis, physiology and surgery requirements they are required to cram into their college time and residency this may not come as a surprise to anyone.

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  4. It is tought to find someone that is knowledgeable and good with poeple and horses.

    My barn owner is a vet and doesn't practice anymore (she works for the govt. and can't treat my horse) so she is a good sounding board for me. I feel pretty lucky most of the time, although she sometimes has a different opinion than the vet I call out.

    She recommended one man who specialized in horses - he was good, but was twice as expensive as the regular vet (ouch!) and had a bit of a "I'm a man and know more than little girls who like ponies" attitude with me.

    I asked that we switch to another clinic with a vet that I worked with at my old barn. This lady is about my age and is super patient with me and the horse. When my horse had stomach ulcers last summer, she would call me for an update if I hadn't called by 3pm. She was also available for questions at any time.

    I also think that the work is tough and it is sometimes tough to diagnose things so it sometimes takes a bit longer or a bit of extra patience to get things going in the right direction...

    (sorry for such a long comment!)

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  5. I am very lucky with my vet clinic , in that they are very goo, listen and respectful not only of my stock , but of my experience . If I call and say I need help i get help!
    A good reminder even on a n emerg call is to give a good history, and clearly identify what is going on IS NOT NORMAL FOR THIS HORSE. While I alsways agree the vet has a greater education and knowledge than I ,the one thing I guarantee I know more about that he/she is MY HORSE. My vet respects that and even idf he doesn't imedieatly see the issue he will look further based on what I am saying

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  6. Kate, I had a similar experience just last week, when I first took my cat Prince to the vet about his teeth. The first vet who saw him was hurried and wouldn't listen to me. So I took him back, this time requesting by name the vet that I used to see. He was much more thorough and caught several things that the first vet hadn't, AND he listened to me.

    The first vet I ever used with Panama was forceful and abrasive. He freaked Panama out with the clippers because he didn't stop to ask me whether Panama had ever seen any before -- just put them right to his face and started clipping away. When Panama (understandably) freaked out, he used his ear to hold him still, just as you described. So when I met a vet the following year that was patient with Panama and listened to me, I switched without hesitation!

    I think asking Dr. Ana for recommendations is a great idea. I was actually going to suggest it until I saw you'd already thought of it. :o)

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  7. It makes me so mad that she treated Noble that way!! He's almost 30 years old! We have definitely lucked out for the most part with the vets we've had. Back in Minnesota, we often had the co-owner of the large vet practice come out, and he was so gentle and listened carefully to everything we told him. Occasionally we had a younger woman come out, and she was not as gentle as I would have liked. When we moved to Iowa, I was nervous about what type of vet we'd have available, but we lucked out again! The vet we had for fall floating, vaccinating and sheathe cleaning was extremely kind and gentle with the horses, and complimentary of their good manners. Mosco is always my barometer of vets, because like Noble, vets make him very nervous. If he likes them, they must be good! :) Here's hoping you get your vet situation worked out.

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  8. You are lucky to have choices in your area as I have talked to many people that only have one local vet, or no at all!

    I love my vet for the reasons you like Dr. Ana. I have stayed with her because of her manner with the horses, along with her listening skills. She also has amazing diagnostic skills and she takes time to explain why she does the things she does. To me that is crucial. I value honesty over everything else.

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  9. I am so lucky here with a number of excellent vets to chhose from. My vet is wonderful as are his two associates. They keep meticulous records on all the horses and are always willing to take the extra time to do a thorough job when necessary.

    Horse handling skills are an amazing and essential part of what makes a vet good. Again, my vets are outstanding here. They would never treat one of my horses with disrespect or disregard for his feelings and reactions.

    But there are additional benefits. My vet is also an acupunturist/chiropractor, so alternative treaments are always an option. He is very particular about keeping appointment times (barring emergencies) and make a point of being here on time. And, his ego is always in check. If we run into an issue he does not have the ability to deal with--a too serious colic, or a potential surgery--he never hesitates in referring me to the right place to get the proper care.

    We have two major surgical clinics within an hour's drive, so there are excellent options for treatment.

    What's good about my vet? Everything! Dr. Elden Klayman is a superstar!

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  10. glad you stood up for noble. geez, what a jerk, using force like that when he didn't need it.

    ~lytha

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  11. I have had an interesting vet dilemma. My long-time vet practice had 2 vets who decided recently to go their separate ways. I had to choose between them, not an easy choice.

    Vet A is a true horseman. He's gentle and caring with the horses, and his calmness and skill makes even nervous horses happy. He's great at identifying lameness, careful and thoughtful in his exams and very knowledgeable. He's also so conventional that and conservative that he won't consider any alternative treatments. None. It's frustrating.

    Vet B is also a very good vet. She's trained in accupuncture and is always open to discussing alternatives, and does a lot of research into better methods. She's also quick to be annoyed at both us humans and our horses, and her temper and quickness sometimes upsets horses, and they become uncooperative (scared).

    I had to choose between these two. Bummer.

    I chose Vet B for my horses at home. I really appreciate the discussions of alternative treatments, and have learned to sort of manage the temper thing.

    Vet A is the barn vet where I board my younger horse, so he is also my vet. Even though I use some alternative/holistic treatments on my horse there, I don't feel free discussing them with Vet A (I've tried and his eyes glaze over). I've actually discussed them with Vet B, but their "parting" is still fresh, and they don't work in the same barns anymore, so I can't ask her to consult without hauling the horse home.

    It's rather an odd situation. I miss having them both together, and being able to access their combined skills. Maybe someday...

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  12. Kate - I am finally back online and just now reading this post. I am so glad you told that vet to stop twisting his nose. I am too passive when the vet or farrier are out. After reading your posts in the past about your dentist and chiropractor I thought you must live in the perfect horse world. Our vet has a fit if we call an equine dentist. I am so glad you protected Noble from any extra stress.
    I, too, was going to be a large animal vet. I went to school for zoology and started working for a vet. I ended up riding in the the truck with the large animal vet for 13 years. Over time, I learned then that I could never be the vet - only work for one. My vet was a good vet, the kind I would want to be. He was on call all the time. He never had time to ride his own horses or be with his own dogs. I had to ride his horses for him. Sadly, he passed away and our location seems to only have vets that are hurried and over-worked.

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