April 27, 2020

Veterinary care in a pandemic: A paradigm shift

UCalgary veterinarians experiencing a new way of helping animals and their owners

If you’ve taken your pet to the veterinarian’s recently, you’ll know this: Veterinary care, like so many other facets of our lives, is seeing great changes because of the COVID-19 pandemic. 

Veterinary medicine is an essential service and while most veterinary clinics remain open, it’s not business as usual. Many have reduced hours and stopped booking routine or non-urgent appointments. Plus, their doors may be locked. 

Small animal veterinary clinic changes

“The biggest difference is there's zero physical client contact,” says Dr. Serge Chalhoub, DVM, a small animal internal medicine specialist and senior instructor at the University of Calgary Faculty of Veterinary Medicine (UCVM). “Outside the clinic, parked cars are running and an animal health technician in full PPE takes a brief history from the owner, then takes the pet from the owner into the clinic to be examined for further diagnostics and treatment. There's complete separation from owners coming into the building.”

Inside the clinic, veterinary staff also wear PPE and try to maintain distance when possible. Their already rigorous cleaning and sanitation procedures have ramped up.

Serge Chalhoub with Ellie-Mae, a 10-year-old bloodhound in for a recheck of a kidney problem.

Serge Chalhoub with Ellie-Mae, a 10-year-old bloodhound in for a recheck of a kidney problem.

Amanda Barker

“Staff shortages are a problem,” Chalhoub adds. “If people have any kind of cold- or flu-like symptoms, they have to self-isolate. And that puts a strain on the remaining staff.”

Challenges in providing empathy and comfort

Chalhoub says it’s stressful for people not being able to be with their pets inside the clinic, but the new policy is necessary in this time of crisis. The one exception is when an animal has to be euthanized.

“We had a very chronically ill case where the cat wasn't doing well, and it was just time. The owner had to wear full PPE as they held their cat,” explains Chalhoub. “I was in full PPE as well and it was so difficult to not be able to comfort the client in ways that I normally would. Even just a simple handshake or a little pat on the shoulder. It changes the way we provide empathy and for the owner to not be able to see my face because I’m wearing a mask — boy, it's just such a different, different scenario.”

The rise of telemedicine

Another big change is more extensive use of telemedicine — be that a phone call or connecting visually through a video conferencing platform.

“I've heard from a lot of colleagues that it takes a real disruption to create major paradigm shifts in how we do things and we’re seeing that with telemedicine,” says Chalhoub. “We’re recognizing that there are clients we can reach now that we couldn't reach before. There's a population out there that we’ve perhaps been under-serving and there’s a potential for increasing or enhancing our capacity to provide veterinary medicine. Anxious clients, anxious dogs, and clients that come from very far. It offers an alternative type of care, but telemedicine won’t and shouldn’t replace in-person contact once the pandemic ends.”

On the farm and in the barn

Many changes now seen in small animal veterinary clinics, however, don’t apply to veterinarians treating horses or livestock. For large animal veterinarians, most appointments are on farm, going into people's barns, handling facilities, and fields.

“It's not like a small animal veterinary clinic where you drop your animal off at the door and you reduce all of that contact,” says Dr. Ashley Whitehead, DVM, a large animal internal medicine specialist and associate dean, clinical programs at UCVM. “You're going to a different barn with different people for each case. This time of year is particularly tough because large animal veterinarians are going nonstop managing difficult foalings and calvings. In addition, equine veterinarians are busy doing essential vaccinations. Overdue vaccinations need to be completed to help prevent disease in horses, especially those related to the upcoming mosquito season and other infectious diseases.”

And unlike treating an animal in a fully staffed clinic, many large animal veterinarians rely on owners or facility staff to handle the animals while treatments are being done.

“For safety reasons, you usually want to be on the same side of the horse as the person who's holding on,” Whitehead explains. “But you can't be six feet from that person when on the same side of an animal. So even the basics of the safe handling and restraint of animals are now an issue.”

Whitehead says large animal veterinarians reduce the amount of close contact by asking clients more questions on the phone beforehand, and limiting the number of people around during appointments. “We’re taking as many precautions as we can, but we can’t all be wearing N-95 masks because there are shortages, and we need to ensure they’re available for human medicine. Large animal veterinarians are out in the field performing lifesaving activities in the best way they can during this difficult time.”

An anxious time for all

But no matter the animal species, owners all experience anxiety about their animals’ health and well-being.

“I can imagine that the stress that owners have is ramped up considerably someone comes in with a mask, gloves, and personal protective equipment. That's just adding to the thoughts of ‘what's going to happen to my pet.’ Anxieties are higher for everyone all around, which then feeds to the animals. It's a time when we have to be very kind and respectful to each other, to know that we’re all dealing with it at this point.”

Chalhoub also sees the strain in both colleagues and owners dealing with same underlying worry about spread of COVID-19. “Being a veterinarian right now, it's definitely a change. I can sense the anxiety in everyone. We're coming to work because we believe in what we do and we provide an essential service. At the same time, everyone is scared because we can all potentially carry the virus without having symptoms. We come back home to our loved ones so there's always that extra concern. It's a difficult time.”