BEST MEDICINE

International Advocacy for Animals in Need

 

It takes a certain type of person to travel abroad to help others. Identifying those that are interested in this type of work and can also thrive in a less-than-ideal environment practicing the best medicine possible is a serious challenge. To many, it sounds like an amazing vacation but in reality, it is a lot of hard work that starts the second you become part of a team.


No one sets out to practice medicine that is outside of their comfort zone but many veterinary professionals find themselves doing just that. When initially developing a team to head to Ecuador back in April 2017 to spay/neuter/vaccinate/deworm street dogs, the choice was made to create a plan that stood out from the rest. A plan that would make people proud to be involved and comfortable with the quality of care we were able to provide. We were determined to blaze a trail of quality care in situations with limited means. We vowed to vaccinate and deworm and to treat what ailments we could. We were committed to providing the highest quality anesthesia and analgesia possible. We created protocols that rivaled top-notch practices stateside. We created them and we actually made them happen. Of course it took months of planning, fundraising and networking but we made our goal, our dream, a reality. We could not have done it without the help and support of our industry partners and donors. For them we are grateful. 


International projects require people ‘on the ground’ or in the country where the project is to take place. Permits are a necessity to bring drugs and supplies from the US so any drugs (controlled or otherwise) that can be obtained in that country should be. Nearly every piece of gauze, every IV catheter, every needle and every pair of gloves are brought from the US.  Supplies are obtained through purchase or in-kind donation, packed in second-hand suitcases and doled out to volunteers to ‘mule’ down with them. Each volunteer is asked to check the maximum number of bags leaving very little space for their own belongings (there is always enough from everyone to bring what they need and this ultimately works out on the way home where volunteers are able to repack their bags with goods purchased from the country visited).

We chose high-quality products that would best suit our needs. We also secured donations of Nocita and have been able to bring a Companion Laser and portable ultrasound. When people find out what we are doing they want to help!


A typical patient would be presented to our team after being brought in from the streets. Animals are nervous and often in poor body condition with unknown physiological challenges. We strive to treat each patient with patience and respect. They are thoroughly examined by a veterinarian and that information is given to the ‘drug lord’ (DL); essentially, an individual trained in anesthesia and comfortable with all the drugs available. The DL creates an anesthetic plan for that animal based on temperament and physical exam findings with a specific protocol in mind but also with the freedom to tailor things to meet the exact needs of the patient. Most animals received a dose of hydromorphone (0.1 mg/kg) and dexdomitor (5-7 mcg/kg) IM as a premed. At that time Rimadyl is given (4.4 mg/kg) SQ along with Convenia (8 mg/kg). Once the animal is calm and sedated, an IV catheter is placed and they are given Cerenia (1 mg/kg IV) and induced with ketamine (5 mg/kg). Every patient is intubated, abdomen is shaved and surgically prepped.


Patients are brought into the operating room and connected to 100% oxygen and connected to IV fluids with hydromorphone and ketamine added and dripped in at a surgical rate (5 ml/kg/hr). Patients are also outfitted with a pulse-oximeter (Masimo Rad-8 or Sentier Vetcorder) and a capnograph (Masimo EMMA) so their physiologic status can be monitored. At the end of each spay procedure, patients are given a line block using diluted Nocita (off label) and neuters are given intra-testicular blocks using the same drug.


When the surgery is complete, the animals are brought into recovery where they are monitored by trained veterinary professionals, kept warm, vaccinated and given topical flea/tick medication. If available, each patient’s incision is treated with low-level laser to decrease inflammation and promote healing. All of this is important because once these animals are fully recovered, they are brought right back to the streets and neighborhoods from which they came. There is very little chance for follow up care.


The volunteer veterinary team is asked to work long days in a new environment with people that they just met. There is no room for anyone’s ego, we are all equal and in this together. The team is asked to respect each other and the culture, to conduct ourselves in a professional manner in and out of the clinic. The goal of the team coordinators is to make sure that everyone has what they need, that they are able to rest when necessary and eat when needed. Team members will be policed to make sure everyone is drinking enough water and not over-working or over-heating. We are a team and even though we have a ton of work to complete, we are understanding and supportive of the potential issues surrounding international travel.

Our inventory list is long and specific. We know what we need and what works best for our purposes. We welcome in-kind donations as well as monetary support. If you are interested in supporting our next project, please contact Azi at azadeh.chegini@zoetis.com

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