As the year draws to a close, suffice it to say that 2013 was a tumultuous one for the world of veterinary medicine. Many of the stories that kept the veterinary news wires humming made it into the mainstream media. However, some of the most persistently attention-grabbing items among vets have flown below the radar of the non-veterinary world.
What follows is a list of items that I found compelling during 2013.
In 2001 I attended a lecture about a then-revolutionary nonsurgical way to neuter dogs. Neutersol, a product containing zinc gluconate, which could be injected directly into the testicles, was poised (according to the manufacturer) to change neutering forever.
The product bombed, but was reintroduced several years ago as “Esterilsol” in Latin America.
In 2013, there was news that the product would soon be taking the USA by storm, but most vets reacted to the news skeptically. In 2014 we will see whether the product gains any traction on its second go.
In December 2011 a scrappy mutt named Kabang saved two girls from being struck by a motorcycle in the Philippines. In the process, Kabang’s maxillary structures (also known as her snout) were severed by the spokes in the motorcycle’s wheel. After an international fundraising effort, Kabang was flown to my alma mater, the UC Davis School of Veterinary Medicine.
Kabang first required treatment for heartworm disease and a transmissible venereal tumor (that’s right, dogs can catch STDs), and ultimately received surgery to close the open would from the injury. She received a hero’s welcome upon her return to the Philippines this year.
Speaking of heartworm disease, this year it was announced that resistance to most of the commonly used preventatives has been identified in a discrete area of the Mississippi River basin. The problem seems to be not a big one for now, but it has caused significant handwringing among veterinarians worried about what the future might hold.
And, while we’re still on the subject of heartworm, it’s time to mention a news item that has been on the top of all vets’ minds for as long as I can remember: chronic drug supply problems. This year saw ongoing shortages of medications to treat heartworm disease, seizures, diabetes, and certain types of infections. Recalls of both manufactured and compounded drugs were common frustrations for vets, and may have caused significant health hazards for pets.
For years, the American Veterinary Medical Association (AVMA) has offered health insurance to its members through the Group Health and Life Insurance Trust (GHLIT). In January, the underwriter announced that after December 31, 2013, it would be canceling health insurance for 17,500 vets covered by the program.
Some have speculated that the program’s underwriter decided that it would be simpler to cancel the program than to comply with the Affordable Care Act. The AVMA has created a health insurance marketplace to help the affected vets get new coverage, but it should go without saying that many people who diligently paid their premiums for years felt terribly betrayed.
In 2012 a DEA agent in Sacramento, Calif., decided to interpret federal drug laws in a manner that precluded carrying controlled substances in vehicles. The shock waves hit the veterinary community in 2013, when it became common knowledge that this practice might make home euthanasias impossible (euthanasia solution is a controlled substance).
Fortunately the agent’s interpretation hasn’t had a grave impact on the practice (yet), and a bipartisan congressional effort is underway to correct the problem.
In August and September an outbreak of vasculitis and hemorrhagic gastroenteritis among dogs in Ohio led to many fatalities. In circumstances eerily similar to the Ebola virus outbreaks among humans in the 1990s, dogs rapidly became sick and suffer from leaking blood vessels leading to bloody diarrhea, shock, and death.
Initial reports suggested that canine circovirus might be responsible; although the cause of the syndrome remains a mystery, the outbreak fortunately faded away before becoming a true plague (but not before causing major anxiety in the veterinary community).
Once an article of faith among veterinarians, the benefits of spaying and neutering — especially early spaying and neutering — have become controversial. Most vets, including me, still believe that, on the whole, most dogs benefit from being spayed or neutered (although the timing should be tailored to each dog’s individual circumstances).
However, in 2013 we saw increasing evidence that spaying and neutering might not be right for all individuals. And a newly vocal group of veterinarians is beginning to oppose the procedures altogether. With time these individuals may be proven wrong, or right. Or, more likely, partially right and partially wrong.
The spay/neuter controversy promises only to become more prominent in 2014 and beyond.
Vets have been aware of a problem with jerky treats since 2007, but 2013 saw the problem begin to receive some traction in the veterinary world as the FDA began to solicit more information from vets about dogs sickened or killed by jerky treats.
Nobody knows why jerky treats are dangerous to dogs, nor what component is responsible for the illness that can occur when dogs consume them. There has yet to be any recall or ban. This issue could take several more years to play out fully; meanwhile, I strongly recommend that you not feed any jerky treat to your pet.
The last three items on my list are related, and they are insider items specific to the veterinary community. You may not have heard of any of them, but for most of the vets I know, the next three items are the news items of 2013.
When I graduated from veterinary school, I took pride in the fact that it was harder to get into vet school than into med school. Well, not anymore. The recent economic downturn led to markedly reduced government funding for vet schools. The vet schools had an epiphany: There is an endless supply of starry-eyed youngsters who want to be vets and will pay anything to achieve their dreams.
So vet schools tried to solve their financial woes by increasing class sizes and admitting more high-tuition, out-of-state students. Simultaneously, entrepreneurial types have realized the potential financial rewards of offering to fulfill these starry-eyed kids’ dreams. Over the last decade and a half new schools have opened, or have been planned to open in California, Arizona, and Tennessee.
Making things worse (or better, depending upon your viewpoint), the AVMA has extended accreditation to a for-profit school in the Caribbean and many additional foreign schools. All of these factors have combined to result in many more available slots for would-be veterinary students. The upshot is that now just about anyone who can fog a mirror and get a student loan can get into vet school (and many people suspect that mirror fogging is optional). Of course, once they graduate, those kids will have massive student loans and poor job prospects. More on that below.
The AVMA exists to support the interests of American veterinarians who comprise its membership, or so I thought when I joined it. It turns out I was wrong. In fact, the mission and objective of the AVMA make no mention of its members or of individual veterinarians. And many dues-paying vets are up in arms. They believe that the AVMA has devolved into a good ol’ boy network that looks out for itself and has thrown its members under the bus by, for instance, accrediting foreign schools and thereby facilitating the education of more veterinarians who will enter an already saturated market (but will become dues-paying AVMA members).
Because the AVMA no longer even offers health insurance, many vets are wondering what exactly they get from the organization. Some vets are reacting by quitting. Others are vocally calling for change. Others still have taken the fight to Schaumburg, Illinois, where AVMA is headquartered. In 2014 the organization will discuss member-sponsored initiatives to change the organization’s mission statement and to cease the accreditation of foreign schools.
And why are elements of the AVMA membership so upset about the organization’s activities? It’s because of the story that is unequivocally the No. 1 veterinary news item of 2013.
You may think your vet’s charges are high, but she may very well be having trouble keeping the lights on and paying her staff. Vets have known for years that our profession is suffering a major economic crisis, but 2013 is the year that the problems really hit the news.
In February, the New York Times detailed the miserable prospects for those above-mentioned starry-eyed young folks who were willing to do anything to become vets. The article appeared to open the eyes of the many vets and especially vet students who formerly had been living in denial.
The economics of the veterinary profession are not good. We are squeezed by high debt, vendors and laboratories who raise prices like clockwork, clients who are still struggling to recover from the recession, and plateauing demand for our services.
Later in the year the AVMA finally got off its ass and released a study that confirmed what most vets in America already knew: There are too many vets in the United States (although the AVMA referred to it by the circumlocution of “excess capacity”). Despite this, existing schools are increasing class sizes and new schools are set to churn out new vets at a record pace. There simply are not enough pets to support all of these vets, and bankruptcy may be looming for many vets. The AVMA’s response — that vets need to “increase demand” — has rung hollow to many in its membership.
However, there may be a silver lining to the cloud. Things have gotten so bad that denial is no longer an option. As mentioned above, the AVMA’s membership is in revolt, and most vets have removed their heads from the sand. My hope for the new year is that constructive action takes place to ensure that today’s veterinary and pre-veterinary students do not face a lifetime of penury.
Here’s to a better 2014. And you can kick it off right by keeping your dog safe and happy on New Year’s Eve.
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