IOWA CITY, Iowa (AP) — Audrey, a 4-month-old Bernese Mountain Dog, caused an alarm in her home one Saturday morning last month when it became clear — based on her inability to keep food down or poop — that something was stuck in her stomach.
Elaine Himadi started looking for somewhere to take her puppy for emergency care, only to discover that the lone veterinary hospital in Iowa City that had offered weekend and overnight hours had recently ceased doing so. The next closest options for Audrey, in Cedar Rapids, were booked.
Stumped, Himadi considered a drive to Des Moines until, about three hours into the search, she found an opening an hour’s drive away in the Quad Cities.
That’s where veterinarians performed life-saving surgery to remove 49 inches of rope that had traveled from Audrey’s stomach to her colon.
“If it had been snowing, or storming, or if it had been more urgent, there wouldn’t have been anybody to see my dog, or anybody else’s dog for that matter,” Himadi told the Iowa City Press-Citizen.
Himadi is among the Iowa pet owners who are feeling the ripple effects of broader issues within the veterinary field, causing longer wait times in addition to fewer off-hours options.
The American Veterinary Medical Association estimates that, as of last spring, there were 18.5 available veterinarian jobs per job-seeker nationally. On top of what many say is a shortage in the workforce, the AMVA reports that demand for appointments increased during the COVID-19 pandemic while the rate doctors were able to take them on fell, because of virus-related safety precautions. And that caused burnout.
“Many hospitals are operating with fewer team members and dealing with higher turnover,” reads a September 2021 AMVA article. “Emergency clinics appear to be having an especially difficult time remaining fully staffed as they are inundated with a continuous stream of patients — both urgent and non-urgent cases. Pet owners, too, are feeling the crunch. They’re having to wait longer to get appointments and to be seen for emergencies.”
The Bright Eyes & Bushy Tails Veterinary Hospital in Iowa City, where Himadi first took Audrey, requires eight full-time veterinarians to fill shifts for a round-the-clock hospital. Anywhere from five to 10 patients came in on a slow emergency shift, and around 20 on busier ones, said Sarah Gingerich, veterinarian and chief of staff.
But the staff has shrunk to the full-time equivalent of 4.5 veterinarians during the pandemic. That’s what led to the decision to end overnight and weekend emergency hospital services beginning Jan. 3, Gingerich said.
“We knew that it would be difficult to take; we knew that it’s not ideal. I wish that it wasn’t the choice that we had to make,” she said. “But in order to keep the vets that I do have … we had to come up with a solution to make sure that they weren’t just being run into the ground.”
Because veterinarians will have their pick of jobs, it can be difficult to draw them to an emergency clinic with overnight and weekend shifts. While there’s always been people who prefer emergency medicine, Gingerich said, “those people are in extreme demand right now.”
The hospital still takes emergency cases during its 8 am to 8 pm weekday hours.
The goal is to “alleviate some of the burden that we know is on the other vets in the area by us not being open 24 hours a day,” Gingerich said.
Still, issues with staffing in veterinary clinics aren’t going unnoticed. Especially during the pandemic, Himadi said Audrey and her older brother, Solomon, have “just become, you know, ‘people’ to me.”
“I think a lot of people feel the same way. When you can’t get care for them, it’s really scary,” she said.
More than 100 miles west, the Iowa Veterinary Specialties Hospital in Des Moines has been training staff on anything from putting a catheter in a guinea pig to drawing blood from a hamster. The hospital is one of the few still operating 24 hours a day.
It’s part of their method for curbing staff shortages. Angie Gearhart, the hospital’s medical director, said IVS is willing to hire people with less experience and train them to the level of proficiency required for the job. The hospital actively recruits second- and third-year veterinary students from Iowa State University.
“Like, can they really put in an IV catheter? If they can, they have to put in 10 — some in dogs, some in cats, some in guinea pigs — before they are moved through the animal (training) system,” she said. “We’ve had to develop a lot of checks and balances, whereas before COVID, if you hired a tech out of one of the veterinary technician programs, and they passed their boards, the expectation was they have a certain level of proficiency.”
It’s been a “tremendous amount of work,” Gearhart said. But it’s been worth it: the hospital began the pandemic with 45 staff and now has 90. She said even before the pandemic, it was common to patients drive from as far away as Omaha for emergency care. It’s also the only hospital in Iowa that provides emergency care for exotic pets like snakes and iguanas.
“It’s really required us, our administration, to look at, instead of hiring people fully trained … ‘What’s our need now, what’s our need in three years? How do I walk back and find that person in time?’” she said.
In the height of the pandemic, the hospital could see 30-40 patients during a 12-hour shift. While the emergency services never ended at IVS, wait times did climb to eight hours. Just as in an emergency room for humans, the patients with the most severe health issues get care first.
Gearhart said people understand that 95% of the time. But the hospital has seen an increase in frustration for pet owners along with the wait times, causing it to hire off-duty police officers to sit in the lobby some nights from 6 pm to 2 am
“That has helped tremendously. We had people screaming, threatening; a couple of times we had owners threaten to injure staff members if it took too long,” she said.
The number of patients the average veterinarian could see per hour decreased by about 25% in 2020, according to the American Veterinary Medical Association. But there was also a 4.5% increase in appointments from 2019 to 2020, and 6.5% in the first half of 2021.
At IVS, it’s been much more: The hospital saw 13,624 patients last year as compared to 6,000-7,000 in an average year before the pandemic.
At the same time, Gearhart noted an increase in health conditions that would typically get taken care of with a routine vet appointment or vaccination, like ear infections, UTIs and parvovirus.
“Suddenly, dogs are getting to be 18, 20 weeks old, and they’ve never had a vaccine, and owners can’t find any place that will take their pet, and now it’s got parvo, and it’s very sick,” she said.
Gingerich, from Iowa City, said the hospital will keep its new hours for the foreseeable future.
“I can keep trying to offer vets more money and make things more appealing to come and work for me, but at the end of the day that doesn’t increase the number of veterinarians who are actually able to work,” she said. “Until the market actually has more veterinarians, it will continue to be an ongoing problem.”
Meanwhile, she said it’s important to address health issues before they become serious. That includes keeping up on preventative care like heartworm, flea and tick medicines, wellness checks and regular exercise.
“If you have a sick pet, (it’s important) you get it taken care of soon rather than waiting to see if it gets a lot worse,” Gingerich said. “Those are all really important things to do to help yourself out and to reduce the burden on emergency clinics.”
Himadi is happy to report that Audrey, with a fresh incision on her belly, is happy and chewing things again.
Recently, Audrey swallowed the binding on her blanket. But the local hospital was open and veterinarians there induced vomiting. If there had been a delay, she might have needed surgery again.
“We have a lot of dogs here in Iowa City; a lot of cats here in Iowa City,” Himadi said.
“We need an emergency vet that’s open.”