Dogged determination: Central Mass. veterinarians on the front lines of COVID – Worcester Mag

Dr. Catherine Claunch is pelted with rain as she walks out into the parking lot. She doesn't have a jacket, because she was in too much of a hurry to speak with her client. As she strides towardthe SUV, the dog inside barks for attention. A veterinarian at Holden Animal Clinic, Claunch has done her fair share of talking about cancer never an easy topic, even when she didnt have to do it in all kinds of weather. She could have called from inside, but she firmly believes there are some things that should be discussed face to face. With COVID restrictions and owners unable to come into the clinic, she goes out to them. She taps on the window before stepping back the requisite six feet.

Vets have never shut down during the pandemic and despite restrictions, they have tried to ensure the same quality of care that they provided before the pandemic. This places them in the category of essential workers who, according to the Centers for Disease Control, provide a range of services for which remote work is not practical. To limit exposure, owners call the front desk upon arrival in the parking lot, staff meet them briefly outside and the patient is handed off. Any other interactions between the clinic staff and owner are done remotely except perhaps in situations like Claunchs. After a year, this has become the new normal for both sides, but familiarity does little to make the system any less cumbersome.

Building trust needs to be done face to face and cannot be done over the phone, said Claunch. Zoom and other video conferencing tools are often not practical due to spotty internet, so the pick-up, drop-offand communication systems have had to be continuously refined balancing safety, efficiency, as well as patient and owner comfort. I try to work with them in whatever way makes them more comfortable, she said, like with speaker phone calls and spending time talking in the parking lot in all kinds of weather, rain and snow.

Thanks to an architectural quirk, Dr. Karen Fine of Central Animal Hospital in Leominster has been able to see her four-legged patients while at the same helping her two legged clients deal with their separation anxiety. Im lucky because my clinic has two exam rooms with windows that clients can look through and see their animal on the table I can open the window to have a conversation, while meeting social distancing guidelines.Even though winter has cut down on this practice, Fine said many still find it easier in some cases to deal with the chilly temperatures than talking on the phone before and after the exam.

While clinic visits may be easier for Fine, COVID restrictions have affected her practice in other ways. Fine practices a holistic approach which integrates both conventional veterinary medicine with alternative treatments such as acupuncture and herbal therapies. I used to leave the dogs with the needles with the owners for 20 minutes while I saw other patients, she explained. Now that clients can no longer come into the clinic, alternative treatments have become much more time consuming, as the pet needs to stay with an assistant. Its just one of all these little logistical things that are affected by the owner not being there, said Fine.

Even though not being physically present is rough for both clients and vets, Claunch is amazed how many pet owners, especially new ones who have never met her face to face, have been willing to work with her on the restrictions. On the whole, people have been very understanding, she said, but we still have pushback from some who say Im not going to bring my animal in if I cant be with them.' These individuals will often ask if she can make an exception, not realizing how many others before them have made this exact same request.

As a small practice of about 15 people, Holden Veterinary Clinic has little room for error. It really just comes down to safety, Claunch said. Were all on top of each other. So if one of us gets sick or exposed, theres a high likelihood it will spread amongst the staff so well have to shut down and then no one gets help. She appreciates that clients have extended their trust, especially since she is a pet parent herself, and knows firsthand about the very special bond between pet owners and veterinarians.

In addition to the trickier logistics of acupuncture, Fine has also had to suspend her 25 year practice of house calls. It was really, really hard to stop back at the beginning when everything was just being canceled, she recalled. It could have been worse, however as COVID struck at something of a transition point in her career. Currently, Fine divides her time between the Leominster clinic for two days a week, where a lot of her house call clients now visit, and writing a textbook on narrative medicine in the veterinary field. She will also be teaching a course on the topic at the Cummings School of Veterinary Medicine at Tufts in Grafton.

Though the window set-up that Fine implemented made clinic visits less stressful on both owners and pets, Fine still receives her share of problematic clients in terms of COVID protocols, especially since the clinic has been busier than ever. When youve been working nonstop with no lunch break or even a bathroom break, its hard when someone gives you attitude when youre just trying to be safe, she said.

There are two primary reasons for the increased caseload. The first is more new animalcompanions being added to families, who now need their check-ups and vaccines. The one bright spot of COVID is that people adopted more animals, said Sheryl Blancato, president and founder of Second Chance Animal Services, an adoption and community veterinary organization.

Another is that remote working people are spending more time with their animals and notice more potential issues. Claunch can readily attest to this for a while, we were so overwhelmed with people bringing current patients that we had to shut down new clients for a while. Everyone was home, paying attention to their animals and noticing things they wouldnt have before.

Everything from breathing funny to finding new lumps on their bodies patients were brought in with symptoms their worried owners had never seen before, if only because they had not been around to observe them until now. One case is a perfect example of both this phenomenon and the occasional absurdity and humor that comes with working in pandemic conditions. Claunch received a call saying a dogs stomach was making wheezing noises. She initially thought it was a respiratory issue but the dog was breathing fine and not making the same noises at the clinic, so the only thing to do was wait until he did. After about 20 minutes, she heard a gurgle. Since the owner wasnt there to identify if this was indeed the sound, Claunch had to call her up and do her best with her vocal chords to imitate the dogs stomach.

Thats how far weve come imitating noises over the phone. Im used to coughing and hairballs but stomach noises were a new one for me, she said laughing, but it turned out the dog had gas. [The owner] was worried since shed never heard this noise before, said Claunch, but when you think about it, the dog probably makes this noise during the 12 hours a day the owners out. A simple probiotic sorted the issue.

In some cases, problems can be caused by more time spent with animals. Claunch has seen more knee injuries in dogs because they are getting so much more playtime, sometimes more than their bodies are used to extended ball or frisbee sessions raising the probability of injury. Adding new clients to the mix opened up a floodgate I think I had five new pets in one day. Three puppies and two kittens and at least three of those were with new pet owners altogether, said Claunch.

As Americans found themselves at home, with their lives seemingly at a standstill, many chose to combat the isolation with a new companion animal. Others found they finally had the time to train and care for that dog or cat they always wanted. Some were first-time owners while others had not had a pet in years both meant new clients for veterinarians across the country.

The animals who share our homes play an important role in supporting our physical and mental wellbeing during the pandemic. Everyone has this different lifestyle [with COVID], so every pet is an emotional support animal right now, said Fine with achuckle.

However, while many days it may feel like life will never return to normal, with the vaccine rollout in full swing, there will come a time when people are no longer at home as much as their pets have grown to expect. So what will be the reaction of pets who have known nothing but the round the clock company of their owners?

I am extremely worried about separation anxiety when people go back to work, Claunch admitted. She strongly recommended that both new and experienced owners begin practicing now for that eventuality, though admitted its hard to not want to spend every possible minute with an eight-week-old puppy.

Fine agrees that return to work routines, home renovation, or kids going back to college can stress animals, dogs especially. She recounted an incident where a family dog had been vomiting, not acting like himself and going into his crate to rest. The owner was surprised when Fine said it was more emotional than anything else the sudden departure of a family member was a major disruption in the dogs routine, with the stress manifesting in physical symptoms.Not only was the dog missing the boy, Fine said, but he was also likely reacting to the mothers stress over her son returning to college. When we get stressed, they get stressed. Were more like dogs now, and change is a little harder for us.

Regarding easing into post-COVID life, Fine agrees with Claunch. Im a fan of crate training because it keeps them safe and keeps your house safe, she said. Sherecommends making the crate a really fun place such as using a reward they dont get anywhere else be it a special toy or particularly tasty treat (she personally uses baby carrots cooked in chicken broth).

All that being said, both vets agree that its still not a bad time to get a puppy as there is more time than ever to focus on essential behavior training. Work with their paws every day, practice brushing teeth, Claunch encouraged. All those things that you used to run out of time for during the day. Teaching the sit and stay commands are especially important and will pay dividends when homes start receiving visitors again, so a dogs enthusiastic greeting doesnt cause problems."

Throughout the pandemic, the primary concern of most veterinarians has been how to maintain smooth, uninterrupted communications with their clients. For instance, if Claunch finds a new lump, she can turn to the owner and ask "have you seen this, how long has it been there, can I evaluate this further?"and so on. Instead, I have to finish the exam and take notes to review, then call the owner about the lump, ask about more testing, run the tests; so its much more of a piecemeal feeling and doesnt have the smooth flow that we used to have.

Owners are also looking for an alternative to current clinic protocols and Dr. Cindy McGinn offers one. If pet owners cant come into the vet clinic, the vet will come to them. McGinn runs Homecare Veterinary Service in Worcester, and travels to the homes of clients in neighboring towns. Her practice has been excessively busy since the pandemic began with clients calling on her, when they could not accompany their animals into other clinics. Were a small business and cant afford to just stop so we never did, said McGinn.

Initially, McGinn had appointments outdoors but in the cold weather, she had to go inside homes. People didnt want to do curbside care, but being inside their homes, she has to constantly remind people to keep their masks on. She recounted how she struggled with emotional burnout when she received calls for euthanasia because owners did not want to hand their pet over at the door, wanting to be with them at the end.McGinn said, its a stressful job when your patients need you and you cant be there for them when you want to be.

Weve realized how much our animals mean to us, observed Claunch. I think we sort of knew but didnt quite know just how important until we had people taken away during the shutdowns. Theres nothing like going home on a hard day for me and having a little snuggle. Unfortunately, with the economic fallout of the pandemic, many people have had to give up the emotional lifeline provided by pets, being unable to keep them due to job loss or having to pay for their own healthcare.

All animals provide emotional support, saidBlancato. To that end, Second Chance Animal Services offers subsidized veterinary care at their three, soon to be four, different animal hospitals. Like other operations, Second Chance has seen a marked increase in clients since COVID. Blancato said numbers have been two to three times higher than usual, requiring them to hire more vets and techs. The initial months of the pandemic were the hardest, as supplies (personal protective equipment and medicine) became hard to come by.

After about six to eight weeks, things started to ease back, she said, and Second Chance began to find its feet, focusing on under-resourced areas and providing access to vet care so people could keep their pets during the time they needed them most. However, to do this safely required them to get creative.

Second Chance proved they could do that when they adapted their existing mobile vet service, which offered free vaccines for pets in low-income areas. It was extremely popular and could attract as many as 400 people at a time. However, under pandemic circumstances, social distancing was impossible. Rather than suspend it, Blancato said they implemented a pre-registration protocol where people chose time windows to maintain social distancing and when we go back out this year, were going to keep using that. It helped streamline the system, staff love it and people dont have to stand in line for hours.

While it is clear that we need veterinarians to be creative and keep doing what they do for us, it is a heavy lift and they put themselves and their staff at risk. In terms of vaccination priority, veterinarian status varies by state. In California, they were included in phase one, along with other healthcare workers. In Massachusetts, they are listed under phase three with the general public.

Honestly, its really upsetting, said Claunch, Out of all of the industries in this state and all the places that are essential services, we have never stopped. Holden Veterinary Clinic has not taken even one day off from COVID-related causes. While they have been able to limit exposure through rigorous safety and cleaning protocols, the constant stress added to their regular work takes a toll. I feel very strongly that we are providing an essential service, said Claunch.

While the state vet association has been working to raise their priority, Fine agrees that the current situation is frustrating. We are in close contact with both the public and with each other, she said. There is no question for her that the vaccine would help everything go smoother and safer.

So next time you take your companion to the vet, and want to grumble about the hand-off ritual and phone calls from the parking lot, bear in mind that you and your pet do this once. Were doing this 20 to 40 times a day, said Claunch.

Everyone Fine knows is exhausted as well. Were doing the best we can," she said,"but between the vaccine and spring coming up, theres light at the end of the tunnel.

Blancato agrees that things have come a long way and the outlook is brighter now. When this first started, I didnt know what we were going to do. Everybody was in panic mode at the beginning and worried for themselves and their families, but we were inventive and were able to continue when others couldnt. So proud of my staff now.

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Dogged determination: Central Mass. veterinarians on the front lines of COVID - Worcester Mag