Rural Equine Vet Shortage: The Troubling and Ongoing Trend

At the Manitoba Veterinary Medical Association’s 1945 annual general meeting, the province’s agriculture minister announced government subsidies for veterinarians who would extend their services to more pastoral locations. Getting vets to practice in rural vicinities was a problem that had already existed in Canada for at least 100 years – and it still does today. “History’s never changed. You can’t get enough veterinarians into rural areas,” said Dr. Paul Schneider, a Manitoba veterinary industry consultant. He asks, “How do we encourage veterinarians to come into rural areas? But probably more importantly, how do we get them to stay?”

Money, of course, is a major factor. Founding member of the University of Calgary Faculty of Veterinary Medicine (UCVM) and now professor emerita, Bonnie Buntain, was one of 18 experts commissioned to contribute to the National Research Council 2013 report, “Workforce Needs in Veterinary Medicine.”

Buntain said salaries don’t equate to the educational investment put forward by veterinarians as compared to other health professionals with similar or less education. Lower wages or an inability to make enough income in rural areas can also dissuade qualified people, most of whom have significant educational debt load.

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According to the Canadian Veterinary Medical Association’s business management program, between 2013 and 2015, 75 per cent of students from the country’s five veterinary colleges graduated with debt, the median owed was between $40,000 and $65,000. Meanwhile, the median annual salary for those employed as associate veterinarians was $71,000.

Very much tied to the financial issue is the fact our country is comprised of pretty vast expanses, making for some long trips from client A to client B. “You don’t make any money driving, you only make money on your services,” said Dr. Kathleen MacMillan, assistant professor and chief of the Ambulatory Equine Service at the Atlantic Veterinary College (AVC) in Charlottetown, Prince Edward Island, who owned her own private equine practice for five years. However, there is some travel assistance for veterinarians in some provinces. Ontario’s Veterinary Assistance Program administered by the Ministry of Northern Development and Mines allows large-animal practices under contract with the province in 22 northern and remote communities to receive call-fee subsidies, thereby reducing costs to the livestock or horse owner.

Another key problem? Work-life balance. Rural veterinarians have to be at the ready a good portion of the time if not 24/7, often caring for all manner of animals. “I was on call for five years. I left the Island twice – for conferences,” said Dr. MacMillan. It’s a very consuming life and you never get off call. For me, I always felt like I was a 1.5-person practice.”

Add to these concerns the demanding physical nature of the job, a high risk of injury, environmental and weather factors and an unwillingness of spouses and significant others to relocate away from urban centres, and it’s understandable why many vets aren’t sold on the idea of a rural practice.

For Canadian horse owners in remote parts of the country, this means sporadic or non-existent veterinary services, a major concern when you consider the ever-delicate and complicated constitution of our equines, not to mention their penchant for injury and harm. And this means rural owners must be prepared to educate themselves and provide most minor veterinary care themselves.

Some people, like Jim Bennett, who lives outside Labrador’s Goose Bay, only sees his “local” veterinarians – based 1,300 kilometres away in Corner Brook, Newfoundland – once a year when they travel north in the fall. Despite the distance, Bennett can’t say enough about the treatment his horses receive, which comes mainly by phone. “It’s top-notch. They usually call me back immediately and they’re fantastic help.”

But, if one of his three horses needed surgery or major care, Bennett said the only option would be to attempt a two-day trek to the AVC in P.E.I. “And that probably wouldn’t happen.”

In fact, he once made the difficult decision to put down a filly that had epiphysis (enlargement or infection of the growth plates) in her front legs. The surgery alone at AVC would have cost $10,000 and offered only a 20 per cent chance of success. Plus, the stress and cost of travel was prohibitive.

By Sea or By Bridge

The four Atlantic provinces have been served by the college since 1986. Under an interprovincial agreement administered by the government of P.E.I., the provinces share funding for the operating and maintenance costs of educating students at AVC. In exchange, each province receives a guaranteed number of seats in the program.

Centrally located, AVC is still a full-day’s drive or more away for many of the region’s horse owners, a trip requiring either a ferry crossing or travelling over the Confederation Bridge, a 12-kilometre span that links the Island to New Brunswick on the mainland. Water travel is seasonal and weather dependent, and the bridge, while rarely closed, is sometimes restricted to high-sided vehicles, including horse trailers, by heavy winds. Plus, there’s a toll to leave the Island.

Many aren’t thwarted by logistics, however, said Dr. MacMillan. She sees many clients who transport horses regularly from remote areas of New Brunswick, Nova Scotia, even Quebec’s Magdalen Islands and the Gaspé Peninsula. Some trailer in one or two horses a week.

P.E.I. horse owners themselves are fortunate the AVC is in their backyard. Often called the Kentucky of Canada, the Island boasts a Standardbred racing industry, and many light horse, draft and mini enthusiasts. With the college never more than two-hours away, P.E.I. horse owners are well served, as are those in neighbouring Nova Scotia. Both provinces also have a good network of private equine veterinarians

Circumstances differ in Newfoundland and Labrador and New Brunswick, the only two provinces in Canada where government livestock veterinarians provide routine and emergency care for horses as well as other livestock (and zoo animals). This set up allows for uniform service fees and ensures animals in the largest, most remote areas in the region receive care.

But New Brunswick may soon dump this arrangement.

A Unique Arrangement

Currently, the New Brunswick Department of Agriculture, Aquaculture and Fisheries (DAAF) veterinarians are based out of eight offices scattered throughout the province. For decades, New Brunswickers also had access to a provincial equine specialist, Dr. Keith Murch, who operated out of the Provincial Veterinary Centre in the capital of Fredericton.

Dr. Murch retired in 2016. Instead of replacing him, the province entered an agreement with AVC to fill in the service gap for more complex cases beginning that October. While industry stakeholders stressed bringing in another full-time veterinarian was preferred, they settled, at least in the interim, for the AVC option. “It didn’t sit well, but it was something,” said Deanna Phelan, president of the 2,200-member New Brunswick Equestrian Federation (NBEA), owner of Geary Hill Stables and a competitive show jumper.

Through the arrangement, an AVC veterinarian spends three days a month at the Fredericton clinic and, periodically, does on-site visits in the Moncton area. Dr. MacMillan is one of the travelling vets, along with her colleague Dr. Martha Mellish. They take their own fully-equipped truck and use the monthly trips as a teaching experience for vet students. “We do mostly the specialty equine cases that maybe the provincial veterinarians are not as equipped to deal with. They’re still doing all the routine work. We’re there to basically enhance the services and as a resource to work with them on their cases, which I think is really nice, because we can approach it as a team effort,” said Dr. MacMillan. “The only reason it’s worked for us is because the provincial government veterinarians provide 24-hour emergency service. So, if one of the patients I work on has a complication, they’re there to deal with that. It’s not just like we blow into town, do what we need to do and leave. It’s a little more controlled than that.”

In June 2016, the province told equine stakeholders it was considering getting out of the horse side of things to focus on food-producing animals. “They gave us no numbers. They gave us nothing except saying they wanted to do this. Of course, we’re screaming health, welfare. We’re saying the sky is falling,” said Phelan.

At the government’s request, industry representatives came up with what they felt were workable models for going forward. One was to continue as it is, but improve how the program is executed. Another would see all provincial vets becoming private and the final was to put the onus on DAFF to recruit private-practice equine-only veterinarians.

Stakeholders met again on September 29th, not long after a Premier Brian Gallant cabinet shuffle saw a new agriculture minister installed, Andrew Harvey. Most parties now appear to be leaning toward maintaining the status quo, but with improvements.

Margie de Graaff and her husband Peter own the western lesson and boarding barn Tetagouche Stables, about 15 minutes outside of Bathurst, in northern New Brunswick. She considers herself and other horse owners in the vast north shore area lucky. “We are very pleased with the service. We’re happy with what we have,” said de Graaff, who has attended the meetings.

De Graaff said dropping the equine service could have serious impacts on rural communities at large. “People will stop having horses or horses will suffer. What follows out of that? Hay makers won’t have a market and other spinoffs – buying trucks, trailers, clinics, gas travelling to shows and the enormous amount of tack that we buy. The spinoff is in the coffers of the province, and I don’t think they realize how big that amount of money is. And if there’s not enough work for provincial vets because one-third of the services are taken away, we could lose dairy too. Will the rest of the services be able to pay for themselves?”

She said DAAF’s suggestion that a private veterinarian could come in and carry the workload is also concerning. It took nearly a year and a half to secure a replacement after one of their three local provincial vets retired. “Personally, I think they’re dreaming. How on earth is a private vet going to cover such an area? The daytime calls and the regular inoculations and lameness aren’t a problem. It’s the midnight call with colic when it’s minus 30 degrees in January.”

AVC’s Dr. MacMillan agrees, “The biggest problem is the area they’d cover. It’s going to be tough to find someone who can make a living and charge a reasonable amount of money to a client if they have to drive two to three hours to see an animal.”

A further update is expected from DAAF in December.

Self-serve Vet Care

As mentioned, Newfoundland and Labrador is the only other province where equine veterinary care is the purview of government veterinarians. The Forestry and Agrifoods Agency’s Animal Health Division provides routine and 24-hour services through four regional offices.

Ruth Story owns and operates Cache Rapids Stable outside of Deer Lake in western Newfoundland. She said the three west coast provincial veterinarians serving her area are great and usually provide same-day service, especially when it’s an emergency. But she added, “The diagnostic equipment they have is limited.”

When one of Story’s horses needed x-rays, it took a couple of weeks for one of her regional vets to pick up the machine from St. John’s, more than 600 kilometres to the southeast. It was returned to St. John’s when another vet went on vacation in the capital city.

The situation isn’t a whole lot better for many horse people in the far-flung regions in central Canada.

According to a 2010 study of the Canadian horse industry, the majority of horses owned by eastern Canadians are located in Ontario and Quebec. But the horses and the resources are largely situated in the southern aspects of both provinces where you can find numerous private equine vets and clinics offering routine and specialist services operating in urban or semi-rural settings. The region is also served by two veterinary schools: in Quebec, the Université de Montréal’s Faculté de Médecine Vétérinaire, and the Ontario Veterinary College (OVC) in Guelph, Ontario.

But these facilities aren’t close enough for Jeff Lewis, whose trail riding and boarding operation, Whispered Dreams Ranch, is in the northern Ontario community of Kaministiquia, 40 kilometres northwest of Thunder Bay. His herd is a robust mix of Canadians and Alberta mustangs, so he counts himself lucky he hasn’t needed to head south for specialty care or surgery. The colleges, for example, are each at least a 17-hour drive away.

The local vets he uses are from either large- or mixed-animal practices, very busy and they charge a lot, sometimes up to $200 just for the call fee.

Lewis’s current situation is an improvement over the time he and a couple of horses lived in Pickle Lake, the most northerly Ontario community with year-round road access. Here, if something goes wrong with a horse – or any animal – you’re on your own, much like Labrador’s Jim Bennet. The nearest clinic is six hours away in Dryden. That can mean putting a suffering animal out of it’s misery…by yourself. “It’s just the way of life up there. Everyone hunts, so everybody has a gun or a rifle. I’m a really good shot,” said Lewis. “It’s the most humane thing you can do for your animal. People in the south probably wouldn’t think of it.”

Reworking Manitoba

Manitoba, too, has a veterinary landscape unique from other parts of the country. Its Veterinary Service District (VSD) program was established in 1970, largely to attract veterinarians to rural areas. Administered by the Veterinary Services Commission, currently 27 VSD clinics receive funding from municipalities and from the province for operation and maintenance. Vets run the business, while the program is monitored by municipal and provincial boards. “The whole purpose was that no one should be more than 30 minutes away from a veterinarian,” said Dr. Paul Schneider. The program was quite successful for many years with about 35 VSDs, but began to “come apart” in the 1990s.

“They weren’t finding enough veterinarians again. Some of the districts were saying, ‘maybe it doesn’t work,’ and started pulling away. Some of them are still strong, others are kind of weak,” said Dr. Schneider, who led a Rural Veterinary Task Force to examine the delivery of rural veterinary services.

Throughout 2015, the task force spoke with veterinarians, the public and various commodity and industry players, including horse groups, to come up with recommendations on possible ways to attract and keep rural vets and how to improve the VSD’s program. “One of the things that’s unpopular is if they’re on call a lot and have a lot of after-hours work. And [at] a lot of these small practices, the vets are on call all the time. So can we help them fix that? Maybe sharing calls with other VSDs?”

Although the report was submitted to the Ministry of Agriculture in January 2016, Dr. Schneider doesn’t think it’s been released, possibly due to, at least in part, a change in government that spring.

As is typically the case, equine-only vets and their clients are clustered mostly around the province’s major cities of Winnipeg and Brandon, he said. “We do have some good people, some good facilities that can serve the horse population. However, they may have to travel a ways to see those people. The more remote areas, the whole level of service is different. The fact is that the general practitioners have to deal with everything that comes in the door. They can do some basic stuff, but they also serve their clients well to refer to specialists when needed. Of course, the more complex surgeries and situations, they can be referred to Saskatoon.”

Training for Rural Practice

Dr. Schneider is, of course, referring to the Western College of Veterinary Medicine (WCVM). It was established in 1963 by the four western provinces through a joint funding program/seat agreement. It was the only western veterinary school until the opening of the University of Calgary Faculty of Veterinary Medicine in 2008.

The Alberta government’s recent decision to boost funding to UCVM to increase student enrolment numbers, “allows more Alberta students the opportunity to study in their home province and serve rural and remote communities,” said Dean Dr. Baljit Singh in a statement.

WCVM professor Murray D. Jelinski, said in his paper “Survey of western Canadian veterinary practices: A demographic profile” that the veterinary profession “is biased towards small animal practice.” He suggests mixed animal practices are moving out of treating large animals altogether in favour of small animals. Jelinski also mentions that livestock producers are generally moving toward consolidation and larger farms and may choose the services of food-animal practitioners specifically, rather than mixed-animal veterinarians. Although he is referring to the western provinces, these scenarios can be applied across the nation and aren’t necessarily promising changes for horse owners, many of whom rely on multi-species vets.

The vet schools are doing their part to expose students, the majority from urban backgrounds, to opportunities in other areas. For example, the OVC, which is currently renewing its strategic plan, is strengthening its commitment to rural veterinary care, even offering a new stream of fourth-year study (in addition to equine, food animal and small animal): rural community practice, which involves four extra weeks of rotation in a rural practice servicing multiple species.

And one of UCVM’s main areas of emphasis since its launch nearly a decade ago is “to meet the need for veterinarians in rural Alberta.” Another is a commitment to equine health and the needs of horse owners everywhere in the province. Its community-based teaching model provides places students in veterinary practices that belong to its “Distributed Veterinary Learning Community” to provide hands-on experience with a variety of animals in a range of settings.

In addition, financial aid programs are available in most provinces to offset heavy debt loads and encourage veterinary school graduates to live and work in rural areas. For example, the Northern Alberta Development Council offers a non-repayable veterinary student bursary of $6,000 per year for each year of vet school if a student agrees to live and work full-time anywhere in the region or $12,000 a year per school year if they commit to a specific location.

Manitoba Agriculture also offers a scholarship that’s written off if the student returns to rural Manitoba. Other initiatives see students taking part in veterinary work experience programs with salaries paid through cost-sharing plans between the clinic and government.

It’s a long-standing issue, but perhaps with foresight and creativity, Canada can eventually lead the world in delivering cost-effective and widespread rural veterinary programming for all animals and their people.