Navigating the Risks of Pregnancy in Veterinary PracticePregnancy is not for the weak of heart, especially when you’re a mixed animal veterinarian. Many people have asked me how I handle the physical requirements of my job during pregnancy. I have also been surprised many times by being asked, “So when are you going to quit working?” This question shocked me; most of my friends and veterinary colleagues worked up until the day they went into labor. I know the intent is to prepare for the baby, but I think I would worry myself into high blood pressure. I think it's better to stay busy and not let the demanding life of motherhood scare me until it's knocking on my door, aka uterus. Every pregnancy for every woman is different, so it’s no surprise that each veterinarian may take different approaches to job risks and hazards during pregnancy. Being a pregnant veterinarian certainly doesn’t come without its challenges. In this blog post, we’re going to discuss those challenges. I’m going to attempt to give advice based on my experiences and the experiences of my colleagues. Do’s and Don’ts of Pregnancy? This is probably an issue with pregnant women in all professions. In the veterinary world, there is a serious lack of practical information available for pregnant women. I’m pretty sure I was secretly hoping that pregnancy came with a manual. Sure, there’s the obvious risks to avoid, like anesthetic gases, taking radiographs (x-rays), not changing litter boxes in the kennel, and veterinary drug dangers (prostaglandins, oxytocin, chemotherapy drugs, insecticides used on cattle, etc.). When you’re a veterinarian that works with large animals, what you should and shouldn’t do gets even more confusing. I must say that just over halfway through my pregnancy, my overall routine at work hasn’t changed a lot. Every woman has to decide for herself what she feels comfortable with, and that may be dictated by pregnancy symptoms she’s experiencing. It can be a tough balance. On one hand, you need to take precautions necessary to protect the health of you and your child. There are no second chances, and one misstep could affect your child for the rest of their life.Your doctor or obstetrician can be a great resource to you on risks to avoid in practice, however, you also have to realize that most obstetricians have very little knowledge of what a veterinarian (particularly a large animal veterinarian) does on a daily basis. The best advice I have received from my doctor is this: If you feel uncomfortable performing certain tasks at work, don’t do it. In other words, trust your instincts! That voice in the back of your head telling you that wrangling that 600-pound calf is a bad idea? It’s probably right! I’m not saying to ALWAYS listen to the voices in your head, but in this case it’s probably okay. Avoid the Internet As Much As Possible This is my advice for any pregnant woman. There are a lot of questions that come up during pregnancy. I have found that the Internet is a scary, scary place for pregnant women. Just ten minutes spent on a pregnancy message board will have you convinced that everything is either going to kill your baby or cause it to grow two heads. Get shocked by an electric fence? The Internet says your baby is definitely going to die. Get scratched by a cat at work? Your baby is probably going to get Toxoplasmosis and die. Get accidentally squirted with some Ivermectin pour-on at work? Your baby is going to be brain damaged. Instead of seeking advice on the Internet, I have opted to ask my doctor these questions instead. Doctors have a way of easing your mind with practical advice based on research, scientific facts, and years of experience. The things the Internet convinces you are crises are probably not a concern. Just step away from the computer screen (unless you’re reading my blog). And for the love of God, do NOT Google “video of childbirth.” Avoid Injury This is a tricky one for a large animal veterinarian. Again, my routine in working with large animals hasn’t changed a lot as of yet. My advice here is to not feel like you have to cowboy everything. If you get into a situation with an unruly animal, don’t be afraid to use sedation (or chemical restraint as I like to call it). It’s relatively inexpensive to sedate an animal, and most clients don’t mind. If a client calls you and wants to rope an animal in the barn, send a non-pregnant colleague on that call or tell the client to call you once they have caught the animal themselves. It’s not a veterinarian’s job to catch animals in poor facilities, but we often make it our job. Use that opportunity to educate your client and encourage them to invest in safer facilities. While having this conversation with one of my clients, I was told it was my fault I was pregnant, and it wasn’t his problem to make safer facilities at his farm. Of course, you will occasionally run into people like this in practice, but most clients and colleagues will be quite accommodating. It’s important to remember that no man or woman is a match for a 1,000+ pound animal. Handling these animals safely requires forethought, good facilities, and skill (pregnant or not). I have found that being in good physical shape before and during pregnancy has (so far) helped my ability to keep up my strength and continue to work with livestock. I have been criticized often for continuing to work with cattle and horses during pregnancy, usually by people who know nothing about my profession (and probably not a whole lot about pregnancy, either). You will be criticized no matter what decisions you make. You simply have to make the decisions that YOU feel comfortable with. Having been an athlete, I’m also quite used to listening to my body and knowing when to stop before I get too fatigued. I’m sure the time will come when I have to scale back my large animal work and rely more on colleagues. Meanwhile, I’ll still enjoy my time outdoors, the added exercise, and my work with producers. Don’t Be Bullied! Unfortunately, some women in our profession face unsympathetic colleagues or coworkers, pushing them to perform tasks during pregnancy they don’t feel comfortable with. I have been very fortunate to work with men and women that see pregnancy as a gift to be protected, not a burden. However, many pregnant veterinarians often need to defend the decisions they make during pregnancy. Communication (which is the next item on my list) is so important here. Don’t be afraid to stand your ground and speak up when you don’t feel comfortable performing certain tasks. It’s ultimately your job to protect your baby, inside and outside the womb. During pregnancy, many veterinarians may find that the biggest bullies in their practice are themselves. A colleague of mine puts it this way, “I keep telling myself to quit doing things like picking up 60-pound dogs, but it’s just easier than admitting I need someone to help I guess.” This is probably more of a problem in our profession than actually being bullied by other people. Most people in the field of veterinary medicine tend to be fairly empathetic with others yet overly expectant of ourselves, and during pregnancy we may feel like an inconvenience. I pride myself on my hard work, so I understand this dilemma. It’s hard to admit when you need help or when you can’t do something. It’s okay to ask for help, and most people are more than willing. Communication! As veterinarians, we hear all the time how important communication is in practice. This doesn’t change during pregnancy. Working in our profession, you’re often forced to tell people at work the news before you’re really ready due to certain precautions you have to take. I recommend telling at least a few people in your practice whom you trust early on, like as soon as you find out. It’s not easy sharing such personal information so early, but it can help you avoid workplace hazards if your team is educated. If your coworkers are observant like mine, it probably won’t take them long to figure it out anyway, so you might as well go ahead and divulge. It’s also important to communicate that even though team members may have to be flexible during your pregnancy, that you want to remain a productive member of the team, either through actions or words. You may think that’s stating the obvious, but some team members may need to be reassured. Keep the lines of communication open. Bottom line, pregnancy should be a time of joy and should certainly be respected. One of the most important things in pregnancy is to feel comfortable with your decisions. Standing by those decisions will give you the confidence of knowing you took care of your baby in the best way possible. It’s also important to realize that the veterinary profession is not a death sentence for your baby. My doctor has reassured me of this countless times. I think most of us pregnant veterinarians somehow manage to find a happy medium between paranoid mania and reckless disregard.
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On June 1st a new doctor entered the practice of Howard County Veterinary Service. We are all glad to welcome Dr. Ben Potter, and I thought I should share this on my blog and introduce him to anyone who hasn’t met him yet. A lot of you already have met Dr. Potter. He’s been at the clinic helping out for a while, getting his feet wet before he took the final plunge and stuck with us. It’s been a couple of weeks since he started. I wanted to give him some time to make sure he really wanted to stick around with all the crazies in the office (Why the accusing stare? I didn’t mean me?). I also needed to approach him with a little care, to ask him gently if he’d be willing to answer some questions for my blog, where I will forever and always come out smelling roses, while I might poke some fun at him (my husband doesn’t seem to mind much). He was gracious enough to do it. Thank you, Dr. Potter! Where are you from and what is your background? I am from the small rural town of Clarksburg, Missouri, population 317. I grew up on a mid-sized farm where we raised beef cattle, were contract turkey growers for Cargill Meat Solutions, and row cropped corn and soybeans. I had an active role in the farm and was able to establish my own cow herd as well as build up a custom harvesting business throughout high school and college. I attended the University of Missouri- Columbia for both undergraduate and veterinary school and graduated in May 2016. The first year of practice can be overwhelming. What have you gathered from your first few weeks of practicing veterinary medicine? Is it what you expected? I have learned that veterinary medicine is extremely fast-paced and rewarding at the same time. In veterinary school each student is responsible for only a few patients over the course of the day, and I can spend ample time studying about the case, but in practice that is not the case. The next emergency dystocia is just around the corner and you have to drop everything at a moment's notice. Then, when you get back to the clinic, you have to catch up on the small animal work as fast as you can and be ready for that next call. Veterinary school definitely introduces you to the fundamental medicine but does not prepare you for the fast-paced atmosphere of private practice. So far in practice, every day has flown by, and that is not something I expected. I guess that means I am having fun! What excites you the most about practicing at Howard County Veterinary Service in Fayette? I love the small town atmosphere and the friendly people in Howard County and the surrounding communities. Everyone has made me feel so welcome so far, and I know I am in the right place. My background and passion for cattle production medicine led me to Fayette because of the potential to work with some of the most progressive cattle producers in the state. I want to be able to help them take their operations to the next level and hopefully improve their bottom line at the same time. What are your hobbies/interests/activities you enjoy when you’re not working? One of my favorite hobbies is deer and turkey hunting in the spring and fall each year. The last week of April and the middle of November, I will be hunting by myself or taking my little brother out in the woods. I used to spend several weeks each year hunting, but now it is a little tougher to find time to hunt. I also enjoy spending time with my wife Leslie and traveling to her students’ sports activities. We both enjoy spending time in the outdoors, whether it is bike riding the Katy Trail or playing sand volleyball in a competitive league. What do you think a veterinarian’s role is in the community? I believe a veterinarian is to be a leader in the community. A veterinarian is looked at by others as a professional in the medical profession as well as someone who has a relationship with many people in the community. Whether it be on the school board, fair board, cattlemen’s board, or whatever other organizations are out there, vets should be involved. Veterinary medicine is a profession that many young people want to become involved in for many reasons. I believe it is partly because of the active role that vets have in the community with several events. At least I feel it is that way in the Howard County Community. The office is full of women. What experience do you have with chocolate and toilet lids? Ha. Stay away from both… June is National Dairy Month! Practicing in mid-Missouri, I work predominately with beef cattle and deal with very few, if any, dairy cattle. I learned quickly in veterinary school that dairy practice was not for me, and we’ll go into more detail about that later. However, I have always had a healthy appreciation for dairy products. I grew up drinking lots of milk from a young age, and I’m thankful for that. Dairy products, including milk and other good stuff like cheese and yogurt, contain nine essential nutrients, from calcium to potassium. These nutrients can help you manage your weight, reduce your risk of high blood pressure, osteoporosis, and certain cancers. I had the great privilege of getting my milk locally sourced from a young age. A friendly man would come to our house and deliver fresh milk in a glass jar. Little did I know that man would someday become my father-in-law. There were times that I even caught some heat for my love of milk. While competing on the track and cross country team at my college in Florida, my teammates just couldn’t understand why I drank so much milk. “What’s the deal with all the milk you drink? Don’t you know how high in fat that is (I drink whole milk)? Have you ever tried soy milk?” They would usually ask these questions while hobbling around on crutches, nursing stress fractures in their legs or feet. By the way, I have tasted soy milk, and it tastes like crap. After running competitively for years and pounding the pavement for tens of thousands of miles, I have yet to have a stress fracture or a broken bone (knock on wood!). Despite drinking at least a gallon of whole milk each week (this is just me, I’m not including my husband’s milk consumption), I have maintained a healthy weight, normal blood pressure despite my high stress job, and normal cholesterol. Okay, okay. I realize not all of this may be due to milk and dairy consumption, but there’s no doubt that it plays a crucial role in my health. At my last prenatal appointment, my doctor exclaimed, “Wow! Your baby already has an impressive level of ossification! (new bone formation)” Yeah! Way to go, Pip! (our nickname for the baby). I’ll give myself a little pat on the back too, as I drink my glass of milk...and then I’ll drink another. For the rest of this blog, I’ll give you a number of stories involving dairy cattle and the dairy business. Enjoy! First Step to Becoming A Veterinarian: Marry a Dairy Farmer’s Son My first exposure to dairy cattle or really, cattle in general, was on the Doxie Draw Dairy (Stroupe dairy farm). As mentioned in previous blogs, I was somewhat of a late bloomer in the field of veterinary medicine. I didn’t decide to be a veterinarian until about a year before I applied for veterinary school. Even though my husband and I dated in high school, I didn’t visit the farm much until after I started college. I suppose he was afraid exposing me to farm life might scare me off? I had put up with my then-boyfriend (now husband) constantly saying he pulled teats for a living, so I figured it was time to see the process and what he actually does. My early days on the Stroupe farm were my first up-close farm experiences. To be honest, when I first stepped foot in their dairy barn, I didn’t know a Holstein from a Hereford. I was amazed the first time I experienced the milking process at the Stroupe farm; the large, docile animals, the rhythmic swooshing of the milk machines, the yelling from the Stroupes and occasional cussing when a foot flung their direction. I would say, “This is so much fun!” and my husband would reply, “It’s always fun the first few times you milk cows.” I think one of my favorite parts of the dairy farm was its most beloved cow, Star. She was one of the only cows in the herd with horns. She must have gotten missed on dehorning day as a calf. She was not afraid to use those horns to boss around the other cows and acquire the best position at the feeding bunk. The best thing about Star? You could ride her! I’m pretty sure everyone in the Stroupe family has gotten a picture riding Star, and I’ve provided examples for you in this blog post. Alas, Star is no longer with us. One day after milking, my husband left the grain bin open and Star got in and got her fill. They thought she would be okay, but she died a day or so later from grain overload. To this day, I still give my husband a hard time about killing everyone’s favorite cow. But in the end, she died doing what she loved: eating. I learned a lot from the Stroupe farm. The first time I ever rectally palpated a cow was on the Stroupe farm. If you’re wondering why veterinarians have an affinity for sticking their arms inside cows’ rectums, it’s to detect pregnancy and confirm their gestation in pregnancy. It’s a skill that is acquired over time. During this first experience, to no surprise, I basically just felt warm mush. That’s generally the sensation you feel for a long time. Once in veterinary school, you learn that it takes going in about a thousand cows before you really know what you’re feeling. That was very much my experience, and we’ll elaborate on that later. I also learned basic cattle handling and behavior, how to milk cows without getting kicked, how to clean the milk machines, and much more. Foremost Dairy: The Beginnings of a Career in Beef Cattle Practice During my education in veterinary school, I spent a LOT of time at Foremost Dairy, the university’s dairy farm. Since I didn’t grow up on a farm, I figured I was behind the eight ball when it came to experience with cattle. After hearing that you needed to palpate about 1,000 cows before knowing what you’re doing, I got a lump in my throat and knew I had to get as much experience as possible. I joined Bovine Club during my first year in veterinary school. Each week, they would have palpation labs at the dairy, usually for at least two to three hours. This was a great learning opportunity as their dairy cows were all artificially inseminated, so we knew their exact point in gestation. I went to nearly every palpation lab I could. The first few times were a blur, and all I felt was mushy warmth, and maybe their hard rumen (one of the cow’s stomachs). Dairy cows are large, so I often needed a stepping stool to reach them. I figured out there’s a reason why experienced veterinarians don’t spend a long period of time palpating one cow. Not only to save time, but after you’ve been feeling around for several minutes, the cow will contract the muscles of their colon (called peristaltic waves) to push you out. This contraction is like a tourniquet around your arm, and your arm eventually goes numb. If I took a long enough time, one of the Bovine Club leaders would walk up to me and ask, “Whatcha feelin’?” Most of the time, I didn’t have the slightest clue. Slowly but surely, I started to feel the parts of the cow’s anatomy that I was supposed to, and I finally felt I may not be a total failure as a large animal veterinarian. Thanks to the dairy cows at Foremost, I learned how to preg check, which is a huge milestone in a veterinary student’s learning process. My positive association with Foremost Dairy took a turn for the worse during my third year of veterinary school. I chose to have my food animal medicine and surgery rotation during March and April, which is normally a busy time of year for cattle work. There was a lot more downtime on this rotation than I would have liked. If things were slow around the clinic and we didn’t have animals to work or treat, the professors would say, “Let’s go to Foremost!” At first, I didn’t really mind, but I slowly learned that going to Foremost mostly meant treating hoof problems (a lot of what dairy veterinarians do). I learned that I wasn’t a big fan of footwork in cattle. I found the work tedious and redundant as most of the same problems came up over and over again in different animals. On top of that, you have to worry about getting kicked by a 1700 pound animal. I may not have minded had I got to treat the animals myself, but I found it even more tedious and redundant to watch a veterinarian do footwork. I’m sure my attention span is probably shorter than the average veterinary student, which didn’t help. However, one of my most memorable and entertaining moments of veterinary school was at Foremost Dairy. A group of students going through veterinary technician school came up to the dairy one afternoon. It was our job as veterinary students to teach them some basic medical skills on the dairy cattle, including venipuncture (drawing blood), urine collection, and rectal palpation. When it came to the rectal palpation portion of the lesson, we got the dairy cows in their stanchions and each took a veterinary technician student to teach. My student was a tall, gangly, hipster-looking fellow. He was a nice kid and eager to learn, but you could tell he had probably never been around cattle before. I could relate as this was me just a few years prior, minus the hipster part. Before he started palpating, I explained the process and the basic anatomical landmarks he may feel. “You’re going to feel resistance when you first go in, but don’t be afraid to push on past it. When you go forward and to the left, you may hit a hard dead end which is the rumen. When you move up, you may be able to feel the left kidney…” and I explain things for another two minutes or so. The kid put his glove on, lubed up, and slowly started to push his hand in. As I had predicted, the cow strained and resisted a little in the beginning. He promptly patted her on the rump with his free hand and said, “It’s okay, girl. Don’t fight it!” Maybe it was my dirty mind or the fact that I had been up all night taking care of sick crias (baby alpacas), but I found this to be quite hilarious. I tried not to laugh, but I couldn’t compose myself. Too much sleep deprivation. Another funny moment was during my fourth year of veterinary school. This involved a classmate of mine, who clearly had not taken advantage of the palpation labs. We were palpating and someone looked over at her. “How ya doing over there, Jenny (not her real name)?” She responded, “Well, I’m not feeling much.” The fellow student responded with, “That’s probably because your arm is in the vagina.” So yes, we all have blond moments (which I’m guilty of). Yes, this student did graduate and thankfully went into small animal medicine. My husband’s family is no longer operating a dairy farm. While dairy cows are no longer a big part of my life (except for the ridiculous amount of milk I drink), I can’t help but reflect on their influence on my life and education during National Dairy Month. So thank a dairy farmer this month. They work hard, care about their animals, and spend their life providing delicious and nutritious products for the consuming public. I watched a rerun of The Office this week, while brushing the thick coat of my Pyrenees to save her from overheating in the hot Missouri sun, and I realized it’s probably a good time to remind everyone about the danger of leaving a pet in the car, even if it’s relatively comfortable weather outside. During the episode, the group finds a dog in a locked vehicle in the company parking lot. They are concerned that it’s too hot in the car, even though it’s nice outside. Kevin sits in a car for a while to test it out, and yes, it’s too hot. They try a few different ways to help the dog. They poured an iced beverage into the open sunroof, but the dog isn’t interested. Instead of calling for help like they should, Oscar breaks the window (then the taillight for good measure). This is not exactly what you should do, but it is a good reminder that pets can get overheated in a car, even on a nice day. Sometimes we think 70 degrees is just perfect weather, but when we go out for a drive and stop by the ice cream store, the pet we leave in the car is in danger of heat exhaustion that could lead quickly to organ failure. Temperatures inside a car can reach 40 degrees more than temperatures outside the car, probably more depending on sunlight and humidity, and cracking the window actually does very little to change that jump in temperature. You’ve probably seen the cute little dog driving a car with the temperature chart showing how hot it may actually feel, but legally, since I shouldn’t use someone else’s photo without permission, I figured I’d explain in comparison how hot those temperatures actually are. A nice 75 degrees outside feels like 118 degrees inside the car. This feels like
A warm 81 degrees outside feels like 138 degrees inside the car. This feels like
A hot 94 degrees outside feels like 145 degrees inside the car. This feels like
Follow this rule: It’s too hot to leave your dog in the car if it’s over 70 degrees. It’s probably too hot for a Pyrenees full of winter hair if it’s over 65 degrees. Harley gets lots of swimming trips during the summer, not that we have to take her. She finds her own places to swim, whether a pond or a puddle, to cool off. Many people get seasonal affective disorder during the winter, but Harley and other Pyrenees probably get it during the summer. They are not fans of green grass and tank top weather, but give them a good snow, and they turn into crazy nuts, rolling around in the excitement. We’ll treat her to a snow cone or two this summer. Remember, keep your pet safe and keep them cool! If you see a pet in a hot car, try to find the owners in any nearby business by having someone call over the intercom with make, model, and license number, but if the pet is in distress in a hot car, just call emergency personnel. Have a great summer, get out and enjoy the outdoors, take a nice drive, and keep your pet safe! |
Jessica Stroupe, DVM
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