Three Days, Three Vets

Photography by Lori Traikos

Time was, nearly every town in Maine had a veterinarian who cared for large and small animals. The decline in farms, combined with a growing preference among veterinarians for pet practices, has led to a shortage of farm practitioners. Today fewer than forty vets offer large animal care in the state. Sixty- to eighty-hour weeks are common, as are fifty-mile farm calls. Here is a look at a day in the life of three who choose this path.

Monday: Dr. Paula Benner
The sun is rising over Lupine Valley Farm, a yellow 1850 farmhouse with a weathered barn tucked into the rolling hills of Washington. Paula Benner is in the driveway, taking a last-minute inventory of the contents of her Jeep Cherokee. “Once I take off, I’m gone all day, so I better have everything in this truck,” the equine veterinarian says, closing the liftgate on a white metal cabinet stocked with syringes, needles, and medicines.

Petite, with shoulder-length blonde hair and bangs, Benner is setting out to see her first patients of the day, a pair of horses in Albion, thirty winding country miles to the north. “When I was a kid, I loved horses, but I never had one,” she says. “My dad would say, ‘When it’s not new anymore, you’re not going to want to take care of it.’ Well, here I am, forty-eight-years old and I’m still taking care of horses. I love them to death. They can be in lethal pain, and they don’t cry, and they don’t whine. They just stand there and look at you. They are the most regal animals.”

She’s been serving this territory in central Maine since 2008, after having spent several years with a racehorse practice that assigned her to the Maryland stables of thoroughbred trainer Graham Motion. A single mother, she worked six days a week and was on call around the clock. “I was lucky to work with some of the best racehorses in the world,” she says. “We sent seven horses to the Breeders’ Cup. I’m glad I did it — I learned so much, especially when it comes to lameness — but I’m glad I’m out of it, too. The career is so demanding. It’s hard on your family. Your beeper is always going off. Here, the pressure is much less.”

As a girl, she spent summers on Clary Lake in Jefferson, so Lincoln County was a natural choice when she decided to strike out on her own. Serendipitously, another horse vet had just closed her practice, increasing local demand for equine care. Benner now has six hundred clients. Her patients include show horses, workhorses, harness racers, and pets. “Maine has a large geriatric population of horses,” she says. “They are people’s old friends. They’ve had them for twenty-plus years. In the fall, they worry, ‘Is the winter going to do my old guy any favors?’ There are environmental considerations. How are you going to bury him if he dies this winter? It’s a very difficult thing to go through. I allow a lot of time for them to tell me their stories.”

Arriving at Sandor Nagy’s rustic home in Albion, Benner selects an assortment of syringes, needles, and vials from her supply cabinet and follows Nagy and his teenage daughter, Erzsie, into a small barn, where Rhett, a handsome Arabian with a gleaming brown coat, waits in his stall. He belongs to Erzsie, who rides him in the fields around her home. Peering uneasily into the stable from an adjoining paddock is Cosmo, a stout, squat pony who for all intents and purposes belongs to Rhett. “Horses are herd animals and they don’t necessarily do well by themselves,” Benner explains.

Rhett is a model patient for this routine exam. He stands still while Benner works her way from his head to his rear, listening with her stethoscope to his throat, his chest, his belly. When she injects two vaccines into his neck, he simply blinks his soft brown eyes. “He looks really good,” she tells Erzsie. “He’s a little thin. You can probably double his feed, but I’d rather see him like this than fat.”

Cosmo is not so malleable. Led into the stall by Erzsie, he strains the lead, stepping back and forth, looking for a way out. Benner places her stethoscope to his chest. “Good boy, you’re a good little boy,” she says softly, waiting for his anxious heart rate to slow. She moves the stethoscope along Cosmo’s short body, then pinching a fold of neck skin, she administers his shots. “They try so hard,” she says, scratching his forehead. “If I tried to do that without placing my hands on him first, he probably would have kicked me.”

The sun is high overhead by the time Benner reaches Mount Vernon, twenty miles northwest of Augusta, where Acadia is resting her head against owner Shari Hamilton’s chest. Lame for days, the big gray show jumper barely lets her left front hoof touch the floor. “I couldn’t manage her pain,” Hamilton tells Benner. “Her eyes glassed over, and she was biting the stall she was so uncomfortable.” Suspecting Acadia has a hoof abscess, Hamilton has been giving the thoroughbred generous doses of an analgesic and soaking her foot in warm water and Epsom salts.

After examining Acadia’s leg, Benner decides to inject a painkiller just above the hoof. If it relieves the pain, Acadia almost certainly has an abscess, and Hamilton should continue the foot soaks until pus drains from the seam of soft skin above Acadia’s hoof. If not, Benner will try the pain-blocking technique near Acadia’s ankle, then her knee, and so on, until she pinpoints the source.

A few minutes later, Hamilton tugs Acadia out of her stall. The horse steps reluctantly at first, then more confidently, her pace quickening as she enters the paddock. Hamilton releases the lead, and Acadia breaks into an exuberant run, prancing round and round the corral, her tail held high. With luck, Benner tells Hamilton as she is leaving, all that joyful hoof-pounding will force the abscess to a head before the painkiller wears off.

Benner drives east, stopping in Augusta to drop off medicine for a horse with a leg infection, then continuing to Warren where she performs a routine blood test on a show horse. It’s after 4 o’clock when she arrives in Union to see a dusty Arabian show horse named Czan. A few days earlier, Benner removed a small, cancerous-looking growth from Czan’s right rear leg, where the skin is so thin the sutures have since pulled apart. Benner wants to remove them — they’re just entry points for infection now — but the wound is tender and Czan stomps at the slightest touch. When his hoof kicks reflexively just inches from Benner’s face, owner Brenda Carver says, “Paula, I think we’re going to have to twitch him.”

Carver slides a large metal clamp over the flesh of Czan’s upper lip. He looks comically uncomfortable, as if he is wearing a giant clothespin on his nose, but a twitch actually calms horses by releasing endorphins. In Czan’s case, however, it is not quite enough — the wound is still too sensitive for Benner to tend it safely. She injects a tranquilizer into Czan’s neck, and soon after his head drops drowsily. Benner snips away the sutures and wraps Czan’s leg in bandages. Czan is led into his stall to sleep off the effects of the tranquilizer. It will be several days before his biopsy results are known.

Tuesday: Dr. Becky Myers Law
The day is shaping up to be a quiet one for Becky Myers Law, who arrives at Turner Veterinary Service shortly before 8 a.m. with only two appointments on her book. That’s good, because she is tired. She spent two hours late last night delivering a dead full-term calf from a beef heifer whose uterus had twisted, making it impossible for the baby to enter the cervix.

“Mom was up and down, up and down, up and down,” Law says. “I’d get my arms in there up to my shoulders, and she’d drop down. My elbows are black and blue. I was lucky she didn’t kick me. My challenge was to get the birth canal lined up straight. You can’t just pull, because the cervix hasn’t dilated and the calf’s head is going to turn to the side.”

She resorted to sedating the cow and laying her belly-down on the grass, rear legs pulled back like a frog’s. Using a wire saw, she removed the calf’s head in utero and delivered the animal in two pieces.

The incident, she says, was frustrating because she responded to a nearly identical emergency involving the same small herd — the owner is a hobbyist — a few months ago. “You’d think he’d recognize the red flags,” she says.

“If he had called in the afternoon when he first began to see signs of trouble, I think we would have had a live calf.” Instead, the man sought the help of a neighboring farmer. By the time he called Law, the calf was dead.

A year ago, Law, 57, was the only food-animal practitioner at this mixed practice eight miles north of Auburn, which she opened in 1989. Raised on a dairy farm in northern Minnesota, she started her career in upstate New York, where she was the first woman vet her clients had met. (Today, the number of practicing women veterinarians is equal to the number of male practitioners nationwide. For reasons not fully understood, the field is becoming increasingly female. Women now comprise 80 percent of veterinarian school students.) She moved to Maine when her first husband-to-be, a dairy farmer, took a job at a farm in Gray.

Law spends the first part of her morning running down cases with Meghan Flanagan, who was hired shortly after her graduation from Cornell University’s College of Veterinary Medicine a year ago. Flanagan, who spends two days a week making farm visits and wants to do more, is interested in buying into the practice someday. “That makes a huge difference to all the farms in the area because she’ll probably be here for twenty-five years,” Law says. “I’m starting to wear out. I never wanted to be a solo practitioner but for one reason or another the associates I hired didn’t stay here long. Meghan is a Mainer. She wants to be here. My dream has shifted from having a group practice to thinking about having someone to pass the torch to. It’s been a real charge of positive energy.”

Law’s first stop is a nearby dairy farm to check on a cow that injured herself three days ago when Flanagan performed a routine tuberculosis skin test — the panicked cow tried to jump through the gate, cutting a leg. “This heifer has been out on pasture and has had a lot of freedoms,” Law says. “She’s not used to having to cooperate.”
 
Law pulls up to an open-sided barn where a row of fifty spotted Holsteins, yellow tags dangling from their ears, placidly munch hay. “There’s our little troublemaker over there,” she says, gesturing to a cow that has been sequestered at one end of the barn. Donning green coveralls and black rubber boots, Law prepares a tranquilizer for the animal, who is bug-eyed and straining against her halter. “Part of every day is dangerous when you’re working around a thousand-pound animal,” Law says. “Most are not aggressive, but they can fall on you, they can kick you. I do a lot of my exams now with sedation. A generation before my time, everything was brawn and muscle and ropes, tie ’em down and sit on ’em. I still do plenty of that, but to be able to use this little bit of chemical restraint is so much calmer, and there’s less stress on the animal.”

Indeed, the tranquilizer, which Law injects into a nerve under the tail, has an almost immediate effect. The cow lowers her head. Her eyes soften. Law cuts away the leg bandage, applies a liberal amount of ointment to some gauze, and rewraps the wound.

There were seven dairy farms on this road when Law opened her practice; now there is only this one, with four hundred cows. That has been the trend statewide. “At one time I alone had 120 dairy farms,” Law says. “Now there are probably about thirty. The farms that are remaining have become bigger. The actual cow numbers haven’t changed that much.”

She works with several registered breeders, whose decisions about cow care are based on pedigree. “A nonregistered commercial cow has to make milk to pay her way on the farm,” Law says. “If she needs surgery, the farmer weighs the cost and the chance of her recovery against replacing her with another cow. If the latter is cheaper, the cow goes down the road on a beef truck. With registered cows, there are other ways to generate income, like the sale of offspring and embryos. Just winning best cow at the state fair is advertising and prestige for the farm. Registered cows are not just working girls, and, so, they get more treatment.”

Law heads to Pownal, thirty miles south, for her first visit with a mother and son who have occasionally brought their goats to the clinic. “They are pets and company for these folks,” Law says, “but we like to visit a property once a year and get to know the herd. These goats are never going to go into the food chain, but we have to treat them as if they could. And it’s better for the herd if we treat them for routine things, not just flare-ups.”

It’s obvious at first sight that this is a family of modest means. The property is jammed with cars, trailers, and truck caps in various stages of deterioration. A half dozen makeshift sheds form a wall between the house and the woods. The four goats — a chubby black pygmy and three wiry Alpines — share a pen with a dozen chickens of assorted breeds. Law’s task: assess the animals’ health, clip their overgrown hooves, and vaccinate them.

Only the pygmy, Smoky, puts up a fuss. The young man holds her tight to his chest so Law can clip her hooves. “It has to be done,” he whispers soothingly “It has to be done.” The other goats hop about the yard and nuzzle Law while she inspects Smoky’s eyes and ears and combs her fingers through the hair in search of lice. She doesn’t find any, but later spots one crawling on the young male, Billy, which means all four animals must be treated. She applies a delousing liquid to their backs.

“I’m not crazy about the quality of the hay — it has a lot of stems — but your goats are in good body condition,” Law tells the mother and son. She gives them advice on hay and grain and makes an appointment for Billy’s castration, then she heads back to the office in Turner. So far, it’s been an uneventful day.

Wednesday: Dr. Meghan Flanagan
Tia, a champion pedigree Holstein, is lying in her stall, head curled against her massive body, when Meghan Flanagan arrives at Pineland Farms in New Gloucester, her first farm visit of the day. Two days ago, the cow was in perfect health, but yesterday, she began showing symptoms of watery mastitis, an inflammation of the udder. By mid-afternoon, when Becky Law arrived, Tia was no longer standing.

Watery mastitis — the name comes from the watery, clotty appearance of the milk — is caused by the immune system’s overreaction to a bacterial infection. “The system kind of goes overboard, and it makes the cow really sick — shocky, dehydrated, not eating, low temperatures, drop in blood pressure, weakness,” Flanagan says. “It is so severe and so fast at the onset that the cow can die from it.”

Tia’s keepers are pulling out all the stops for their valuable cow. They have been up all night, milking the toxic fluid from her udder and administering fluids through the catheter that Law inserted in the heifer’s neck yesterday. This morning, Flanagan has brought support in the form of anti-inflammatory medicines, oxytocin to get Tia’s milk flowing, and plasma to bind up the toxins and calm her immune system. She has a sling to hoist Tia to her feet, which will take pressure offer her muscles and nerves and make her udder more accessible.

“Ideally we’d have her on continuous IV fluid therapy, but that’s difficult to do in a farm setting,” Flanagan says. “Next summer we hope to build a haul-in facility at the clinic in Turner so we can have these kinds of animals brought to us. We’ll have it fully stocked with everything we need for intensive nursing.”

Slender with short, curly hair and a splash of freckles across her cheeks, Flanagan, 26, grew up in the central Maine town of Solon with a family that kept horses, chickens, rabbits, and the occasional calf. She has wanted to be a veterinarian since age five. “I always wanted to do large animals,” she says. “Even though I didn’t like cows at first –– like most little girls, I liked horses — I always assumed I would do cow work because that was part of being a large animal vet where I lived. You had to take care of anything that lived in the barn, including the occasional cat and dog.”

Homeschooled through eighth grade, she took every science and math course her high school offered — “I didn’t really want to take anything else” — and was accepted to Cornell’s College of Veterinary Medicine after only three years in the University of Maine animal sciences program. She started sending out cover letters in October of her senior year at Cornell — months earlier than her classmates — but no one responded except Becky Law. “It just felt comfortable right away,” she says of her first interview some months later. The day found her on the road with Law, delivering goat kids and performing a necropsy on a sheep.

Flanagan takes Tia’s rectal temperature. She checks the cow’s ears and eyes. Tucking her stethoscope under the cow’s front leg, she listens intently. “She has a pretty high heart rate,” she tells the farmhands, “but her lungs sound good.”

The visit stretches into hours. Bottles of IV solution laced with plasma, calcium, and analgesics are dripped into Tia’s veins. Between bottle changes, Flanagan checks on some of the other residents of this large barn, which is home to one hundred cows. One is a heifer suspected of having miscarried her two-month-old fetus. Flanagan dons an arm-length examination glove and, after scooping out several handfuls of dung, inserts an ultrasound cable deep inside the heifer’s rectum. A hazy image appears on the screen of the lunchbox-sized device attached to her waist.
 
“She’s not pregnant anymore,” Flanagan confirms.

It is well into the afternoon when the effort to hoist Tia to a standing position begins. Eight men and Flanagan spend upwards of thirty minutes positioning the sling under 1,800 pounds of inert cow. The belt is attached to a bucket loader, which slowly lifts Tia to a standing height, but she just dangles. The men rub her legs and firmly plant her hooves on the barn floor. When they let go, Tia’s feet curl.

Flanagan tries to give Tia an adrenaline boost with an antihistamine injection, but it has no effect. She attaches a bottle of hypertensive saline to the catheter, followed by painkillers in IV fluid. There is nothing more she can offer that the well-trained Pineland crew can’t handle themselves. She leaves them with several dozen bottles of intravenous fluids to be administered every two hours. It will be another long night.

Post Script
It took several days for the abscess in Acadia’s hoof to come to a head and drain. The horse’s foot remained tender for another week or so while she healed.

The results on Czan’s biopsy showed a mast cell tumor, a benign growth in horses. In Czan’s case, however, there were some atypical cells, so he will be watched carefully in case the growth returns.

Tia showed slight improvement the evening of Flanagan’s visit, but her condition deteriorated the next day. Flanagan had stepped outside the barn to call a colleague at Cornell’s College of Veterinary Medicine for advice when one of the farmhands informed her that the cow had just died.