Melting in the Desert

    February 20, 2015
    Filed under: Uncategorized — webmaster@hagyard.com @ 5:08 pm

    Any horse can get a tendon injury, but our equine athletes are at a greater risk for soft tissue injures due to the additional strains and forces applied during and in preparation for competition. In the past, certain tendon injuries meant the end of a horse’s career or the start of a long and frustrating period of rest; but thanks to the advances in the field of regenerative medicine we are seeing improvement in quality of healing, reduced re-injury rates and less time until return to work. But let’s be honest: It doesn’t make desmitis—inflammation due to an injury to a ligament–any less frustrating because controlled rehabilitation programs are still the most important (and patience-testing) aspect of recovery.

    As a budding veterinarian it is important to me to use my time at Hagyard not only to read and be exposed to current research surrounding regenerative therapies like stem cells, Platelet Rich Plasma (PRP), etc., but to pick the brains of experts and hear their opinions formed from years of experience and training. Call me a nerd, but to me that’s the best part of veterinary medicine: We are always learning and changing for the better of our profession.

    In Thermal we are lucky enough to have access to the latest and greatest equipment and Dr. Liz Barrett’s expertise to offer and apply regenerative therapies to appropriate cases. Recently we had a horse who presented with a significant left front lameness–what we would grade a 3/5 lameness baseline at the trot. Our examination started with palpation and flexions, and then we began isolating the lameness. Because our patients can’t “point to where it hurts,” we target specific nerves with subcutaneous anesthetic to locally block regions of the limb. Once we had identified the general location of the problem, it was time to image the fetlock with radiographs and ultrasound the suspensory branches and the attachments. The pathology that was discovered at the conclusion of our exam lead to a discussion of therapeutic options to make our new pal sound.

    After discussing the available options for this injury, pricing and side effects, one of the therapies chosen was Platelet Rich Plasma. But what exactly is PRP, where does it come from and why is it going to be helpful? PRP is a biological product consisting of concentrated platelets. It is prepared by collecting the patient’s own blood and then processing the sample in a centrifuge-like machine specific for producing PRP. Unlike stem cells, which can take weeks to be cultured, PRP is ready to be injected directly into the lesion in less than an hour. We know that platelets are important in the clotting process, but how do they help tendon fibers heal? The big challenge with tendon injury is that once the fibers have become disrupted the body doesn’t replace them with the same type of connective tissue previous to the injury. This makes the tendon predisposed to future tears and injury because the fibers have less elasticity and strength. Platelets contain growth factors that, when released, aid in the healing process. The theory is that these growth factors produce less scar tissue and a larger percentage of new fibers closer to the strength of the original. With this particular case we injected the PRP into the medial suspensory branch and expect that this will be the only injection needed. However the number of injections varies depending on what is being treated and the horse’s healing response.

    That was another glimpse in my life as a HEMI intern and some of the cases I am seeing out here in Thermal, California. Now back to working and melting in the desert!

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    Jumpers or Superheros??

    February 13, 2015
    Filed under: Uncategorized — webmaster@hagyard.com @ 3:11 pm

    The first was the inaugural Wellington Eventing Showcase. As an eventer, I have been eagerly awaiting this. The entire event was held at the Palm Beach International Equestrian Center’s dressage complex. It was lovely being able to watch eventing dressage with palm trees in the background. The real fun came on Saturday: Show jumping was held in the dressage arena, which made for a more intimate setting than many other show-jumping events. Cross country was held that afternoon, and the riders went in reverse order of placing, which made for a great atmosphere as the class went along. For many of the horses, this was their first run of the year, and you could feel their excitement! The course was shorter than a typical Advanced-level course, and the speeds were decreased due to the arena being quite small. With that being said, the organizers did a fabulous job of setting up most of the typical cross-country obstacles: corners, skinnies, a small water complex, ditch and wall, banks, gallop fences, etc. The jumps themselves–created especially for the event–were beautiful. As a spectator, it was so fun to be able to sit in one location and see more than 90% of the course. The crowds were phenomenal, especially considering that many of the people probably had little exposure to the sport; by the end there was lots of cheering and many congratulations. I hope they continue this event for years to come!

    The other fun event that was held recently was the Great Charity Challenge. Usually on Saturday evenings the International Arena hosts large Grand Prix classes, but this last Saturday many of the riders changed out their show coats for capes and became superheroes for the night. The evening is all about charities–$1.5 million was distributed among 34 local charities. Teams of juniors, amateurs and professional riders competed in a relay fashion. Jumps were set at different heights and one horse and rider jumped all those at one height before the next rider took off to do his or her set. The highlight wasn’t necessarily the jumping but instead watching costumed horses and riders fly around the ring as you imagine superheroes would! All the caped crusaders from Batman (or in many cases Batgirl) and Robin to the Incredibles were represented. My favorite team of superheroes may have been Captain Canada, who was represented by Ian Millar–they proudly wore Canadian flags as capes and their horses were adorned with letters spelling out “Captain Canada”. All the riders looked to be having the times of their lives and the horses loved the atmosphere!

    Wellington definitely has some interesting and fun events that you would not normally see at an average horse show. It has been such a pleasure to be able to go and watch these extraordinary classes.

    Dr. Marty Whitehouse

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    Hagyard Sport Horse Intern in Thermal, CA

    February 6, 2015
    Filed under: Uncategorized — webmaster@hagyard.com @ 4:31 pm

    Hello from Southern California! I am Dr. Magda Stewart, a Hagyard Sport Horse intern who is getting to experience practicing veterinary medicine not only Hagyard- style but on the other side of the country at the HITS Desert Horse Park in Thermal. Our technician Rachel Blum and I road tripped across the United States in my trustful steed “The Silver Bullet”– a gas-guzzling Tahoe packed high with equipment. We made a quick detour through Red Rock Park in Arizona for some scenic views and to acquire some extra earth energy from the famous vortexes in preparation for nine weeks of horse show fun!

    Now I am here with the Hagyard HITS team and I am finding not only how different equine management is in California but also the challenges the environment presents. I know that I should not be complaining about my inevitable farmer’s tan while the East Coast prepares for blizzards, but the desert conditions are keeping us very busy, especially in the evenings when we are often called out to treat emergency colics.

    Here in the desert the temperatures vary greatly over a 24-hour period–hot and sunny during the day and then dropping down into the 40s overnight. Temperature swings can cause a horse to drink less water, which when combined with a hard day in the show ring can lead to dehydration as well as gastrointestinal disturbances. I am lucky to have the guidance of a boarded surgeon, Dr. Liz Barrett, who is skilled at performing abdominal ultrasound as well as thorough colic examinations. Abdominal ultrasound provides a window into the abdomen to evaluate stomach size and small intestinal motility, locate the kidney to rule out nephrosplenic entrapment (when the large colon becomes trapped between the left kidney, the spleen, and the ligament that runs between them) and measure colon wall thickness and cecum status. With Dr. Barrett’s guidance I am learning this important skill that helps to make game-time decisions such as whether to trailer to the nearest referral clinic, three hours away. I find abdominal ultrasound to be such an important skill, particularly because in the jumper world it is common for the colon microflora to become unbalanced from the stresses surrounding showing and for a gas-filled colon to be moved into an abnormal location from the motion of jumping. Being able to identify these displacements is important because it alters your treatment of choice and the likeliness of referral.

    This doesn’t mean that we refer everything, in fact at this point our team has been able to treat all of our colics either stall-side or by bringing them to our veterinary building here on the grounds, which is equipped with stalls for hanging fluids and hospitalizing patients overnight for observation. A fluids shortage is making it very difficult to obtain 5-liter bags of Plasmalyte. Having only single 1-liter bags and a USEF rule requiring a minimum of 10 liters run to any horse has required us to get creative. Thankfully we are ambulatory vets, so along with some help from Hagyard Pharmacy, our skilled technician Rachel Blum and some MacGyver-like skills, we have come up with a solution to run multiple liters of fluids efficiently into our patients.

    All of our patients have done well and it is exciting to see them returning to the show rings. That is a small glimpse of the official show vet day, or more accurately nights, here in California. I look forward to sharing more of my intern adventures next week!

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    Ultrasounding in Wellington

    February 4, 2015
    Filed under: Uncategorized — webmaster@hagyard.com @ 6:22 pm

    Hi again from Wellington!

    This last week has been another fun and exciting week in the life of a sport horse intern. The main draw of doing an internship for me was the opportunity to continue my education after graduation from veterinary school in specific avenues, such as improving my techniques in ultrasonography.

    This last week Dr. Courtney Wittich and I have had a couple of cases that required the imaging modality of ultrasound and we also found a couple of normal horses for me to practice ultrasounding different lower limb areas.

    Typically, Dr. Wittich will scan the horse first and we will discuss areas with lesions or strains. Then it is my turn- we spend time making sure I am able to get good quality images of all important structures within the specific area we are examining. Another part to the learning are the discussions we have with owners and trainers after the ultrasound exam. We are able to formulate the best treatment schedules and training plans based on the findings.

    It has been great to learn so much from both the cases and “practice” horses. Stay tuned for another update next week!

    Dr. Marty Whitehouse

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    Hagyard Sport Horse Intern in Wellington, FL

    Filed under: Uncategorized — webmaster@hagyard.com @ 6:18 pm

    Hello from Wellington! I am Dr. Marty Whitehouse, the lucky sport horse intern, who was sent down along with Dr. Courtney Wittich, to serve as the Hagyard Sport Horse team in the Wellington community for the winter of 2015.  This first week has been a whirl-wind of both work and fun, but I am going to elaborate on some of the special events of this week. We arrived in time for the first week of showing at both the Winter Equestrian Festival and Global Dressage Festival.  These locations are hosting world class competitions with some of the top horse and rider combinations from around the world over the next three months. This past Friday night we went to Friday Night Stars, which was an FEI Grand Prix Freestyle class. The musical freestyles were fun and breathtaking to watch, with the music ranging from today’s hits to several fun Disney themed ones! Saturday was filled with jumper classes in the international ring, but at night a different tension could be felt as it was the Battle of the Sexes night. The two teams competed in three different jumper classes- Speed round, Head to head round, and a Six Bar competition. Points were awarded throughout the events to determine the winners- it turned out to be a tie between the men and the women. The packed stadium lead to the atmosphere being electric! Though the speed and head to head rounds were fun, it was the six bar that really tested the athleticism of the horses. Alison Robitaille was the only person to clear the final vertical which was 1.80 meter (5’9”!)- talk about having to have your horse at the top of it’s game! On Sunday we returned to watch the Grand Prix in the afternoon which had 55 horses entered in the event. As always the jump off was where all the action was- the speed, accuracy, and shear power shown by each equine athlete was awe inspiring. Todd Minikus won riding a horse he had only been partnered up with for a couple of weeks! At the end of the day it is always fun to watch each rider come out of the ring with their special equine partners and dote on them for a job well done, even if the result was not being the winner. Until next time, everyone in colder environments, stay warm and continue to look for more posts from sunny Florida!

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    My First Rollercoaster Ride

    April 5, 2013

    Rollercoaster Ride

    Rollercoaster Ride


    Dr. Ashley Craig

    Imagine waiting in line to ride a rollercoaster. You sit there wondering if the waiting will end, then it is your turn. You climb into the seat and ride towards the first hill. As the chain slowly pulls you up the hill, your heart starts to pound; you are excited but yet apprehensive as the anticipation of the first hill looms. And then suddenly, you are there zooming down that first hill and you realize any apprehension or anxiety you had is gone and you enjoy the ride. As quickly as the ride started, it stops but you look forward to the next rollercoaster ride.

    So why is an equine intern describing a rollercoaster ride? Because it is the perfect metaphor for my first solo emergency call that I had back in September, and yes I know this is a little late, but better late than never! Hopefully no matter how far along I go in this field, I hope to always remember the feeling of my first solo emergency. For the first month of the internship I was busy riding along and attending emergencies with other Field Care veterinarians. It was a great chance for me to get my feet wet and learn more about how Hagyard handles cases. My second month was in Medicine, where I was on-call, but more as a secondary doctor since the board-certified Medicine experts attend every emergency and case. During my third month in the internship; I am put in an on-call rotation where other doctors are also on-call but I am sent out to emergencies on my own. Up until my first true emergency, my time on-call had included some fun cases and routine problems, but no “true” emergencies. I was just waiting in line for the rollercoaster.

    My morning had been unexpectedly slow as a couple of calls were cancelled and I had some time before joining another Field Care veterinarian to do a castration. I decided to hang out until it was time to head out to my next call in Dispatch, which put me in the right place at the right time. The phone call came in that a farm had a horse that needed help immediately. As Dispatch tried to reach the primary vet for the farm, I talked through how I would handle the situation with another Field vet. When the primary vet for the farm couldn’t be reached, it was my chance to ride the emergency rollercoaster – and I jumped at it! With a vote of confidence from Dispatch and a mentor, I was on my way armed with directions, experience from my internship and four years of veterinary school knowledge. The drive to the farm was like the climb up the first hill of the rollercoaster; my adrenaline was high but my anticipation was higher. I ran through what information the farm had shared, all the possible scenarios, how I would handle the situation, what I would do, and how to differentiate the potential problems that I would encounter. Turning into the farm, my heart was pounding as I made the mental checklist of what I needed to pull out of the back of my truck when I got to the horse. Reaching the horse, I got straight to work assessing the situation, examining the horse, and determining the course of action. I was riding down that first hill of the rollercoaster and just focusing on the task at hand. As I completed the treatment that the horse needed and informed the farm of the next steps that needed to be taken, I finally took my first deep breath. I had handled my first solo emergency call without having a panic attack. My rollercoaster had come to a momentary stop.

    Driving back to the clinic, I called the primary vet for the farm to inform her of the situation and what all went on during the call. As I walked into Dispatch at the clinic, I was greeted with high fives from all of the dispatchers and one of my mentors. My rollercoaster ride was over for the time being, but I couldn’t wait till the next time. The rest of the day I was overwhelmed with the compliments from other Field vets who had heard about my first solo emergency call. While the rush from the adrenaline high was gone a couple hours later, I will never forget my first emergency call, nor will I ever forget how much support and encouragement my colleagues give to me each and every day. I am truly lucky to be riding the rollercoasters at the Hagyard theme park! =)

    Since my first emergency, I have gotten the chance to ride lots of other rollercoasters. Each and every single emergency brings about a very similar feeling to my first time. There is a sense of anticipation as I get the call, the mental exercise of running through all of the possibilities as I drive to the horse, sometimes the discussing of ideas with mentors, the excitement of treatment and the greater excitement of a positive outcome. With each and every call, each and every case, I am reminded of how lucky I am to have great patients, amazing clients and supportive mentors and staff at Hagyard.

    For the Love of the Mare

    March 21, 2013

    Mares and foals running in a field

    Mares and foals running in a field


    Dr. Ashley Craig

    Its breeding season in Central Kentucky; that magical time of year when new foals are hitting the ground and the farms are busy with the hustle of breeding horses. It’s easy to get caught up in the excitement that hangs in the air. As I start my first breeding season as a veterinarian, I am anticipating many adorable foals with soft noses perfect for kissing, hours in a breeding shed, a strong palpating arm, some sleepless nights, adrenaline rushes and time spent doing what I love most- practicing veterinary medicine.

    When I was in undergrad at Georgetown College, I went to work for a breeding farm. As I interviewed for the job, the broodmare manager asked why I wanted to come work there. I gave the standard answer that any younger girl would- “I love the foals”. While this statement still rings true, it doesn’t fully begin to explain what all I love about breeding farms. Foals are wonderful. Watching a healthy, energetic foal bounce around a stall or field can always put a smile on your face. But for me, my admiration, respect and affection is given to the unsung heroes of the breeding industry, the mares. These mares put up with so much and yet, they are often the kindest and most patient beings. Every year, they have a vet palpate, ultrasound, culture, re-ultrasound, and check their reproductive organs on a fairly regular basis. They are sent to the breeding sheds, where in an unfamiliar environment, they meet the future father of their next offspring. They handle the hustle and bustle of the breeding shed with ease before being loaded back onto a trailer and head to their main farm, upon which the cycle of vet checks continues until the mare is declared pregnant. If the mare is “easy” to get in foal, she will produce a foal every year. Being pregnant so frequently is what the mares are made for and what nature intended. If she were out in a herd with a stallion, a similar cycle would happen just minus the human intervention. Through all of this, the mare finds joy in her foal, and patience with the humans (and the foal!).

    Recently, during my second rotation through the McGee Medicine Center, I ran across a maiden mare, or a mare that has not had a foal previously, which demonstrated all of the qualities that I love in mares. She had just recently given birth to her first foal but the foal wasn’t doing well. The foal came into the neonatal ICU not able to stand on it’s own and having seizures. The mare followed patiently behind the techs as they carried her foal into the stall. Since some maiden mares can be a little anxious, a technician stood with the mare as the doctors worked to help her foal. The mare stood quietly occasionally nickering softly to her foal. She watched the entire time as the foal was being given the medical attention it needed. As soon as the foal was stabilized, it was propped into sternal position on a tempur-pedic mattress (yes, a memory foam bed) in the stall and covered with blankets to help to keep it warm. The tech slowly loosened her grip on the mare and let her investigate what was going on. The mare walked over gently to the foal and nickered to her new baby. She then proceeded to pull the blanket back so she could touch her baby and make sure he was all right. After investigating the foal, she then went to the IV fluid lines and nosed at them a little. Once she decided she was ok with the process, she stood next to the bed where her foal was laying and kept a watchful eye on him. As it was time to reassess the foal, I walked into the stall apprehensively, not knowing if the mare would be ok with someone handling her foal again. Instead of heading straight to the foal, I paused at momma’s head. I am a firm believer that a horse’s eye can tell you their thoughts and what they are feeling. This young mare had a kind eye with a gentle spirit radiating through her expression. As I started to kneel down to the sick foal, the mare placed her head onto my shoulder. For most horse people, this isn’t always a welcomed feeling especially when you don’t know the horse; having a horse’s mouth near such a vulnerable spot in your body can quickly turn disastrous but luckily, this mare meant me no harm, she just wanted to watch her foal. Over the several days that the mare and foal were in the NICU, the foal grew stronger and my respect for the mare became greater. She was taking to her job like a pro. She understood that the doctors and technicians were only trying to help her foal and at every turn, she demonstrated kindness to the humans and love for her foal. When the pair was finally able to head back to their farm, I shed a small tear of joy. It always great to see a baby able to overcome such sickness and its always wonderful to come across such remarkable new mothers.

    With the breeding season ramping up, I look forward to so many wonderful memories that I will be apart of. But most importantly, I look forward to spending time with the unsung hero’s of the breeding industry, the kind mares.

    He Touched my Heart

    March 5, 2013
    Filed under: Uncategorized — Tags: , , , , , , , , , , , , , , — webmaster@hagyard.com @ 6:31 pm

    Dr. Ashley Craig

    Have you ever worked with an animal that just instantly touches your heart? Just reaches down into your soul and plants a hoof firmly there? For those of us who work with animals on a daily basis, we have a list of animals, in my case- horses, that I hold near and dear to my heart. Every patient that I meet is special in one way or another but it takes an extraordinary animal to leave an imprint on my heart. One such horse walked into my life while I was on a rotation at Medicine. He was a tall lanky handsome colt who just wasn’t responding to treatment in the field for his medical problem. I met him on a Monday morning and he quickly won me over. His medical problem required extensive treatments which took not only time on the doctor’s part, but also patience from the colt. With every treatment that was performed, the colt was calm and seemed to understand that we were trying to help. I caught myself wondering if maybe he just felt that bad that he wasn’t reacting in a way that would be expected of a young stud colt, but I was later proven that wasn’t the case.
    One morning I stepped into the colt’s stall just to take a deep breath; I stood there rubbing his handsome face, he dropped his head into my chest, looked at me with his kind eyes and just let me love on him. I am not sure who needed this time more, me or the colt. As time progressed, the colt’s condition finally started improving but his patient attitude and kind ways never changed. By the end of my rotation at Medicine, he was able to go home to continue treatment under the watchful eye of his owners and the Hagyard’s Field vet. A few times I visited the farm where the colt was born, raised and was recovering and I always made a point to stop and spend a couple of quiet minutes checking on his progress and visiting with the colt.
    One morning I met up with the primary Field vet who helped manage the colt’s recovery and got to help with a thorough re-check of the colt’s progress. As we did an extensive examination of the colt, I was reminded again exactly how kind he was. Looking up from my ultrasound screen towards the colt’s head, I saw him drop his head into his owner’s arms as she rubbed on his head. When the primary Field vet gave the word that his condition was 95% resolved and was continuing to improve on a daily basis, the smiles that came on the owner’s face lit up the room. At that moment, I realized just how remarkable this young stud colt was. He had touched not only my heart but the heart of his owners who run a large farm. His courageous and kind spirit in the face of hard times will serve him well as he heads to the racetrack. I am lucky to have had the chance to meet him and to be a small part of his life; he has firmly left a footprint on my heart.

    The Calm Before the Storm

    February 1, 2013
    Filed under: Uncategorized — Tags: , , , , , , , , , , , , , — webmaster@hagyard.com @ 3:39 pm

    Calm before the storm

    Calm before the storm

    Dr. Ashley Craig
    January in Kentucky is an unpredictable time. We all are waiting patiently for the hustle and bustle of breeding season to start but often times the start can be unpredictable. Thoroughbred, and other breeds that are registered, all share a birthday of January 1st, but not all foals are born exactly on or even near that date. Equine vets in Central Kentucky are sitting on go at the start of January, just waiting for the storm of foaling season to start.

    One quiet week in medicine in the middle of January left me wandering if breeding season would ever get here. My thoughts must have reached mare’s ears because it wasn’t moments later that it seemed as if there weren’t enough people to handle the influx of newborn foals entering the hospital. I am not sure if it was a change in weather, the moon, or just time, but a steady stream of mares and foals signaled the start of the breeding season. As quickly as the flow started, it stopped again, leaving me slightly perplexed. A mentor suggested to me that it was just like a storm; you knew it was coming, you could feel the change in the atmosphere and a short burst of activity was just a sign that it would all start soon. Her description reminded me of the movie Twister- where Helen Hunt and Bill Paxton watched a small tornado quickly pull back into the clouds as fast as it had descended. Bill Paxton analyzed the sky and realized that the tornado wasn’t done but was just “back building”. To me, this is the perfect example of the atmosphere in Central Kentucky in January. It is the calm before the storm and the rush of foaling season is just “back building” until the right moment arrives for it to touch down and start. Until that time, I am sitting on Go- just waiting on the call.

    How do you do what you do?

    January 25, 2013
    Filed under: Uncategorized — Tags: , , , , , , , , , , , , , — webmaster@hagyard.com @ 5:36 pm

     

    The joy of a new foal
    The joy of a new foal

    Dr. Ashley Craig

    The other day a young horsewoman was asking about the cases I had seen in my time at Hagyard. I discussed the medical problems I had dealt with in my short time as a Field intern at Hagyard. At the end of the discussion, she looked at me with heavy eyes and asked- “Have you had to euthanize any patients?” Inside, I cringed. Euthanasia is not an outcome that veterinarians like to talk about. No one goes into veterinary medicine because they like to see patients have a negative outcome, but I couldn’t lie to this young lady so I answered honestly- “Yes”. She immediately followed up with, “I don’t know how you can do it.”

    While her statement is one I have heard before, for some reason this time, it made me think a little harder. Thank goodness driving around farm to farm gives me a lot of time to think and reflect. As I reflected on the euthanasia cases I have witnessed in my time working at farms, as a vet tech, at veterinary school, and now at Hagyard, I formed my answer to the young woman’s statement. I can emotionally handle the death of an animal because I see it as the final gift we can give to our sick and dying animals. I don’t know of anyone that enters into the discussion of euthanasia lightly. As a veterinarian, we took an oath to help with the “protection of animal health and welfare, the prevention and relief of animal suffering…” After we do all that can be done for the animal and the animal is still suffering and will eventually die, we can give them a final gift- the relief from suffering.

    Another reason why I can handle the death of a patient is because I am surrounded by so much life. Being in the field, I am often called out to handle preventative medicine such as vaccinations or teeth floating (dental care for horses). Not every horse I see is sick; at times it is the exact opposite! The joy of watching a new foal bounce around their mother, the anticipation of a yearling walking in the sales ring, the excitement of a racehorse or a show horse performing, or even the contentment of a pasture horse grazing in a lush field of bluegrass is what drives me. These magnificent creatures need veterinarians to help prevent and treat medical problems.

    So how do I handle the lows of death? Because I get to see the highs of life and I know that in everything I do, I am doing it for the benefit of the animal.

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