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Throughout the pandemic, pet adoptions have increased, but animals in need of homes continue to make their way through our doors. In 2021, we relocated 4,124 animals from other areas of the country due to floods, hurricanes, and other natural disasters. This was in addition to the thousands of local animals surrendered to us. There are many reasons why animals are surrendered. Some owners are too ill to take care of their pets, others struggle to find housing that allows pets, and other owners are forced to surrender their pets due to financial stress. An example of a unique and heartbreaking situation is the nearly three dozen cats living in a single house in Tewksbury, MA. The surviving spouse was left to care for the cats when their owner passed away. He became overwhelmed by the required care and surrendered the cats to the Nevins Farm staff in February of 2022. (In total, 91 cats were surrendered. Nevins Farm received 32 cats, while the other 59 were sent to Tewksbury Animal Control and other local humane organizations.)
Each cat had significant medical needs and ranged in age from six months to ten years of age. Most of the cats suffered from upper respiratory infections, ear mites, and periodontal disease. Furthermore, many of the cats suffered from untreated eye problems, with some losing their sight entirely as a result. Upon the cats’ arrival at Nevins Farm, Dr. Ruth Marrion, formerly an intern at Angell (Class of 1992) and currently a volunteer ophthalmologist at our Methuen adoption center, examined and treated their eye problems.
The cats’ vision was affected by persistent pupillary membranes. Additionally, some cats had entropion. Sadly, others with perforated corneas had to have their eyes removed. Besides treating their health issues, Nevins Farm staff ensured that all adopted cats were neutered and spayed. To date, 17 cats have been adopted because of the unending support of staff and volunteers like Dr. Marrion.
The estimated cost of the cats’ medical care was significant. The staff at Nevins Farm took care of the cats while our Development and Public Relations teams promoted the story. To offset the costs of the medical treatments, they launched a fundraising campaign. The story went viral on social media and was featured on the local news. As a result, donations began flowing in. To date, the campaign has raised a total of $58K which will cover much of the care for the Tewksbury cats and many others in need.
The MSPCA-Angell has a long history of innovation, compassion, and resilience, and stories like the Tewksbury cats’ are a rewarding reminder of the positive change that results from the collaborative efforts of our team, our donors, and our volunteers. Since joining the MSPCA-Angell in early 2020, I have been continuously inspired by veterinarians like you, who have used the training they received at Angell early in their careers to care for animals in need and preserve the bond between humans and animals. With every pandemic-era challenge we have overcome, we have gained new perspectives. And I am confident that, as a team, we will continue to adapt and persevere on behalf of our beloved animals as we move forward with this new normal.
MSPCA-Angellʼs New Intensive and Supportive Care Units
Ann Marie Greenleaf, DVM, DACVECC, Chief of Staff
The MSPCA-Angell opened the first animal intensive care unit in 1959. We remain a leader in veterinary emergency and critical care, a strength we could not have developed without the tireless efforts of our interns and residents. As we continued to provide emergency and critical care to an increasing volume of patients, it became clear that we needed a more modern, expanded Intensive Care Unit (ICU).
With the onset of the COVID-19 pandemic, a new normal was born. As a result of more adoptions and people staying at home during the pandemic, there was a dramatic increase in emergency veterinary cases nationwide. So, it was fitting that we broke ground the same year on constructing the MSPCA-Angell’s new Intensive Care Unit (ICU) and Supportive Care Unit (SCU) for emergency cases and recovering patients.
A renovation was necessary. Our previous facility was built about 40 years ago when there were very few veterinary intensive care units in the country, so the space was designed and constructed with limited collective experience. There was no other facility like it to emulate. Over the years, our clinical team — including our valued alumni — constantly adapted within the existing space to support a growing caseload until dramatic renovation of our physical space became the only solution.
The new Intensive and Supportive Care Units were constructed in two phases. Phase 1 was an extension of the current footprint of the foundation. We renovated 7,906 square feet of existing space and added 9,257 square feet. We pushed the building out into the existing parking lot and built two floors; by doing this, we gained over 9,000 feet of new space.
Once that area was completed in the fall of 2021, we vacated our in-patient wards and moved those non-critical patients into the two floors of the new Phase 1 space. The roughly 8,000 feet of cleared ward space was then demolished to construct the new ICU. This two-phase process was essential to allow us to maintain cage space for our hospitalized patients during demolition and construction. By building up and creating a second floor with considerable cage and run space, we were able to continue working and helping animals during all construction phases.
The MSPCA-Angell’s renovated ICU and SCU are now officially open. Our Supportive Care Unit has already made it easier for our more stable hospitalized patients to receive care. Our updated ICU and SCU provide easier access, maintenance, and a higher comfort level for our patients. There is a separate emergency room where most animals are triaged, and their initial stabilization procedures are carried out. After initial treatments are completed, patients are either moved into the ICU wards or SCU wards based on the level of nursing care necessary.
As a result of these newly constructed areas, we can provide our hospitalized patients with more runs and kennels and more space for individual patients. One of our objectives was to maximize the amount of natural light in each room. Another was to make the new area as comfortable as possible for patients staying with us. Rooms dedicated to mechanical ventilation and dialysis provide customized space for two of our higher end treatment modalities that require specialized infrastructure. Two recently added client visiting rooms are more like living rooms than a busy ICU; these rooms allow clients to spend some quiet time with their pets during their stay with us. Separate wards also exist for cats, dogs, avian/exotic patients, and those who require isolation.
Our isolation space is designed to safely house patients with respiratory or gastrointestinal infectious diseases. It has a negative airflow system that prevents air — and airborne pathogens — from escaping into the general wards. We have space for eight patients in this new ward. There is a direct exit to the outside to avoid potential mingling and contamination of the adjacent ICU space. Additionally, the new ICU has centralized workstations for a dozen doctors and technicians so that the Critical Care service can be conveniently at hand.
In the past two years, the MSPCA-Angell, like primary care practices and the rest of the world, had to adapt quickly to a “new normal.” We are grateful to our dedicated staff who have nimbly adapted and enabled us to provide the highest level of care and comfort to our patients.
The Emerging Role of Urgent Care
Douglas Brum, DVM, Angell Alumni Director (Angell Intern, Class of ʼ86)
In the wake of the pandemic, veterinary hospitals — including here at the MSPCA-Angell — have had to modify standard protocols to ensure the safety of clients and patients and fulfill the growing demand for veterinary services.
Over the past two years, the MSPCA-Angell experienced a significant increase in caseload, as have other veterinary hospitals. The pandemic may have been a boon for pets in many ways. As adoption rates soared and people — some first time pet parents — spent more time at home with their pets, subtle changes in pet’s behavior didn’t go unnoticed. A dog who vomited once — an emergency, perhaps? (And pet owners scrutinized everything: in the past two years, we’ve received twice as many emails from people asking questions about their pets.)
Throughout COVID-19, we never stopped working at Angell — our doors were always open. Although this was great for our clients and patients, it was draining on the team, especially frontline staff, who were already doing their best to follow safety protocols despite reduced staff capacity. Burnout is a challenge in the veterinary field, but it became more severe with the addition of the pandemic. Many people left the profession because of COVID-19, and it played a huge role in some practitioners retiring when they would have otherwise stayed on to work.
Unfortunately, at the height of the pandemic, we had to close the Emergency and Critical Care (E/CC) service at the MSPCA-Angell West in Waltham due to a lack of technical staff. It was a temporary closure (we reopened the MSPCA-Angell West E/CC in February 2022).
Still, as the pandemic continued and patients kept arriving in more significant numbers, we had to do something to help clients. So, we started an Urgent Care Clinic. Although it was by appointment only, it helped alleviate some of the burden on the E/CC service in Boston and it helped make up for the lack of an E/CC at West. The Waltham Clinic treated patients with non-life-threatening emergencies, such as lacerations, impacted anal glands, and the like. In the pre-pandemic “old days,” we saw these types of patients alongside those needing heavy, supportive care. However, by diverting these types of patients to the Urgent Care service, those with dire, life-threatening circumstances (e.g., a dog hit by a car or a cat who ate a poisonous flower) could receive treatment immediately.
Not being able to see urgent appointments hurts us as veterinarians. It goes against everything we hold dear — and it goes against our mission to provide the highest standard of care for animals. There is nothing worse than saying to a client, “No, we can’t see your dog with itchy ears.” It almost sounds condescending to the pet owner, as if their pet isn’t just as important as the cat who ate part of a houseplant. Being unable to care for every animal that comes through our doors — this guilt creates a great deal of stress within the profession. People find they can’t keep up with demands. They’re stretching themselves too thin. And when this happens, they must take precautions to avoid burnout. As important as taking care of ourselves during this time, it is just as crucial for veterinary practices to implement protocols and workarounds to prevent burnout, such as providing an urgent care service. It is impossible to care for a sick pet when you are ill. This sometimes means you need time off and say “no,” and the patient is referred to an urgent care clinic off-site.
While urgent care is relatively new to veterinary medicine, COVID-19 brought it to the forefront. We cannot turn people away when we are understaffed or have too many patients. If that’s happening, it’s evident that we need to do something. Emergency rooms are not recommended for non-emergency medical problems in human hospitals. I feel this should be the same for veterinary hospitals. Even though some health issues may not be life-threatening, they are still considered emergencies. They cannot wait and must be treated as soon as possible.
Looking Back: An Intern Year in Review
Jake Stokes, DVM (Angell Intern, Class of 2022)
The day that I found out I had matched with Angell Animal Medical Center for my rotating internship is a day that I will never forget. Angell has a reputation for molding competent clinicians and an emergency department that is well known, albeit very busy. I had always hoped to participate in the internship at Angell. I was initially filled with excitement and eagerness to jump into the world of veterinary medicine as a new graduate and begin practicing my own medicine. However, I soon became filled with fear and nerves. Will I be able to keep up with the caseload? Will I make mistakes? Am I truly ready for this? These were the questions that filled my thoughts until day one of my internship.
Upon arriving at Angell for orientation, I quickly realized that I was not alone with these thoughts. I met nineteen other eager but equally anxious new graduates. Little did I realize these colleagues would soon become a second family. The past 380 days have been nothing short of a whirlwind. Whether we were sprinting to the lobby for codes, resuscitating newborn puppies, or playing the daily online game Wordle, my fellow intern-mates and I have been through many highs and lows. In addition, we have had many challenges to overcome.
The first few months of the internship were by far the most challenging. We were adjusting to a new hospital, with a record-keeping system with which we were unfamiliar, and a large facility that was confusing to navigate. Even the smallest tasks seemed daunting: requesting radiographs, filling medications, and finding the nearest bathroom. In addition to this, we were new veterinarians tackling various cases for the first time. Fortunately, Angell has a strong support system behind us in the form of technicians, residents, and senior clinicians. I immediately felt very comfortable discussing cases with others, asking for guidance, and in some instances, admitting that I was overwhelmed. We quickly learned that it was okay to not have answers for everything. We were, after all, here to learn and grow.
As the fall months came, we hit our stride a bit more confidently. We were able to work cases up more efficiently and independently. We found ourselves working more quickly and keeping up with the busy caseload that our emergency service has to offer. In turn, this came with the difficult task of managing a heavy inpatient load in addition to actively seeing new cases. This was when we looked to each other for support. Our intern class went above and beyond to work as a team to survive this past year. Whether it was in the form of splitting the inpatient load evenly, staying late to help with a procedure, or filling extra medications for others, we realized that a small favor can go a long way during someone else’s busy day.
Among our intern group, we have a diverse set of interests. Whether cardiology, oncology, neurology, or emergency medicine, we have interns moving forward in their careers in all aspects of veterinary medicine. This has been a great tool for us. I have found myself calling for help for an orthopedic exam multiple times from our more surgery-oriented interns or for an ophthalmic exam from those interested in pursuing ophthalmology. We have truly learned to work as a team and use each other’s strengths to make it through the year.
One unique aspect of our internship year has been the concept of “diversion.” Due to a nationwide shortage of veterinary technicians, our emergency department has occasionally diverted stable patients to other facilities. This allows our current technical staff to provide the appropriate attention needed for our inpatients. With that being said, it has been challenging and heartbreaking to turn owners away from the care they are seeking. As pet owners ourselves, we understand how worried and anxious they are regarding their pet’s health. It has been disheartening to look them in their eyes and ask them to seek care elsewhere. Fortunately, most owners are very understanding, even though it does not make the situation any easier.
Looking back at this past year, I can truthfully say that I have grown as a more competent and confident clinician. I have met lifelong friends along the way and wish nothing but the best for my fellow interns in the future! Although I am happy to return to a regular sleep schedule, I will miss the busy days and long nights that my intern-mates and I have endured together.