Dedication and Passion in Mexico

by Susan Monger, DVM

November 12, 2012

Spay surgery
Dr. Edmundo Castillo (front right) works one-on-one with HSVMA-RAVS veterinarian Dr. Lynn Perdzock (front left) to perform a canine spay, while Dr. Antonio Zendejas (back left) monitors anesthesia.
Dr. Susan Monger/HSVMA

Guadalajara, located in the State of Jalisco, is the second largest city in Mexico with a population of approximately 1.5 million people1. According to local sources, Guadalajara has an estimated population of more than 800,000 street dogs.

Worldwide, there are countless documented stories and photos of the daily pain and suffering endured by street dogs and cats. Guadalajara is no exception. This large population of intact, free-roaming animals results in enormous suffering and risks to both the human and canine populations. There are too many dogs suffering from a lack of food, water, and shelter. There are increased incidences of dog bites, of human health issues and zoonotic disease such as rabies and parasite infections. Packs of dogs cause fear as they roam in search of food and females. Fights and injuries are common as competition for resources is high. Mistreatment, poisonings, and hit-by-car incidents are high. As a result, although reducing the suffering of individual street dogs is a priority for animal advocates in the city, the ultimate goal is to decrease the number of dogs living on the streets through sterilization.

Addressing the Welfare of Guadalajaran Street Dogs

Guadalajara is fortunate to have a government-sponsored spay/neuter program to help address the enormous animal and human health issues associated with overpopulation of dogs in the community. Although the State of Jalisco employs 14 full time veterinarians in their spay/neuter program, their work is constrained by their extremely limited resources. Each veterinarian performs between 40 and 100 surgeries per week. Each clinic is supplied with 1 to 4 surgical packs and sterile gloves. Some clinics have sterile drapes, but there are no sterile gowns. The clinicians work without the benefit of gas anesthesia and their injectible anesthetic protocols are dictated by the few veterinary drugs at their disposal. Plus, almost all of the veterinarians work by themselves, which means they do everything from intake to physical exams to anesthesia and surgery to recovery. As a result, surgery numbers are decreased because the veterinarians need to induce animals on their own, prep their own surgeries, top off their own anesthesia, clean their own packs with chemical disinfectant between surgeries, and recover their patients among other tasks. The need for such extreme multi-tasking by each veterinarian decreases efficiency and at times compromises patient welfare.

The State-employed veterinarians recognized that they were experiencing a much higher-than-normal rate of surgical complications in their spay/neuter work, but they were limited by a lack of staff and resources. Fabiola Alvarez, a local street dog advocate who the veterinarians worked with regularly, took it upon herself to garner government support to help the veterinarians gain access to continuing education in field surgery spay/neuter techniques, in hopes of helping them to decrease their complication rates and improve patient care.

In September 2012, Fabiola’s selfless efforts on behalf of the spay/neuter veterinarians became a reality when she, seven veterinarians from the State of Jalisco, and four veterinarians from the State of Colima participated in a continuing education course conducted by HSVMA-RAVS, in collaboration with The University of Colima, Tecoman College of Veterinary Medicine, and the Jalisco government. The intensive continuing education course in small animal anesthesia and surgery was designed to enhance anesthesia and surgical skills in a high-volume setting while dealing with the reality of extremely limited resources.

Quality Care with Limited Resources

Over the course of the week, the veterinarians attended lectures and surgical demonstrations and participated in wet labs and surgical training centered around supplies, equipment, and techniques that were available to them in their own clinic setting. The lectures covered principles deemed basic by practitioners who have the luxury of working in state of the art veterinary hospitals with multiple sets of extra hands and access to numerous veterinary products, but when working within the limitations of scarce or absent resources, basic principles become life-saving principles. The details also become more important when working not only under the pressure of an ever-growing population of patients – many of whom are in heat or pregnant – but also with a population of patients who are compromised from living a life on the street. As a result, the continuing education provided by HSVMA-RAVS had a resource-sparing and detail-oriented preventative approach. The training focused on realistic high-volume anesthetic and surgical techniques with an emphasis on patient assessment, emergency techniques, and recovery assessment.

Wet labs focused on aseptic techniques and effective knot tying and suturing techniques. The group completed a low volume of surgeries each day in order to facilitate learning. The surgeries were performed one on one with an experienced RAVS veterinarian using high-volume techniques to emphasize safety and efficiency.

For the solo practitioners, rounds were the favorite part of the day. Asking questions and assessing one’s techniques is a brave and effective way to learn. It is never easy to discuss surgical infections, hemoabdomens, dehiscences, or anesthetic deaths; especially since all medical professionals live in a society that expects perfection from humans who are, fallible. The veterinarians who attended the HSVMA-RAVS course proved to have strong characters, humility, a dedication to learning, a desire to push themselves to be better clinicians, and the passion for animals that defines true animal welfare advocates. As a result, they sought solutions to their individual complications rather than burying them under the challenging circumstances in which they work. Through their efforts, they will be able to better help the vulnerable animals with which they work.

Optimistic for the Future

Guadalajara team
The HSVMA-RAVS, University of Colima, Tecoman College of Veterinary Medicine and Jalisco government field spay/neuter continuing education presenters and attendees.
Dr. Susan Monger/HSVMA

The HSVMA-RAVS International team looks forward to continuing to work with Guadalajaran veterinarians and other Mexican veterinarians to conduct veterinary continuing education opportunities. This type of educational outreach fits perfectly with HSVMA-RAVS’ priorities of animal welfare, education, and sustainability. By providing access to continuing education to the Mexican veterinarians, HSVMA-RAVS has helped to create a pool of local professionals that will be able to help greater numbers of the street dogs through increased surgical numbers and improved standards of care, as well as through knowledge sharing with other local veterinarians. As a result of this work, thousands of animals will receive better and more humane care.

The feedback provided by the veterinarians who attended the course tells us that the HSVMA-RAVS program is helping them to make a difference for the street dogs of Guadalajara:

I thought I'd seen everything on the subject but I learned more in one week than I could have even imagined. It gives me pride to say that two months after the course, I [am able to] apply the knowledge I learned. I would like to reiterate my thanks to HSVMA-RAVS for being trainers and promoters of this noble cause.

-Dr. Erika Yazmin from Guadalajara

Through the support and encouragement of HSVMA-RAVS, we have increased the animal welfare in Jalisco in one short week of intensive training. All of us who participated in this course are better veterinarians and animal caregivers. I have no words to describe my thanks for taking the time to teach me more...

-Dr. Andreas Velarde from Guadalajara

Victor, one of the veterinarian participants, is teaching your techniques to different doctors… Victor's working partner, (who was trained by Victor) was transferred to another county where no one went to the course and they have tons of problems she will teach the new technique to [other] doctor(s). The veterinarians are very eager to improve their operations...HSVMA-RAVS is sure making wonders here. Thank you from the bottom of my heart.

-Fabiola Alvarez from Guadalajara

1 Mexican census 2009