http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2006/05/30/BUGF8J3DIF1.DTL&hw=cow&sn=002&sc=878Turlock, Stanislaus County -- Dr. Robert Cherenson has tendinitis in his left elbow, the result of palpating cows -- reaching his hand into their rectums to examine reproductive tracts. He often examines hundreds during a single day -- what veterinarians call a herd check. He has learned to live with the pain.
On a recent Tuesday, it was hot and the down side of Cherenson's 13-hour workday. "This is all I ever wanted to do,'' he said as he administered a tranquilizer to cow No. 3748 at Lucas Dairy, a major client for Lander Veterinary Clinic in Turlock, where he has practiced for 16 years. He made an incision on the cow's left side so he could reach inside the animal and with a suture reposition the animal's abomasum, the stomach part that normally lies on the floor of the abdomen but can be displaced by the uterus during pregnancy.
These days, there aren't enough farm vets like Cherenson to meet demand. As a result, there's so much work in the heart of California dairy country that he and his wife and two teenage kids have had only seven days of vacation in two years. But Cherenson, 48, is not complaining.
"I like the animals. I like the people. I like the environment. But it's not a business for the faint of heart,'' said Cherenson, a New Jersey native who studied dairy science at Clemson University and Rutgers University and got his veterinary degree at Purdue University.
Throughout California, there's a shortage of veterinarians. "We know in California we need 725 or 750 new vet practitioners in the state annually, and we do not come close,'' said Dr. Bennie Osburn, dean of the UC Davis School of Veterinary Medicine.
The Bureau of Labor Statistics projects 28,000 veterinary job openings nationwide by 2012. The nation's 28 veterinary colleges aren't satisfying the demand.
"There is a huge shortage of all veterinarians in this country,'' said Dr. Shirley Johnston, dean of the College of Veterinary Medicine at Western University of Health Sciences in Pomona (Los Angeles County), California's second vet school.
The situation is most dire when it comes to those who treat farm animals.
In California's countryside, the vet shortage is more than an inconvenience -- it's a problem that some experts fear is depriving farm animals of the care they need, leaving them vulnerable to disease. The shortage extends to state government veterinarians, who are the first line of defense against animal epidemics.
The situation is getting worse. Take, for example, UC Davis' class of 2007. Of the 122 students, four said they want to work with cattle, four are interested in working with both food and small animals, and six selected large animals, meaning bovines and horses. That's a total of just 16 farm animal vets.
Some states are creating incentives to bring more vets to farm country and UC Davis is considering ways to attract students into the field. But there is no solution in sight as old-time farm vets retire and new graduates go for the good life in the cities.
In rural California, "The reality is the vets that are there are working longer days. They are overworked," said Dr. Don Klingborg, associate dean at Davis. "They are not doing everything that they might do to optimize the health of the animals."
The extreme San Joaquin Valley temperatures and long work days that Cherenson routinely faces are two factors that discourage many veterinarians from working with livestock. But the main reasons vets are increasingly few in farm country are demographic and lifestyle issues that have pulled graduates away over the last generation.
In cities and suburbs, doting owners regard their pets as members of the family and spend billions of dollars on care. Veterinarians earn good money, have more control over their schedules and more-normal family lives. They leave after-hours emergencies to clinics. Farm vets can be called at all hours.
Spouses or partners of vets often don't want to live and work in rural places. Meanwhile, fewer kids are coming of age on farms. Traditionally, rural kids who studied to be vets returned to the country to care for cattle and other large animals.
And finally, working with big cows and horses is hard, physical work.
Veterinary medicine is no way to get rich, but most vets earn decent pay, whether in the city or the country. At the Lander Clinic, new graduates start at $72,000 a year, going up to $78,000 after six months with generous benefits, Cherenson said.
Western University is the nation's 28th and newest vet school and the first established since 1979. The private school also trains pharmacists, nurses and allied health professionals. There were 639 applicants for the 100 slots in the first graduating class, which finishes up in 2007. Six or seven members of the class already have offers for jobs with salaries of $100,000 or more, according to Johnston.
One shortage is veterinarians trained for government work, such as protecting the food supply and countering epidemics. About half of state and federal veterinarians are nearing or are eligible for retirement, Osburn said.
Dr. Annette Whiteford, director of the California Department of Food and Agriculture, headed an effort to counter an outbreak of Exotic Newcastle disease in Los Angeles and Riverside counties in 2002 and 2003. She presided over the destruction of 3 million birds.
Whiteford said vet pay in the private sector and the federal government has increased but has not kept pace in state government. California government vets earn about $63,600 a year. She's looking to improve that.
Not everyone is convinced that the rural shortage is a crisis.
"We do not have animals that are not being treated,'' said Dr. Eric Weigand, a small-animal veterinarian in Claremont (Los Angeles County) and president of the California Veterinary Medical Association, which represents some 5,000 of the state's 7,000 licensed veterinarians.
Whatever the dimensions of the problem, in California and across the country, officials and educators are exploring ways to boost the number of farm vets.
Several states are creating incentives for students to become large-animal veterinarians. In Kansas, Gov. Kathleen Sebelius recently signed a bill to grant five Kansas State University veterinary students as much as $80,000 to cover tuition and training expenses if they agree to practice for at least four years in any of the state's counties that have a population of 35,000 or less. The Illinois Farm Bureau has a similar program.
A report to be published next month in the Journal of the American Veterinary Medical Association recommends student loan debt relief for those working in underserved areas.
In addition, Congress is considering the Veterinary Workforce Expansion Act, which would offer grants for expanding veterinary schools to increase the number of professionals working in public health practice and biomedical research.
In California, educators are looking at ways to boost the number of veterinary students and get more of them to treat livestock.
UC Davis is graduating 122 vets this year. The graduating class size may grow to 160 in a few years.
Meanwhile, a University of California planning committee is expected to recommend in autumn that the system study the feasibility of establishing a second veterinary school, Osburn said.
Cherenson suggests the state allow graduates to work temporarily with large or food animals, even if the grads have not yet passed a state-required exam, which is offered only twice a year.
Back in dairy country, hard-pressed farmers depend on good veterinary care.
Mike Lucas, the owner of Lucas Dairy, founded by his grandfather in 1938, says he's getting $10 for every 100 pounds of milk from his 850 cows, down from $15 a few months ago. He's keeping an eye on expenses. He's still going to have Cherenson and the other Lander vets do weekly checks to examine the cows' reproductive health. But he probably won't have all 850 cows checked each time.
The $300 surgery Cherenson performed on cow 3748 was not optional. The animal's stomach was twisted -- displaced abomasum is the medical term for the condition. The cow just had a calf. She was in pain and not eating.
She was a good candidate for surgery, Cherenson found. Her temperature was 102.2 (normal is 101 to 102). Her blood sugar was low, which he corrected intravenously. He shaved her and gave her a tranquilizer, but because of their size, he doesn't knock out cows.
He scrubbed her three times, gave her antibiotics and splashed her generously with iodine.
Reaching the abdomen through the incision, he poked a needle into the abomasum to release gas and, with the suture, put it in its proper place. He sewed her up and declared her a sweetheart.
During that 30-minute surgery, Cherenson kept his eye on cow No. 3928, which was trying to give birth. It was going slowly, so he, Lucas and a visiting veterinary student from Portugal, Ana Cunha, used a chain to pull the calf out.
The male, correctly emerging from mom front hooves and head first, fell hard to the ground and looked a bit stunned. Cherenson gave him an injection of Dopram, a respiratory stimulant. Mom came over and began nudging him to stand up.
Cherenson had left home that day at 6:30 a.m. and driven first to Mater Dei, a Merced dairy. He palpated 180 cows and vaccinated animals to prevent contagious diseases and brucellosis, a bacterial infection that can spread to humans.
He was at Mater Dei five hours, then had a large chicken salad and ice tea at an Atwater restaurant before answering the call from Lucas Dairy.
After that, Cherenson returned to his clinic, did some paperwork and examined cows in the clinic's own herd of 500 Jerseys. Two were treated for milk fever intravenously with calcium and potassium. They both got up. He left for home at 7:30 p.m.
"Many of our days are long,'' Cherenson said. "But many are full of adventure and a sense of having served mankind and our wonderful patients in a fulfilling manner.''
