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Local veterinary clinics provide essential care for animals and their people

Wednesday morning was not as warm as the teasing April sun suggested, so some of the cars in the parking lot at Four Paws Veterinary Clinic in Mystic had their motors running for heat. Visible in most vehicles were the silhouettes of dogs or wire animal cages. Clients had instinctively parked so there was one empty space between cars — the better for vets and technicians to maneuver within the six-foot, "safe distancing" recommendation during the COVID-19 pandemic.

Taped in the center of the several windows that front the clinic are signs that said, "PLEASE!! STAY IN YOUR VEHICLE!!" with instructions to call reception. In accordance with safety concerns during the coronavirus, almost all the examinations and appointments are curbside at Four Paws.

Accordingly, after a few minutes, two smiling technicians approached the journalist's car and, with all precautions, led the dog Virgil into the parking space next to the car and quickly gave him an annual inoculation. Shortly thereafter, another tech emerged from the clinic and glove-handed a bag of heartworm and flea/tick medications through the car window.

At the same time, an elderly dog was brought out of Four Paws by a white-jacketed veterinarian, who then had a safe-space discussion with the animal's owners a few parking spaces down. As for Virgil, after a quick client call back to reception to provide payment information, his trip to the vet was complete.

"We're discouraging any but the most essential visits," said Dr. Cheryl Monteiro, one of four fulltime veterinarians at Four Paws. "Things like nail trims or even an annual examination for a puppy can be delayed a bit. We've had to prioritize, and we can't do everything we normally do, but we're here and doing what we can to help our clients and their pets. In certain circumstances, if a vet or technician needs to see an animal in an examining room, the pet will be taken inside the clinic while the client waits in the car."

It's not business as usual, but it is a committed, make-the-best-of-it approach by those area veterinary clinics that are still open in the wake of the coronavirus — and, with virtually every other business and household, the vast, grim and long-reaching realities and implications hit very quickly. Four Paws reacted in similar fashion to the rest of society.

"We were watching and listening to the news and getting head's up information from the state and national veterinary groups and planning accordingly," Monteiro said. "It was literally a situation where, on one day, we thought, 'Well, let's stay open,' and the next day it was, 'No, we shouldn't do this.' There was a little hysteria at first in terms of how to take care of our clients — and customers were over-ordering food and meds — but within 48 hours I think we all calmed down a bit and we had everything in place."

The routine, as such, is very different now. Receptionists are fielding a barrage of phone calls and emails, and the staff is practicing a lot of telemedicine.

"We might use video to look at a bump on a puppy or see how a dog is walking, and we don't bill for that," Monteiro says. "Our clients are super accommodating and telemedicine needs a good patient/client relationship with that trust that can give us a little laxity in some cases."

"Personally, I've been acting as the medical director of our little community hospital under the assumption that southeastern Connecticut is as infected as northern Italy," said Dr. Neil Marrinan, who owns and operates Old Lyme Veterinary Hospital with his wife, Dr. Alice Kroger-Marrinan. "And we advise our staff to do the same: Whatever you would be doing if it 'got bad,' you should be doing now."

Like Four Paws, Old Lyme is practicing curbside medicine with the goal of the finest pet/client care.

"The short answer is yes, vets are still here to help," Marrinan said. "We're doing our best. You'll be safe as we can make it (when you come to the clinic). Your pets will get good care. And we're trying to do what will be sustainable for many months because the risk will be present for many months.

One of the roughest situations in veterinary care is euthanizing a pet. It's an incredibly emotional and important decision and procedure, and the arrival and rampant path of COVID-19 hasn't changed that. Marrinan and Monteiro explained that their respective clinics and staffs are prepared with maximum precautions in place, in the way that best fits the set-up of their respective operations.

"This is something where we make exceptions about allowing clients into the clinic," Monteiro said. "We have a separate, sanitized room with blankets, and we schedule it so there's minimum interaction with staff. This is something that's too awful to separate the owner from the pet."

Marrinan said they take the animal into the clinic for calming medication and to insert a catheter and line for the procedure, and have used Facetime or other video so the pet can see and hear their owners. Then, he said, "We return for the owners to hold their pets, either in the car or, if it's a sunny day, by a cedar tree on the property."

Essential business

In terms of adapting care and procedure as more is known about the virus and projections are made, both Marrinan and Monteiro said their clinics follow state and national guidelines as provided in daily updates from the Connecticut Veterinary Medical Association and the American Veterinary Medical Association. Within the state, the CVMA offers advisory components ranging from information on virtual "town hall meetings" for member vets and recommendations that all vet team members wear masks to providing a list of compounding pharmacies that are authorized to formulate custom prescriptions and distribute non-patient specific medications in Connecticut.

"Both the state and federal groups have really stepped up," Marrinan said. "Their guidance is very American: science-driven, group-discussed, and agreed by consensus — very ground up, not guided-down."

"We get mails every day from the Connecticut and national organizations, and we're members of both," Monteiro said. "It's been very helpful and it's a central place for communication. There have been solicitations for supplies and maybe if a clinic has closed, they can help out. There are vets offering relief services. And (the organizations) have provided advice on how to break down the trillion-dollar government relief package if we run into payroll issues."

Staff safety

Of course, it's also a maximum priority that the doctors and staffs at vet clinics are as safe as possible.

"I know that closing completely would be safer for the staff," Marrinan said. "Just having me and Alice here alone is the best way to reduce transmission risk between our staff of 10 or so. But we're following guidelines and doing what we're told is relatively OK for right now."

"Everybody is rightly worried," Monteiro said. "A lot of the contamination of the virus comes from people who are asymptomatic. We're taking all precautions, of course. Someone is constantly making the rounds, wiping down keyboards and computers and equipment. We're doing everything we can, but we all know there's some risk, too."

Both veterinarians said their clinics are making every allowance for employees who might be at higher risk or feel uncomfortable.

"Some members of our staff are older or have health situations where they don't want to take the risk, and we're doing the best we can to support them," Monteiro said, "Hopefully, there will be some options to help out down the road if need be."

"Alice and I are over 50 and we have staff who are over 50, as well," Marrinan said. "I am obligated to protect them. We don't want anyone to catch the virus regardless of their age or health."

What the animals know

Ultimately, veterinarians and their employees are about the care of animals — and it begs the questions: Do these creatures of innocence sense that something major is happening? And, as always, do our pets provide comfort particularly in crisis?

Marrinan said his own experience is a clue to our reliance on animals and that he misses the normal interaction with creatures and their people.

"It's different having a hospital empty of clients but still seeing so many sick pets," he said. "Usually, this place is like an equatorial bus station: women with a duck in their arms, two chickens in a box, various lizards and chinchillas, rabbits ... (But) ultimately, the human/animal bond sustains us despite the necessary social distancing."

"I do think the animals know," Monteiro said. "Things are different at home. They're getting more exercise and their owners are there a lot more. We had one situation where a Dachshund hurt her tail wagging because she was so happy her mom is home all day. We don't want any animals hurt or sick, but that was for the best possible reason.

"The truth is, we just don't know. We're lucky to have a wonderful clientele and we have a lot of long-term relationships, so I think we all understand this is a different and evolving process."

r.koster@theday.com

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