Returning from my hiking trip in the Torres del Paine National Park, I am once again strolling pass the World’s End Bar in Puerto Natales and notice that the dog with the suspected ruptured cruciate ligament hasn’t made a lot of progress.
Spending most of the day lying in front of the Bar and checking who is passing by is now his main occupation, but when getting up, he is still displaying an obvious limp and running is out of the question.
I had noticed in Puerto Natales a considerable number of – mainly long haired (because of the weather in the winter) – homeless or semi-homeless dogs. I make this distinction, as there appeared to be a grey zone with dogs which didn’t seem to have a specific owner, but which remained just in one street and which benefited from comfortable dog houses or other means of shelter that had been arranged by animal lovers in the local community.
All these dog appeared to be reasonably well fed and socialised and most of them seemed to belong to a local group of dogs. One of these “street gangs” appeared to have taken residence in front of the “Wild” Cafe which featured not only their resident canine who was the proud owner of his personal spot inside the building near the bar
but also this group of dogs which were sleeping both underneath or on the chairs infront of the establishment. There wasn’t a better place I thought for a veterinarian to have a coffee….
The usual comings and goings in the street didn’t interest the gang too much, but that changed at once with any event that differed from the regular passing of just cars or pedestrians.
This included motorcyles, cars with faulty exhausts and tuned engines or the appearance of a dog that didn’t belong to their patch, including dogs inside passing cars. From a state of near comatous sleep the whole pack would immediately jump into action to investigate, challenge and then ideally chase off whatever had dared to disturbe the peace in their neighbourhood.
Thankfully this paroxysms involve just barking and some chasing – I never witnessed a physical attack. Even with passing dogs this often meant that the dog in question was challenged, investigated and – if the other dog was reasonably confident and didn’t try to intimidate the pack – finally allowed to pass or to retreat.
However, within seconds the street could be full with half a dozen of dogs and it was just a matter of time that this would go wrong…..
A fair number of the dogs showed some forms of gait abnormalities with some dogs virtually running on three legs all the time. Most of these injuries were surely caused by an encounter with a passing car.
Again it was time to visit a local colleague……
Just a few blocks away I had noticed a green bungalow that turned out to be one of the local veterinary practices and as before I turned up unannounced…….
Following a short wait in the busy reception area, I was greeted by the friendly face of Maria Jesus Garrido Bauerle who spoke an excellent English which made the conversation so much easier.
Maria had set up this small practice just a few years ago in the house of her mother and she was running it with three other colleagues.
Without any hesitation I was given a tour of the place and a few minutes later I found myself in the operating theatre helping to sedate a feline patient with a cat bite abscess – here in Patagonia as well a very common injury.
While the cat was falling asleep, Maria talked about her difficulties to obtain some basic medication and of their often prohibitive cost. For the sedation of the cat we had used a combination of Xylazin and Ketamin – something that came out of fashion over thirty years ago in the UK , but something that still continues to be popular in some veterinary practices in Continental Europe as well. Dexmedetomidine, a much better choice, which can be reversed with Atipam, was a drug Maria and her colleagues were aware of, but according to Maria the sourcing was a real challenge.
Here I was…being directly confronted with some of the global problems of my profession which I had debated with my colleagues in Lima just a couple of weeks ago: stray dogs and the access to basic veterinary medication. Yet these had never been problems of any great concern in my own practice (stray dogs were nearly always collected by their owners within a matter of hours and supply shortages of veterinary medication were rarely an issue. If so, these were in most cases limited to newly launched medicines that had turned out to be much better than anything else that had been used so far). Despite the fact that Chile isn’t a third world country and Puerto Natales didn’t seem to be the poorest place in Patagonia, my colleagues were struggling with these issues on a daily basis.
The price for a standard consultation in Maria’s practice was circa 20 $, but none of her patients was insured and spending money on pets wasn’t very high on the agenda of the people here. This was apparently even worse on the countryside.
Unfortunately it had some serious consequences:
In an economy traditionally based on sheep farming and with dogs that were not regularly vaccinated and treated against parasites, Eccinococcosis, an infection with a special kind of tape worm, is a huge problem. The parasite can affect humans, especially children. As an intermediate host for the parasite, infected people develop cysts in the liver, the lungs or even in the brain or occasionally in the eyes with severe and debilitating symptoms and occasionally with a fatal outcome. In some parts of South America according to the WHO the prevalence level is as high as 5-10% in humans and up to 95% in slaughtered animals….
Maria and her colleagues are going to great length to inform pet owners about this, but encouraging regular preventative treatment and good hygiene remains an uphill struggle.
Somewhat better is the situation with rabies, another serious zoonotic disease. Although not completely unheard of, according to Maria they haven’t seen a case for many years now.
Maria’s resources were limited though and when I arrived at the practice, another dog was driven off with a splinted leg as it was fractured but an operation for this condition was only possible in Punta Arenas which was over a 2 hour’s drive away.
I saw some similarities with the working conditions I had found at the other side of the world in the polar regions of Sweden and Norway where pet owners had to decide between many hours of travelling or surgery performed under not ideal conditions because of a lack of equipment or skill (or both) or even the hard choice to have a dog or a cat put to sleep as no feasable alternatives could be provided.
Despite not having an anaesthetic machine, X-Ray or ultrasound facilities, Maria and her team remained upbeat and provided the best service possible under these circumstances.
Once again I could witness what difference the internet had made to my colleagues in these remote parts of the world: continuing education of very good quality was provided in the form of online lectures and the local colleagues – despite living hundreds of kilometers apart from another – were helping each other at least with much appreciated advice. If this was not enough to help a patient, vets were reaching out to specialists at the nearly thirty vet schools in Chile or at clinics in the metropolitan areas of Latin America or in Spain.
This was unfortunately of only limited use for the street dogs of Puerto Natales: without owners or well funded charities in this remote corner of the world, treatment – if any – was confined to some short term pain relief courtesy of the local veterinary practices or – in the worst cases – just euthanasia.