Veterinarians say they're buckling under pressure. Can a change in rules help?

Laura Perry knew she wanted to be a veterinarian by age 16. After watching her cat succumb to a disease, Perry decided she never wanted to feel that helpless again when it comes to animals.

But today, as a 30-year-old veterinarian at Celtic Creatures Veterinary Clinic in Sydney, N.S., she often still feels helpless — especially when it comes to her mental health. 

"There are days I like my job: spaying, neutering, doing surgery, helping animals, being with clients who are really grateful and love their animals. There's definitely positives to it.

"It's not that I hate it, it's just that it is slowly killing me."

Long hours, on-call time, and staff shortages all take their toll. The on-call portion of the job is particularly difficult, Perry said, but it's something she's required to do.

According to regulations of the Nova Scotia Veterinary Medical Association, the regulatory body that oversees the veterinary industry in the province, accredited veterinary clinics must provide after-hours emergency care to their clients.

There are no emergency animal hospitals in Cape Breton or most other rural parts of the province. Many vet clinics, especially in rural areas, have agreements with other clinics to share emergency after-hours services. 

In the case of Celtic Creatures, it had been sharing on-call services with the Northside Animal Hospital. But the company that owns the hospital, VetStrategy, withdrew from the agreement in January.

That's left Perry dealing with a lot more on-call shifts and a lot more anxiety.

"It's not just simple feelings of anxiety, taking an Ativan and getting through it, it is very physical symptoms of panic constantly throughout the day and throughout the night in which I am on call," she said.

The stress of not knowing what emergency awaits her on the other end of a phone call can be paralyzing, she said, and interferes with her sleeping.

The symptoms range from "a heaviness in the chest, headache, constant sweating and agitation, to actual physical nausea to full blown panic attacks where it doesn't matter that I'm safe, I'm at home, I don't actually have to deal with a call," she said.

Few independent clinics left

In 2020, VetStrategy bought 360 veterinary hospitals across Canada, including four of the five clinics in the Cape Breton Regional Municipality.

The company cites burnout and a shortage of vets for ending the agreement between Celtic Creatures and Northside Animal Hospital.

"We would love to continue shared on-call with every clinic and be able to be there to support the patients and clients. But when you're running a clinic where the veterinarian is working their 40 hours a week and then on-call one, two, three evenings through the week for four hospitals, it's a lot," said Marsha White, regional director of operations for VetStrategy's Atlantic Canada branch.

Both Perry and Celtic Creatures' owner, Rebecca Korven, wrote to the Nova Scotia Veterinary Medical Association to ask for an exemption to doing on-call emergency care, because of the loss of the shared-services agreement and because Korven was recovering from a concussion.

Korven is a veterinarian and shares the on-call load with her staff. However, she had to pause those shifts because she was unable to drive at night for a time. That made her worried about the added workload she was putting on her staff.

But the association's accreditation committee denied her request.

Similar regulations surrounding on-call services exist in most provinces. However, the rules in Newfoundland and Labrador recently changed to allow more flexibility, including the ability to close for one 24-hour period per month without providing on-call services. British Columbia also changed its regulations in 2015 and no longer requires 24-hour on-call services.

Korven said there isn't a lot of wiggle room in Nova Scotia, and her own mental health has also been suffering as a result.

"I don't think the regulations right now really allow us to put our health first," she said. "We have to provide that care, no matter how tired we are."

Burnout and mental health issues

The president of the Nova Scotia Veterinary Medical Association, Jeremy Orr, said it's hard to strike a balance between the needs of pet owners and vets. 

Issues like burnout and understaffing came to a head during the pandemic as pet ownership spiked, Orr said. Although some of those issues are improving, he said that's not necessarily the case in rural areas where it can be more difficult to recruit and retain vets.

Veterinarians have been bringing their mental health problems to the forefront in recent years with campaigns such as Not One More Vet, which is aimed at supporting vets in crisis. A study published in 2020 showed that around 26 per cent of veterinarians have experienced suicidal thoughts. Perry has spoken publicly about her own mental health struggles and has written about the topic in columns to the Cape Breton Post.

Orr said he is hesitant to forgo requiring vets to provide on-call services, although his association has been discussing the changes made in Newfoundland and Labrador.

"If your pet's hit by a car at two in the morning and you can't find a vet … that is not a situation we want to have our clients in," he said. "There does have to be some ability to kind of meet a middle ground."

Orr said the legislation governing his association is more than 20 years old and they will be considering some changes over the next year or so.

'Tele-triage' helping lighten the load

For now, the association has been recommending a "tele-triage" service to vet clinics. Their clients can call a company that will help determine whether their pet needs to be seen right away, whether they can wait until business hours, or whether a virtual appointment with one of the company's vets will help.

"The feedback thus far has been very positive, where the number of calls that have come through has reduced dramatically," Orr said, adding that one clinic in the province told him their call volume dropped by half.

That shows many of the calls that clinics are getting after hours aren't for true emergencies, he said.

Orr also believes that setting up more emergency clinics outside of the Halifax area could minimize burnout and help with recruiting and retaining vets in rural areas. But making that happen presents a challenge since veterinary clinics are private businesses.

Meanwhile, Korven said she has been invited to join a planning group the association has set up to deal with ongoing veterinarian shortage.

"I feel hopeful that I'll be able to push for change and really voice our concerns," she said.

If you are experiencing distress or overwhelming emotions at any time, you can call the Nova Scotia Provincial Crisis Line 24/7 at 1-888-429-8167. The Nova Scotia Provincial Crisis Service can also provide contacts for other crisis services that are available if you live outside Nova Scotia.

If you or someone you know is struggling in any way, you can call 211 or visit 211.ca. 211 offers help 24 hours a day in more than one hundred languages and will be able to connect you directly to the right services for your needs.

Additional supports for across Canada are available at www.wellnesstogether.ca.