Dr. Dana Koch with puppies
Dr. Dana Koch
Words by:
Dana Koch, VMD — Associate IndeVet

Rural Area Veterinarian Services (RAVS)

Imagine owning 10-15 dogs, worrying about how to feed or care for these animals properly, and having limited access to veterinary care. This is a reality for many families living in Bylas, a community within the San Carlos Apache Indian Reservation in Arizona.

Recently, I completed a medical mission with the organization Rural Area Veterinarian Services (RAVS) in Bylas. Observing firsthand the struggles these people and their animals endure gave me a new perspective on accessible veterinary care for certain people in the United States.

Rural Area Veterinarian Services (RAVS)

The RAVS program has worked to expand access to veterinary care in underserved rural communities where poverty and geographic isolation make regular animal health services unavailable. RAVS’ veterinary groups have provided thousands of animals with necessary care and treatments and essential education to pet owners. Further, RAVS offers valuable service-learning opportunities to those in the veterinary field, including veterinary students. RAVS sets up recurring clinics in Washington, South Dakota, North Dakota, and Arizona.

I have been drawn to volunteer work in the veterinary field domestically and internationally throughout my entire veterinary career. In the past several years, I have traveled to countries in the Caribbean and South America to participate in surgical campaigns, offering my skills in high-volume spay and neuter procedures. These missions were life-altering because they opened my eyes to the barriers in obtaining adequate medical care for many of our animals worldwide. Furthermore, the problem of overpopulation in many countries threatens the basic healthcare of humans and animals alike. I chose to volunteer with RAVS this year because I was interested in helping animals in this country with primary non-surgical healthcare needs.


A day in the field: Providing care and education

On the first day of the clinic, we met with veterinarians, veterinary technicians, and support staff from different states within the country. We were separated into groups of 3-4. Each veterinary team would meet with a patient outside their vehicles to limit the spread of infectious diseases and the possibility of dog fights. Surgical patients would come inside the building to receive examinations and pre-surgical treatments. Pet owners could also gather free food and supplies, including cat litter, carriers, gates, ramps, and crates. The teams were able to offer routine vaccinations, deworming, and flea/tick prevention. If the patient was sick, they were triaged, and diagnostics and/or treatments were discussed with the owners. It was nice to observe that most patients came with their entire human family to the clinic, and the families were receptive to educational discussions about the best care and treatment plans for their animals. Dr. Dana Koch with dog

Several dogs tested positive for parvovirus, and owners had limited funds and resources to treat these sick animals. The medical teams discussed that ideally, these patients should be hospitalized for the best chance of survival, but with the limitations we experienced in the field, we did the best we could to help these puppies become healthy and to prevent the spread of the deadly virus. We designated a team to handle infectious disease cases. We were able to treat these cases twice daily with fluids and supportive care, including anti-nausea medication and antibiotics. Another critical component of encountering these patients was to educate the pet owners on the severity of this disease and how to prevent other dogs from contracting it through appropriate timing of vaccinations and limiting exposure to unvaccinated animals.

The clinic had a donated pharmacy, and the medical staff was able to provide medications and supplies to treat health conditions such as tickborne diseases, skin infections, respiratory diseases, and transmissible venereal tumors. The latter are cancerous tumors that are passed from one dog to another through breeding and by physical contact with an existing tumor. These tumors are mostly found on the genitals but can emerge on the noses, mouths, anal areas, and other anatomical sites. Many regions in the world with a stray dog population find this specific disease to be quickly spreading and can cause serious issues. The treatment protocol for these patients included giving light sedation, placing a catheter, and administering vincristine, a mono-chemotherapeutic drug, once a week for approximately 2-6 weeks until resolution. Also, spay and neuter were recommended or scheduled right away for these animals. RAVS works with a local veterinary clinic in Thatcher, Arizona to help facilitate the vincristine treatments when the RAVS staff is not in the area.

There were several emergency cases, including a handful of dogs with embedded collars in their necks, a dog with severe sloughing of skin on his feet, life-threatening dog fight injuries, and abscesses on various regions of the body. Some of these patients required surgical intervention and medical fostering, which we were able to provide.


Extending care beyond the clinic

Dr. Dana Koch with dog

Another exciting component of this trip was having the opportunity to travel in a mobile capacity to pet owners who could not bring animals into our clinic.Many of these individuals had over ten animals living on their property – most were kept outside and had never worn a leash. 

The dogs were acutely aware that we had lots of food and treats, so they followed our cars through the neighborhood.The environments in which these dogs and cats lived were challenging; many were covered in ticks or had skin conditions. We saw several litters of puppies and discussed with owners the importance of spay and neuter. The Arizona Humane Society (AHS) works alongside RAVS to provide free spay and neuter services. AHS has started traveling to the reservation once a month to help with surgical and wellness services.


Reflections on the impact of outreach

The people of Bylas were so kind and appreciative of our time, expertise, and services. Bonding over the animals and providing each one the best care possible was the most rewarding aspect of this mission. It amazes me how a group of volunteers can bond over a common cause to make a difference, no matter how small, in the lives of animals and their human counterparts. I have come to understand that access to veterinary care is a complex problem that revolves around numerous societal factors, including socioeconomic inequality, knowledge-based barriers, access to transportation, availability of veterinary care providers, and cultural differences. Personally, I feel that it is a commendable and invaluable undertaking that organizations such as RAVS are striving to overcome and extend continued support to communities and animals in need.


Post-clinic adventures and reflections on a fulfilling mission

Dr. Dana Koch on a camelFollowing my five days at the clinic, I was able to enjoy some nature and hiking in the beautiful region of Scottsdale. I was fond of the warmer weather and the landscape filled with cacti and rocky formations. A trip to the Phoenix Zoo was also on my docket, which included a quick camel ride.

I feel very fortunate that I was able to dedicate my time and efforts to helping a worthy cause. I return home to my clinics, happy to provide quality medical care to the animals I enjoy seeing daily. It gives me happiness and some solace knowing many of these animals spend their days lounging on couches and beds, living their best lives.

I look forward to future missions and assisting new people and their animals with veterinary care. I hope my dedication to animals leaves a lasting impact on the veterinary community.