ABSTRACT
Introduction
U.S. Army Veterinary Corps provides highly skilled and adaptive veterinary professionals to protect and improve the health of people and animals while enhancing readiness throughout the DOD. Army veterinarians must be trained and credentialed for critical tasks within the animal health and food protection missions across all components. The Veterinary Metrics Division in the U.S. Army Public Health Center’s Veterinary Services and Public Health Sanitation Directorate is responsible for tracking readiness metrics of Army veterinarians and maintains a robust online Readiness Metrics Platform. Readiness targets were developed based on trends in readiness platform data, input of senior veterinary subject matter experts, and feedback from the field. To date, no data have been published describing the cases presented to DOD-owned Veterinary Treatment Facilities (VTFs). Without capturing and codifying the types of cases that present to the VTF and comparing to cases typically encountered during deployments, it is difficult to determine whether the VTF serves as an adequate readiness platform. In this study, we compare a representative random sample of non-wellness VTF patient encounters in garrison to cases reported from two different combat zones to determine if the VTF is a suitable clinical readiness platform.
Materials and Methods
Multiple data sources, including pre-existing published data and new data extracted from multiple sources, were used. The Iraq 2009-2010 dataset includes data collected from a Medical Detachment, Veterinary Service Support (MDVSS) deployed to Iraq from January 5, 2009 through August 23, 2010. The Iraq 2003-2007 dataset originated from a retrospective cross-sectional survey that included database and medical record abstraction. The Afghanistan 2014-2015 dataset includes data collected from the MDVSS deployed to Afghanistan from June 2014 to March 2015. Working dog veterinary encounter data were manually extracted from monthly and daily clinical reports. Data for the Garrison 2016-2018 dataset were extracted from the Remote Online Veterinary Record. A random representative sample of government-owned animal (GOA) and privately owned animal (POA) encounters seen across all DOD-owned VTFs from June 2016 to May 2018 were selected.
Results
We found that animals present to the VTF for a wide variety of illnesses. Overall, the top 10 encounter categories (90.3%) align with 84.2%, 92.4%, and 85.9% of all the encounter types seen in the three combat zone datasets. Comparing these datasets identifies potential gaps in readiness training relying solely on the VTF, especially in the areas of traumatic and combat-related injuries.
Conclusions
Ultimately, the success of the DOD Veterinary Services Animal Health mission depends on both the competence and confidence of the individual Army veterinarian. As the MHS transitions and DOD Veterinary Services continues to transform emphasizing readiness through a public health and prevention-based Army medicine approach, Army veterinarians must strike a delicate balance to continue to provide comprehensive health care to GOAs and POAs in the VTFs. Leaders at all levels must recognize the roles VTFs play in overall public health readiness and disease prevention through the proper appropriation and allocation of resources while fostering the development, confidence, and competence of Army veterinarians training within these readiness platforms.
Variation in the Care of Acute Liver Failure: A Survey of Intensive Care Professionals
