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Veterinary Medicine & Earthquake Recovery

Mukti N. Shrestha, BVSc, MS, WSAVA Nepal Representative, Patan, Kathmandu Valley, Nepal

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The veterinary clinic Pulchowk is located in Patan, one of 3 cities in the Kathmandu Valley in Nepal. Pulchowk, the first private clinic in Nepal, was founded in August 1978 to provide primarily small animal veterinary services, in line with One Health initiatives. The clinic is supported by 4 veterinarians and 5 team members, including veterinary nurses, and is open 7 days a week. 

Services

Services include routine health checkups, surgery, orthopedic treatments (eg, bone pinning and plating), diagnostic imaging (eg, ultrasonography, radiology), laboratory services (eg, hematology, biochemical blood testing, skin testing, fecal testing, antibiotic sensitivity testing), dental services, immunization, and deworming. Pulchowk is the only clinic in Nepal providing alternative medicine (eg, electric acupuncture) for paretic and paralytic pets. The clinic also frequently handles complicated referral cases from other veterinary clinics.

Services are also provided for pets being transported internationally. Pulchowk provides microchipping services and procures blood serum for required rabies titer tests, which are completed at approved laboratories in other countries, including Japan.

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Modern diagnostic facilities, although expensive, can be advantageous in diagnosing complex cases; however, pet owners typically cannot afford such tests. Most clinics lack ultrasound and x-ray machines, and those that have them purchased them second-hand from human clinics. 

Because modern drugs are not readily available for animals in Nepal, human medicines are still used. Veterinarians consult books about small animal clinical pharmacology to properly administer these generic medications.

The Nature of Care

Nepal is home to more than 3.5 million dogs; approximately 25% of the canine population is made up of stray dogs. Among Nepal’s districts, there are more than 50 private veterinary clinics and 75 government veterinary hospitals, which treat animals raised for food or work. Pulchowk offers house calls for large animals (eg, cows, horses). Smaller patients—including calves, goats, rabbits, parrots, budgerigars and love birds, birds of prey, and leopard and tiger cubs abandoned in the wild—are treated in the practice. 

Exotic breeds (eg, German shepherd dogs, Doberman pinschers, Labrador retrievers) are more popular among local Kathmandu pet owners and those who live in the Terai plains. However, most Buddhist pet owners—particularly those who come from the Himalayan mountain regions—prefer to keep native breeds (eg, Tibetan mastiff, Lhasa apso, Tibetan terrier, Tibetan spaniel). 

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Parvovirus, canine distemper, kennel cough, ehrlichiosis, and babesiosis are common in dogs, as many pet owners cannot afford vaccinations and do not regularly control ectoparasites in their pets. Depending on the season, digestive disorders and skin diseases may also be common. Recently, pyometra has become an increasing problem, and the incidence of mammary and skin tumors has increased.

Local municipalities try to enforce rabies vaccination for all dogs and cats but cannot properly implement and monitor this requirement. In partnership with a few nongovernment organizations, local Kathmandu clinics began administering rabies vaccinations to all dogs in the Kathmandu Valley. These efforts significantly reduced human and animal rabies deaths. 

Religious & Cultural Values

Many animals (eg, cows, bulls, dogs, birds) are important to the religious and cultural values of the people in Nepal. Animals are celebrated throughout Tihar, the Festival of Light, a popular annual 5-day Hindu festival. On the second day of the festival, when dogs are celebrated, Pulchowk offers free rabies vaccinations for dogs.

Despite these values, stray dogs are treated poorly or left untreated; they can carry many zoonotic diseases. Nongovernment organizations are working to manage the stray dog population by spaying female dogs and finding them homes in the Kathmandu Valley; however, progress is limited because of lack of funds and the sheer size of the stray dog population.

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In Nepal, the killing of dogs is considered unacceptable, even in cases of pets suffering from incurable diseases. Because of religious beliefs, some clients object to using insecticide against ectoparasites. Some will compromise by allowing topical treatments if they repel parasites rather than killing them.

Some Nepalese community members oppose keeping pets because they perceive pets as a burden and a danger and do not believe in the human-animal bond.

The Importance of Veterinary Care

The need for veterinary care is gaining recognition, and many new veterinary clinics and hospitals are opening. They are supported by professional organizations such as the Veterinary Practitioner Association of Nepal (VPAN) and the Nepal Veterinary Association (NVA). 

Client education varies. Some families have more access to education about companion animals and the need for veterinary care; their pets are highly valued and cared for. Many other pet owners, however, do not have this knowledge and are unaware pets should be dewormed, treated for ectoparasites, and vaccinated. Lack of education about communicable diseases in pets can create health hazards for the entire community. Unfortunately, even those aware of the need for routine deworming treatments and vaccinations cannot typically afford them. 

Pulchowk, although respectful of each individual’s choice, advises against keeping pets if the family cannot afford to procure vaccinations and antiparasitic treatments, provide a balanced diet, and offer continuous care and attention.

Some pet owners are also unaware of their pet’s nutritional needs and feed leftovers from their own meals, which can cause nutritional deficiency in the animal.

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Earthquake Recovery 

The 7.9 magnitude earthquake on April 25, 2015—and subsequent aftershocks—took nearly 9000 human lives, injured more than 22 000 people, and claimed the lives of more than 17 000 large animals, 41 000 small animals, and more than half a million poultry. Surviving animals experienced further health issues. After the earthquake, changes in canine behavior patterns were reported—previously friendly dogs became vicious, and the incidence of dog bites increased in many villages. An increase in female goat miscarriage was also reported, as well as loss of appetite, which caused body-weight reduction for these animals. 

The devastating tremor and resulting reduction in animal production caused about 1.5 billion Nepalese rupees in economic loss. Shortly after the earthquake, the Nepal–India border blockade occurred. This cut off the transport of petroleum products, cooking gas, medicines, and other necessities into Nepal. Earthquake relief work was severely hindered and development efforts were paralyzed.

In coordination with the NVA, the VPAN initiated animal-relief programs and organized animal-health camps to provide medical and surgical treatment services to 11 721 injured animals, as well as vaccinations, sanitization and carcass management, counseling and consultation services, injured animal rescue, and shelter construction. In addition, 55 goats were distributed in 2 villages of Dolakha, a severely affected district in the epicenter of the earthquake where many farmers had lost livestock. These farmers bred the goats and sold the kids for income.  

Animal-relief efforts were financially supported by the WSAVA, the Veterinary Practitioners Association of Thailand, and the Hong Kong Veterinary Association.

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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This article is published as part of the Global Edition of Clinician's Brief. Through partnership with the World Small Animal Veterinary Association, the Global Edition provides educational resources to practitioners around the world.

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