The woman on the phone said her dairy cow could hardly stand. It was 4:30 a.m. The call had awoken Dr. Kelsey Hilton, a veterinarian in central Maine. She’d gotten to bed late because she’d been at the clinic until 10 p.m., treating a young goat with a blocked urethra, then driven an hour home. Now, in the dawn light, she told the woman to give calcium tablets to the Jersey and call her back later. Then Hilton caught what sleep she could before another long day of ministering to farm animals throughout a great swath of the state.
During her 14-hour day, Hilton — who is 32 and 6’2”, with long brown hair the color of her eyes — would crisscross the rolling countryside in her truck. She would vaccinate some llamas, treat a goat with diarrhea from a parasitic infection, and examine a weird growth on a sow.
At a pig operation in Waldoboro, an hour’s drive from her clinic, she realized she needed to draw blood samples on 15 piglets being shipped to Connecticut, something she’d never done before. Trying a new procedure on the fly worried her. But her schedule was so booked, she wouldn’t be able to come back for weeks. So Hilton opened her computer and watched a video from Norway on how the procedure works.
Hilton has an increasingly rare job in the United States — farm animal veterinarian. The nation has plenty of veterinarians in general, some 113,000 by one count. But over the last 20 years, fewer and fewer have chosen to work in rural America with livestock. As older vets in farm country retire, younger ones have not taken their places. From 2012 until 2018, the number of veterinarians working exclusively or mostly with farm animals dropped from 5,100 to about 4,300, according to the American Veterinary Medical Association (AVMA).
Farm veterinarians treat diseases that could kill entire herds or flocks and cause enormous economic losses.
That leaves farmers with nobody to call when their animals have a life-threatening emergency — a problem with ominous implications for both food safety and public health. Farm veterinarians treat diseases that could kill entire herds or flocks and cause enormous economic losses. China, the largest pork market in the world, has lost up to 100 million pigs to African swine fever this year. Farm animal vets are also on the front lines of treating and containing pathogens like salmonella or diseases that could make humans sick, such as mad cow disease.
In 2015, avian flu swept through poultry operations in the Midwest. Medical experts feared it might infect humans. Veterinarians were charged with identifying the diseased flocks, which were culled by the millions. “They were on the frontlines,” Matt Salois, chief economist for the AVMA, says of farm animal vets. “Without them, we couldn’t have the agricultural industry that we do.”
Rural America once produced most of the country’s veterinary students, and Hilton follows that tradition. She grew up on a 700-acre farm, near the college town of Farmington, Maine. Her family kept beef cattle and grew hay. Hilton grew up riding horses. Today, she owns two, named Acadia and Koko, and still keeps them at her parents’ farm. She grew up with dreams of becoming a farm animal veterinarian. She went to the veterinary college at the University of Pennsylvania, where she was among the relatively few students aiming to care for livestock.
“I love animals and wanted to work outside,” she says. “I also really care about the public health aspect of the work.”
But today, most veterinary students come from cities and suburbs. They may have only touched farm animals at a petting zoo. “If they didn’t grow up [in the country], they probably won’t think of going into practice there,” says Dr. Rustin Moore, the dean of The Ohio State University’s veterinary school.
And most would-be rural vets find their economic prospects daunting. New veterinarians typically graduate with $170,000 to $200,000 in student loans. Farm animal veterinarians generally earn far less than vets who work with pet dogs and cats. And veterinarians in rural practices can make about half of those in cities, according the Bureau of Labor Statistics. In Maine, Hilton says, salaries for large animal vets top out at $65,000.
That is why the federal Veterinary Medicine Loan Repayment Program was established in 2010. It pays $75,000 of student loans for a vet who works for three years in areas designated as under-served. Dr. Rod Hall, Oklahoma’s state veterinarian, says that thanks to the program, about 20 young veterinarians have set up shop in the state. Still, he says, “We could use a lot more.”
Hilton got one of those awards fresh out of school in 2012 to practice in Franklin and Oxford counties in central Maine. That was the only way, she says, that she could become a farm animal vet in her home state. Maine has 8,000 farms spread across its great expanses, most of them family-owned commercial operations or hobby farms with a few goats and one or two dairy cows. Some 80,000 cattle, 4,400 hogs, and over 200,000 chickens live on those far-flung farms. Most of them will need a veterinarian at some point.
In Hilton’s first practice, she was on call every other night. Now, she works at a comparatively plush practice, the Annabessacook Veterinary Clinic in Monmouth, Maine, which has a mix of small animal, equine, and farm animal veterinarians. She puts about 50,000 miles a year on her 2012 Toyota Tundra pickup, traveling Maine’s many winding two-lane country roads, braving snowstorms and the occasional dense fog near the coast. “It’s really a glorious kind of thing, because you are driving around the countryside seeing animals all day,” Hilton says.
She’s partial to horses, goats, and cows, especially dairy cows, because they are easy to work with and have strong immune systems. Pigs are fun, she says, but so smart and sensitive that treating them makes them obviously miserable. Sheep, she says, hide their illnesses until they are really sick. She also loves getting to know the farm families and teaching them how to take care of their animals.
“If I didn’t do this, I’d have to do something else,” she says. “I really didn’t like working with small animals at all.”
Still, her days often stretch well past dinnertime. She is normally on call only once every six weeks, but that can change, as it did this spring when one of the vets in her practice got pregnant and another was kicked badly by a horse. Hilton calls spring “everything season,” when cows, goats, and lambs are all giving birth. Suddenly, Hilton was on call every third night.
“This is how much this rules your life,” says Hilton, who is engaged. “If you are trying to have kids, you try to plan to have them in the fall so that you aren’t inconveniencing everybody you work with by leaving in the middle of the spring. It’s a really difficult job to have a normal lifestyle.”
That, Hilton thinks, is as discouraging as the financial challenges. Once student interns get a taste of the demands that come with treating farm animals, she says, they often choose the more predictable schedule that comes with ministering to cats and dogs.
The demands on farm animal vets become even more extreme when they work on their own and are essentially on call every single day, which was once the profession’s standard. That is what Hall, who graduated in 1977, did in Oklahoma for 30 years before joining state government. He says it took a toll, especially on his marriage. He eventually limited how many emergency calls he would answer at night and on weekends, “to save my sanity.” He hears older vets grouse about the work ethic of younger ones. But he believes the new generation has a healthier approach.
“We never talked about work-life balance when I was in vet school,” Hall says. “Now they do.”
Achieving a better work-life balance for rural practitioners will require major changes, Hall says. State laws need to be changed so that veterinarian technicians can become more like nurse practitioners, authorized to perform procedures that only a veterinarian can now, such as delivering calves. Rural vets, he says, also need to charge more for their services, not just what they think a farmer can afford. They should also form group practices to share on-call responsibilities.
“We are agricultural people, and agricultural people are an independent bunch, but I think economics will push us that way,” he says.
At the swine operation, Hilton closed her computer and approached a piglet, as big as a good-sized dog. With her height, she can usually manage the physical demands of her job. But she needed help restraining the 50-pound piglets. Luckily, she had two students accompanying her that day, who could help her hold each piglet on its back atop a haystack.
Hilton, her hair tied back, got down on one knee by the piglet’s head, leaned over and slid the syringe through its pink hide and into its jugular vein. By the 15th piglet, her worry had faded, but she was about two hours or more behind schedule.
She and the students didn’t get back to the clinic until 8 p.m., and even then, they still had to clean out the truck. Hilton had eaten a late lunch while driving between appointments. She skipped dinner. Normally she would have stayed at the clinic to update her paperwork, but she was too exhausted. Instead, she did that on her day off. And then she got into her truck to see two more animals — her own horses.