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Melanie Cole (Host): Welcome to UF Vet Med Voice with the University of Florida College of Veterinary Medicine. I'm Melanie Cole. And joining me today is Dr. Lawrence Garcia. He's a Clinical Assistant Professor of Shelter Medicine and Surgery in the Department of Small Animal Clinical Sciences, the Service Chief of Veterinary Community Outreach Program of the UF Veterinary Hospitals and the Medical Director of the UF Veterinary Emergency Treatment Service Team. He's here to tell us today about Animal Disaster Response: An Essential Function of a Veterinary College.

Dr. Garcia, it's such a pleasure to have you with us, and I absolutely love this topic. So much respect for you and your team and what you guys are really all about. So, can you tell us about the broader importance of veterinary colleges, having a well-trained team poised to respond to help animals in need, medical care assessment, rescue or other response in the aftermath of a disaster? Why is this so important for veterinary colleges to have? But not only, Dr. Garcia, from the standpoint of providing medical help to animals in need, but also as a way to prepare those students to respond and help in their very own communities.

Dr Lawrence Garcia: Thank you very much for having me. Yes, it's a very exciting and kind of important part of things that is not always necessarily thought about. One of the things that we run into is we've learned over time that disasters in some cases cause people not to evacuate when there's animals involved. If they can't evacuate with their animals, they're going to be less likely to evacuate. We also know that there's stray animals in these areas that are impacted by disaster, and oftentimes they're not evacuated or they're hiding in places where they can't be found leading up. And so, Hurricane Katrina really kind of opened many people's eyes to the fact that we run into situations where animals left behind often are not reunited with their owners. And also too, animals left behind can really suffer some pretty terrible tragedies.

And so, one of the things that veterinary colleges are so good at is, number one, taking care of animals, right? And so, it's really important that we have these functions and we have all these areas of expertise. So down here in Florida, for example, our big deal is flooding and hurricanes and things along those lines, right? But you are going to have other areas of the country where we have animal production systems that can be impacted, things like highly pathogenic avian influenza. And so, you have these experts in these fields that deal with these sort of diseases. And so, it's really important to utilize these expertise to help these animals post-disaster or within an outbreak of some sort. And so, teams like ours do just that.

And so, what we do is we are fully prepared and equipped to go into an area that absolutely has zero infrastructure. So in our case, hurricanes are going to be kind of the primary example. And so, we oftentimes are going into an area that has no cell service, no power, no running water. And so, we come equipped with extra fuel, with water, with pumps that we can use to get some running water, we can actually bring water with us as well. And so, what we're equipped to do is go into these areas that have lost all infrastructure and provide care to these animals, because you have animals that get injured during the disaster, whether they've escaped, whether, say for instance, the house becomes flooded or windows blow out because of winds or foreign objects flying around. And so, what we do is we come in after the disaster and help take care of these animals.

So, we see all different sorts of things. Animals that have ingested contaminated waters or animals that are contaminated by water that has fuel and oil and other things that are circulating in there. And, you know, one of the things that people may not often think about is the fact that there can be sewage circulating in these flood waters as well, and oftentimes is. And your water supplies, in some cases, even when they are still operational, the cleansing systems, the cleaning systems have been overwhelmed. And so, even the running water can be pretty heavily contaminated by many different toxins and other substances.

So when we think about these things, we have the ability to adapt in many different ways from the perspective of our team. So, what we'll do is we have actually a medical-surgical unit that belongs to another program with a college that they generously allow us to take with us. It provides us with surgical tables, other exam tables, and some cage space. And then, we also have some collapsible tents that can be air-conditioned. We create exam spaces there. We also have our utility trailers that bring supplies and equipment that are air-conditioned, and so we can actually use those as exam spaces.

So in this particular situation with Hurricane Ian, we actually used several different areas to provide enough exam space, so that we could provide the care to the large number of animals that were coming through. In order to prepare for things like that, it's really important that we train our team So, what we do is we have drills every year and we have mock cases, and we set up our camp as we would for like a field hospital-type setup.

And so, I say camp because, as part of our setup, as I mentioned, we have a tent, we have a surgical unit, we have utility trailers. And so, we kind of create a smaller area where all these items are close together. It allows the doctors to move around and examine animals as well as, in the event there's extra need, people are close by and can hear and can help. Well then, what we do is we kind of have a separation barrier where we put our bunk trailer. So, we have a bunk trailer that sleeps 11, that's sort of our barrier. On the other side of that is where we have our living space. These days are pretty hectic and pretty long and, this way, we can have our volunteers and our team members go have a space kind of away from the chaos to relax and recoup and recover, and have a meal and have lunch or breakfast or what have you.

So, we set those areas up so that the students understand, these are the kind of things that we're going to encounter and these are the kind of things that we might have to address and this is the way that we can address them in the field, because the field is going to be far different from what they experience here in the teaching hospital where we have all the advanced diagnostics and equipment and facilities. And the thing is the way our team is set up, we create this field hospital to sort of help in the early post-disaster period and allow the veterinarians in the area and the veterinarian infrastructure to get back on its feet, because some of what that takes is veterinarians and technicians and staff getting their homes situated, getting their lives back on track so that they can come back to work.

In other cases, it may be that the veterinary facility is also heavily damaged. And so, it's not only the living spaces, it's also the workspaces and so we can provide care. And as we experienced down in Fort Myers, we had quite a few of the local veterinarians and technicians who wanted to give back to their community, but couldn't do so in their facilities. So, they came and volunteered, and they came and helped, and they came and pitched in. So, our team is very adaptable, where we can expand to as many exam spaces as we need and we can expand to as much as we need to accommodate the number of cases coming in, as well as the volunteers that we have and the veterinarian technician staff, that's why we do regular trainings with the students.

And the thing is, as you mentioned, one of the most important things is we have all this expertise as a veterinary college, so we definitely need to be involved in animal disaster response because, as time goes on, we're seeing more and more disasters of many different kinds, as well as we want these veterinary candidates to go out into the world and to be able to help their communities because, in disaster situations, everything starts at the local level. So in other words, what you want to do is if Gainesville's impacted, well, I want to start right here, I want to help right here. And the thing is, a lot of veterinarians don't know the resources that are out there. They don't know who to reach out to, to say, "Hey, I'm available. I have medications. I can help. Where do you need me to go?"

In general, in the state of Florida, which is one of the few states to have an Emergency Support Function 17, which is through emergency management, under that organization, it's generally your animal control for the county or for the city that manages that. So, that's who the veterinarians would reach out to to say, "Where can I help?" Well, the animal control services are going to be the ones that are going to get the requests. And then, there's ways that they can actually request through the state and various ways like that.

So, it's kind of a complex route to get to help, but sort of knowledge is the first step. So, the FEMA has many free courses that we encourage our veterinary students to take so that they are trained. And it's not limited just to hurricanes or floods, it includes potential terrorist threats, includes disease outbreaks, exposures to things that are toxic, that can spread through animals, and then potentially become a public health issue. So, it's a very complex field that includes so many different parameters. And ultimately, the fundamental goal is to care for those animals that really previously didn't necessarily have a resource to consider.

One of the things that we're seeing more and more of now is pet-friendly shelters. So, you can actually come to a storm shelter and bring your pets with you. And this is becoming more and more important because we're seeing when these things are offered, people will evacuate with their animals. We always encourage people to have a plan, have some sort of hard format of medical records or at least a thumb drive, so you have those medical records. And then, even if you can't get into a shelter, at least have a plan. What are your most common evacuation routes and where are the pet-friendly shelters? Or are you going to evacuate to a different state or to a family's home, but are there hotels along the way where you can also shelter with your pet if it's too far or if you can't get as far as you'd like? So, it's very important to be thinking about those things.

And same thing too, if you have refrigerated medications, it's so important that you have extras. All veterinary practices that are in the path of any kind of impending disaster when we know they're coming should be able to give additional prescriptions. Probably, the most common thing we see is insulin is very, very delicate and needs to be refrigerated, and a lot of families are unaware. And so, they don't have a cooler or something set aside to at least keep that cool for as long as they can. So in a lot of cases, the insulin is warmed and then, obviously, we'll see quite a large number of those at our field hospital-type setup because what happens is they start to see the symptoms of the diabetes come back because the insulin's no longer working because it's been warmed or, obviously, there's no refrigeration and things like that since there's no power.

So, planning is such a huge part of it. And the more planning families can do, the better off we are because then we can address the more emergent issues, an animal that gets injured by debris in the yard or the animal that accidentally escaped and gets injured while out in the storm and things like that. Because unfortunately, the animals don't understand. They just know it sounds really bad outside. And now, there's an open window or there's an open door, whether by damage or by wind or what have you. So, thinking about all the levels and making sure we provide animals the care that they need.

In our case, in Fort Myers, we treated 422 animals, and it was a range of upset stomachs, vomiting, diarrhea. A lot of things that get disrupted in a storm situation are your pollens. So, a lot of animals are exposed to all different pollens, where normally a five-mile radius would impact potential allergies, now things from a much larger radius are coming in. So, these animals are going to potentially have exposure to those and potentially have some allergic reactions. We see a lot of displaced kittens and things like that, and so a lot of that kind of care is just making sure they're healthy enough to where they can get to their next step, whether it's through a rescue organization or in some cases, like we experienced, people kept kittens, people kept the two or three kittens that they found. One of the things that was really interesting with our team is one of our team members actually kept one of the displaced kittens. The finder just couldn't keep the kitten. And it actually worked out to be very therapeutic for the team. So at night, we would just pass the kitten around and she just would sleep on you, and it was just sort of this really nice, peaceful pacifying effect.

Melanie Cole (Host): Oh my gosh. You know, I was thinking when you were talking about that, how you don't want to keep every one of these little sweet animals and certainly little kittens. That's so adorable. And Dr. Garcia, this is some of the most compassionate, really caring type of care that I have ever heard of, and you're really helping our most vulnerable. And it's so complex, as you said. And what you're doing is so important not only in communities but globally. My goodness. I mean, this is just such a huge problem.

What about after the disaster? Now, you said some of your people even kept some of the kittens and that it helped to minimize some of the stress and support of your team, which are really, I'm sure quite large, the stress, when you're going through these, especially in these situations. So what about after the fact? How do you support those animals that are in those situations and extend those capabilities through your presence?

Dr Lawrence Garcia: So, we connect with the local veterinarians. And what we do is as we leave, especially those animals that will need the ongoing care, we connect them to those veterinary practices and to those veterinarians so that they can have that ongoing care. Because you're right, one of the things that we're very cautious of is because we don't charge for our services, we don't want to be competition.

So, what we do is we work to make connections with the local veterinary practices and veterinarians. One of the nice things is we work very closely with the Florida Veterinary Medical Association. Once we go into any disaster area, we immediately connect with them so that we can start connecting with veterinarians to see are there things that we can do to help support them, to help get them back on their feet so that they can continue the care. Because you're right, it's interesting, there's the preparation for the disaster, the disaster itself, and then the response. The response generally realistically is about a month. And then, the recovery can go on for many, many months, in some cases years. I would say following Hurricane Ian, there's going to be areas that are going to recover for years.

And so you're right, it's like we're trying to make sure that wherever there were veterinary facilities, there's still access to veterinary care. And one of the things with where we were stationed was they put us in a central location and one of the most hard hit area, so that allowed people to go a shorter distance to get care. We kind of try to work into those things because it's really important.

And beyond that, each night we try to talk through the day and try to work with our team because, like you mentioned, this is very, very intense and emotional work. And one of the things that you don't anticipate is, while you're sitting there working on this animal or talking to the client, they're telling you these stories of where they were swimming in their living room, finding things that float to try to get a raft or like finding the access to the attic to get out of the water. And you can't help but feel the pain and the fear and everything that they experienced. And so, a lot of them are very honest about the things that they experienced. So that's a part of it a lot of times we don't think about, so we do try to debrief and talk through things to help everybody process everything that they're hearing and seeing.

One of the things with Hurricane Ian was that turn that it took at the last minute that sent it towards Fort Myers really did so in a timeframe that did not allow evacuation. And many people fear evacuation that close to an event because sometimes you get stuck in traffic and you don't want to weather a storm like that in a car, in a truck on the road, not to mention the risk of flooding and all of that that they experiences because all the rivers surrounding that area where it flood staged before the storm even came close to have impacts on the area. So, it was like a double disaster because some individuals made it through the hurricane and then, two days later, were dealing with flooding that destroyed everything that survived.

Melanie Cole (Host): Wow. These are incredible stories, Dr. Garcia. What amazing work that you and your team do. As we wrap up, can you summarize lessons learned for future opportunities? And you mentioned the complexity of the hierarchy that it goes for animal control first. While you're giving us this brief summary of what you would like the key takeaways to be from this podcast, I'd like you to give us a view from your experienced point of view of how you think that could possibly be more streamlined. Does it need to do it that way? Do you see a better way? What do you see happening or would you like to see happen in the future?

Dr Lawrence Garcia: Well, one of the big things is planning is everything. From the perspective of individuals and families, they really need to plan and prepare. The more they plan and prepare, the less the burden is on the first responders, which allows the care to those that are most heavily impacted, those that don't have the resources, those that really need the care.

And then, the other part of that is, as we look at this as a veterinary college, all veterinary colleges are in unique areas of a state and of our country and even globally. So, it's one of those things where each will have a niche. Like for us, we deal with a lot of hurricanes and floods. Out in California, they deal with a lot of fires. Texas is a mix of things. And some of the areas that have teams, you kind of almost specialize in those areas. And in the middle of the country, like I mentioned earlier, some states are very heavy cattle production states or heavy poultry production states. And so, it's a matter of having that plan and having those expertise pulled in to help address those issues and then regular drills to practice to make sure the resources are up to par. And then, really from my perspective, I think the biggest challenge from the perspective of veterinarians, which we are obviously training our students in, is finding those emergency resources before the storm.

One of the things we talked about is gray skies is when the disaster is coming, when the disaster is there and the response. But blue skies are the rest of the time when things aren't going on. And that's the time where veterinary colleges and veterinary practices and veterinarians should be preparing so that when these things happen, there's a business continuity plan. There's plans for how we can respond, how can we help our community. And I think that's the biggest mindset.

And then really, as far as the complexity of the response system, I think having that preparation and having those relationships beforehand are probably the key thing and the best way to streamline. When we've gone on responses, a lot of it is making sure that all the organizations within the emergency management structure know that we're a resource. Some veterinary practices and other veterinary infrastructure may not know that the veterinary college has a response team and that the response team can help them. So, I think for streamlining things, it's a lot of awareness and knowledge. We're trying to get the word out to the Florida Veterinary Medical Association, so that they know, hey, we're an option. Getting the word out to all the state animal control associations so that they know, hey, we are an option and that we are a resource. We can help them with their emergency management plan because we know these things and we've experienced these things and we know the common things that happen.

One of the other nice things about veterinary colleges is that we have strong connections with a lot of the pharmaceutical industry. And so, a lot of times when something like this is coming, they do their best to send any kind of supplies and resources that could be necessary while they can be shipped in and mailed in, so that those items can be taken to those areas that are most heavily impacted and can provide care and provide support to the community. And so, it really is a community effort on many levels, but veterinary colleges are just so well-suited to provide this type of care and then provide the storage and maintenance of the equipment. I mean, our team has five trucks and trailers and those things need maintenance and tires and axles and all those kinds of things. And then, we work with the hospital to rotate our stock of medical equipment and supplies as well as pharmaceuticals, so that way nothing goes to waste because obviously these things can be a little expensive.

And so, it really is kind of a constant collaboration on so many levels and really a lot of planning. I spend most of my year planning and going through my inventory and making sure that everything is in line and prepared, because for us, June 1st to November 31st are key times. I try not to plan vacations. I try not to do anything. I was a little scared I wasn't going to be able to escape for Thanksgiving break because it looked like we might have to deal with some of the issues associated with Nicole. For the most part, there weren't many in the way of animal issues, thankfully, for Nicole, but there's still definitely was quite a bit of devastation there as well.

Melanie Cole (Host): Dr. Garcia, what an incredible person you are. You really had me choked up in so many ways. The work that you're doing is just absolutely unimaginable and the stress. And I just want to thank you so much for everything you're doing for our sweet, sweet little animals and all of the work that your team is doing. And please come and join us again absolutely anytime. And for more information about the UF College of Veterinary Medicine, please visit vetmed.ufl.edu/ufachievers. And to listen to more podcasts from the experts at the University of Florida College of Veterinary Medicine, please visit vetmed.ufl.edu.

That concludes today's episode of UF Vet Med Voice, brought to you by the University of Florida College of Veterinary Medicine, advancing animal, human and environmental health. I'm Melanie Cole.