global edition

Practice Profile

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In this month’s featured Practice Profile, Ellen F. K. van Nierop de Fierro, DVM describes her
practices, Ecuavet and Vet2Home, which she co-owns with her husband, Dr. Germán Fierro,
in Quito, Ecuador.

Ecuavet Veterinary Services

Quito, Ecuador

Our Team & Practice

My husband and I, both veterinarians, own a small animal practice. Our main clinic is situated
in a suburb of Quito, Ecuador. We also have an auxiliary clinic and a pet hotel on the property
where we live. Our team includes four veterinarians, three assistants, and one receptionist.
Because veterinary nurses or technicians are not available in Ecuador, we train our assistants to
do basic cleaning and handling.

All medical and diagnostic procedures are done by our veterinarians. It is normal for most vet-
erinary centers, like ours, to offer grooming, pet shop, pharmacy, and pet hotel services aside
from veterinary care; this is an important source of income.

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Diagnostic Availability
Our practice would be considered an above average facility in
Ecuador; it includes blood chemistry and hematology machines,
a surgery room, and radiograph and ultrasound equipment. The
price for the use of these diagnostic machines is relatively high
because of import tax, high maintenance costs (some mainte-
nance is required outside the country), and the low number of
clients accepting these tests making the overhead more expen-
sive. There is one specialized laboratory for veterinary samples in Quito, where we send samples
we cannot do in house. Until recently we did not have any veterinary histology.

Culture & Castration

In Ecuador people generally believe in keeping things as natural as possible, and neutering a
dog is seen as unnatural. The many stray dogs show the result of that and keep the prevalence
of Parvo and Distemper viruses high. Rabies is a concern outside the major cities, and free
vaccinations against rabies and yearly vaccination campaigns are organized by the government.
Puppies are often acquired for a pleading child or given away as party prizes and then cast out
when housebreaking does not quite work on its own.

Across the Medical Professions

Pediatricians often advise owners to get rid of pets when a woman is pregnant or a baby is born.
The willingness and the ability of clients to pay for health services varies. Willingness is often
related to how apparent the results are. The number of people who want their dog groomed, but
do not have money to pay for vaccinations is frustrating.

Client Communication
We spend at least 50% of each consultation on client education. We need to justify exactly why
we need each test, instead of just doing a CBC and chemistry without really knowing what we
are looking for. We are reminded
daily to treat the dog, not the lab
results. Some small animal med-
ication is available, but we use a
lot of human use drugs because
of price and availability.

Referral
There is a problem in getting
certain drugs, such as analgesics,
anesthetics, and endocrine medi-
cations. Typical cases include der-
matology, GI disorders, wounds,
mammary gland tumors, intoxi-
cations, and respiratory problems.

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The lack of referral centers and specialists makes veterinary medicine extremely challenging.
We cannot send difficult cases elsewhere; we make do on our own and call in the few special-
ists we have (all trained outside of Ecuador). Although
satisfying to find solutions to problems just beyond our
reach and with limited resources, it is at least equally
frustrating, when things don´t work out, to know that
in other parts of the world you might have been able to
save the patient.

Continuing Education
There are no specialist courses in Ecuador, and most
CE is in English and relatively expensive. We get our
CE from WSAVA and FIAVAC courses, and some
Spanish online courses.

Our clinics sometimes welcome international veterinarians, often fresh out of school, who want
to travel through one of the most biodiverse countries on earth and learn about veterinary care
here. By inviting them to be a part of our team for a time, we are updated on the newest trends
at universities abroad, and they are introduced to the casuistry and basic diagnostic techniques
of a developing country.

The Future
Happily pets are moving up the social ladder in Ecuador. When I first came here and asked
for blood work, clients would laugh and say it was only a dog, and they would not go as far as
taking blood samples. Now, twelve years later, it is a common procedure, although not all pet
owners can afford it.

10 cliniciansbrief.com • May 2014