The Equine Ambulatory Service at the University of Missouri College of Veterinary Medicine has served the greater Columbia area for more than 20 years, providing the highest standard of medical and surgical care to patients, while training the next generation of veterinarians. Three faculty clinicians, Alison LaCarrubba, DVM, DABVP-Equine, Martha Scharf, DVM, DABVP-Equine, and Kelly Gravitt, DVM, DABVP-Equine, lead the service, alongside three DVMs who are undertaking rotating internships at Mizzou. The team uses three fully stocked trucks to provide routine and 24-hour emergency care to horses of all ages within a 35-mile radius of the university.
LaCarrubba, an associate teaching professor, has been a faculty member at the CVM since the inception of the service and says it has always filled multiple missions. “The original idea behind it was to have a primary care service that would care for the community,” said LaCarrubba. “At the same time teach our students basic general equine practice, which is what most equine veterinarians will go into, rather than specialty practice. The third leg is to be supportive of the hospital and to be able to grow and support the caseload of the Veterinary Health Center.”
“With us having this service for the university, we are able to show that we really are part of the community,” said Gravitt, an assistant teaching professor. “We can go out to their farms and service their horses during the daytime and after hours. We can also offer a continuity of care with certain referral horses. If a horse comes in and sees our surgery or medicine service, we also have the ability to continue that leg work for them.”
LaCarrubba, Scharf and Gravitt, who are all graduates of the MU CVM, serve in primary care roles for the Equine Ambulatory Service. “All three of us are considered primary care doctors, just like people have a general practitioner,” said LaCarrubba. “One of the real benefits of that is the relationships we develop over time. I have had certain clients for 20 years and we’ve gone through a lot together. You develop a long-term relationship and I think that’s one of the best parts of community practice that’s different from in-hospital referral practice; those intimate relationships you build with your clients are special to our area.”
LaCarrubba has also recently focused on equine dentistry in addition to primary care. She performs routine dental procedures in Columbia, as well as Kansas City, St. Louis, and other areas within the state.
The American Board of Veterinary Practitioners certifies diplomates in the Equine Practice Specialty. There are approximately 50 active diplomates with only three practicing in Missouri: LaCarrubba, Scharf and Gravitt. According to the ABVP website, veterinarians who pursue equine certification may work in equine-only practices or prefer horses as patients. They are expected to be skilled in the art and science of medicine and surgery, as well as other areas, such as preventive wellness care, husbandry and behavior. To achieve certification, veterinarians must have at least five years of full-time, high-quality practice experience with horses and be able to document a commitment to high-level continuing education. The certification also requires the passing of an examination and is an American Veterinary Medical Association recognized specialty.
Gravitt, who completed her certification in November is the most recent of the trio to achieve ABVP diplomate status. “I did an internship and a two-year residency,” said Gravitt. “During that residency you have to have a certain amount of continuing education hours and learning hours. I had to write two large case reports and finally the examination.”
LaCarrubba, who had a slightly different path to certification, said being at Mizzou helped her attain diplomate status. “One, we have a huge support system of equine veterinarians here; we have tons of specialists,” said LaCarrubba. “We’re held accountable to teach students and we’re already in an academic environment where we’re always pushing ourselves to be a little bit better. When I started here, I did a lot of time on the medicine service. I almost felt like I got a mini-residency and was mentored heavily by the medicine faculty, which was a big help in developing my application and being able to pass the exam.”
Excellence and being a better veterinarian are big parts of becoming and remaining an ABVP diplomate. “This definitely pushes you to be better,” said LaCarrubba. “You have to maintain status by either retesting every 10 years or resubmitting credentials. It forces you to put a little more energy and effort into researching your cases and staying current on all the information. I think it gives us more credibility with our client base.”
“Veterinary medicine is a progressive field and things change all the time,” said Gravitt. “I think with all these extra letters after our name it tells clients that we are trying to keep current on the new things that are coming out and it gives them that confidence that we are aware of what the next best thing is.”
Along with the benefits of having a community-focused ambulatory practice led by experts, advantages for the students include being exposed to the level of knowledge and cases that come with it. “Every day students are experiencing cases and client interactions that are so important,” said LaCarrubba. “The communication and relationship developments that they see are exactly what they will be doing as equine veterinarians. They’re doing the job and basically apprenticing with us.”
The three say that it is a point of pride to be able to provide expert level general practice services, while also being role models for the next generation of veterinarians. “When I was a student, I wanted to go into general practice,” said Gravitt. “I remember Dr. LaCarrubba coming in and talking about the ABVP process, which I became very interested in. It was really nice to be able to learn from two people who had successfully been able to get through it and I really relied on them. To me it’s a point of pride because I had these two women that I was looking up to with ABVP status and now I get to be a part of it, hopefully showing that you can be in general practice and still be at the top of your field.”
By Nick Childress