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A veterinary service squad deployment in support of operation Iraqi freedom.

INTRODUCTION

The 64th Medical Detachment (VS) deployed to southwest Asia and northeast Africa from January 2005 to January 2006 in support of Operation Iraqi Freedom. The unit was divided into squads providing veterinary services in 3 countries: Kuwait; Qatar; and Djibouti, Africa. A squad typically consists of a Veterinary Corps Officer, an animal technician (MOS * 68T), and one to 4 food inspectors (MOS 68R). The mission at each location consisted of food inspection, assistance with stray animal control, and medical care of military working dogs (MWDs). (1)

The deployment offered Soldiers the experience of working in all 3 countries. Each location had a busy food mission. On a frequent basis, food inspectors recommended rejection of food delivered onto base due to decreased quality and condition. Stray animal control by euthanasia was routine work in all 3 locations as well. This is an unpopular task among Soldiers and difficult for veterinary services personnel, but it is absolutely necessary to protect Soldiers from zoonotic diseases. Many challenges were routinely faced while attempting to provide adequate care to MWDs. The treatment space and equipment at each location varied and was usually inadequate. This was largely overcome by coordination with human medical facilities. In fact, 3 MWD surgeries were performed at medical facilities on base.

FOOD MISSION

There are a variety of food facilities on a forward deployed base, for example, dining facilities, fast food establishments (Burger King, Subway, Pizza Hut), AAFES ([dagger]) exchange, operational ration storage, and prime vendor warehouses.

The food inspectors typically inspected from 200,000 lbs to 300,000 lbs of subsistence per month at each location. Support provided by food inspectors included: receipt inspections, military-wide and local recalls, product shelf-life extension at the AAFES exchange and prime vendor warehouse, operational ration inspections, monitoring temperatures and expiration dates at the AAFES exchange, verification of approved sources, guidance on refrigeration failures, and attendance at monthly menu board meetings. (2)

Receipt Inspections

The majority of food inspection work consisted of receipt inspections. As trucks arrived at the base with food, the food inspectors checked the seals on truck doors; looked for evidence of tampering; measured the temperature inside; checked for approved sources; and inspected the quality and condition of food. Our squad found a substantial amount of food from unapproved sources as well as problems with the condition of food arriving on base. As a result of our initial findings, we implemented 100% receipt inspection, out of necessity, to ensure that only safe food entered the base. (2)

Food Trends. There were 3 common problems found with food arriving on base:

* Unapproved Sources. The Worldwide Directory of Sanitarily Approved Food Establishments for Armed Forces Procurement (3) provides a list of acceptable manufacturing plants that may be used to obtain food sources for the military. In our experience, lack of compliance existed from the prime vendor. Products typically can be acquired more quickly and less expensively by the prime vendor from surrounding countries rather than by shipment from Europe or the United States. However, without evaluation of the sanitary practices and security of these plants, the products could pose a health risk to military personnel.

* Insect Infestation (Figures 1 and 2). Infestation occurred mostly in the pasta or flour which was stored for too long at higher temperatures, allowing insect eggs in these products to hatch.

* Temperature Abuse (Figures 3, 4, and 5). The quality and condition of subsistence was frequently diminished due to improper temperature while in storage, during delivery, or at the search pit **.

[FIGURE 1 OMITTED]

ANIMAL MISSION

Military Working Dogs

Depending on the location, a squad was typically responsible for 10 to 20 MWDs:

* Preventive Medicine. Dogs at home stations and those deployed are provided parasite prevention and routine vaccinations. MWDs deployed to southeast Asia, southwest Asia, and the Balkans are additionally provided doxycycline or tetracycline daily as prophylaxis against rickettsia and babesia infection. (4(p33))

* Physical Examinations. At a minimum, military veterinarians perform semiannual physical examinations of MWDs to detect and address problems or changes in the health of the animals. (4(p26))

* Sick Call/Emergency/Surgical Care. Military veterinarians and animal technicians are on-call 24 hours per day to care for MWDs. As mentioned earlier, each location varied, but most were inadequate for MWD treatment due to lack of equipment and/or space. Kuwait had an acceptable facility which included a designated veterinary trailer with a storage area, as well as a treatment room/laboratory with a sink and microscope. In addition, a surgery suite with anesthetic capabilities was provided. Upon the team's arrival in Qatar, the designated veterinary treatment room doubled as the dog food storage area. The room was too small to set up an exam table and be able to move around and treat an animal. We usually worked where space could be found, offices, hallways or outside. An anesthesia machine and microscope was available, however, no dental, radiographic, or sophisticated laboratory equipment (ie, blood analysis) was available at either the Qatar or Kuwait locations. On a regular basis, radiographic and laboratory equipment was used at the medical facilities on base. There was no veterinary treatment room and only sparse medical equipment was available in Djibouti. There was a very small number of MWDs in Djibouti, therefore, extensive equipment was not feasible. If a dog required further diagnosis or treatment, it could be flown to Qatar, and, depending on the case, to Germany if necessary. If an emergency arose, a civilian veterinarian off-base could be used.

[FIGURE 2 OMITTED]

Four MWDs required surgery during the deployment. Two aural hematoma repairs, an extraction of an abscessed tooth, and a root canal on a fractured canine tooth were completed. In 3 of the cases, we did not have the proper room or necessary equipment (ie, dental drill) to perform surgery. The medical personnel on base were cooperative and allowed us to use their facilities and equipment to successfully accomplish the procedures. When necessary, we had the option to fly dogs to the 51st Medical Detachment, our referral center in Germany, for treatment. However, if the opportunity existed to treat dogs in-theater, it was best to get the dog back to duty as soon as possible. Understandably, time was always a concern to the kennel masters who had a severe scheduling problem if they were short a dog team on the gate.

The availability of base funding was explored to address the need for more efficient treatment. We were very proud that the necessary funding was secured after 8 months, and we broke ground to build a treatment room/surgical suite with veterinary equipment for the dogs in Qatar. The room was built as an addition onto the dog kennel and contained an isolation kennel and an area for food inspection. Equipment purchased included a surgery table/dental sink, centrifuge, surgery light, dental unit, and an autoclave.

[FIGURE 3 OMITTED]

* Medical Evacuation. As mentioned above, we had the option to coordinate with human medical facilities to fly an MWD to Germany for care if the dog required emergency care beyond our capabilities. However, that is more easily said than done. Patience is required as there is always much coordination with aeromedical assets as flight times can change frequently. Also, personnel rotate often so you must keep your points of contact roster current. Another factor to consider is the requirement to keep the patient stable until the flight, and then en route. The handler accompanies the MWD, however, the veterinary unit must decide if the handler can adequately monitor and treat the dog during travel, or if an animal technician is required to accompany the patient.

[FIGURE 4 OMITTED]

[FIGURE 5 OMITTED]

* Kennel Inspections. Kennel inspections were performed on a monthly basis to ensure MWD housing was adequate, clean, and safe. The kennels at the different sites also varied in size and quality, from very well built concrete structures with well-landscaped training yards and new obstacles, to dog crates stored in a tent with old worn obstacles in a dirt yard. (5)

* Handler Training. Training was offered to the dog handlers on various topics such as heat injury prevention, ear cleaning, first aid, bandaging, subcutaneous and intravenous fluid administration, and intravenous catheter placement.

MWD Trends. The 3 most common problems encountered with MWDs:

* Otitis externa. The dogs work in hot and dirty conditions, which provides an environment that favors bacterial and/or yeast infections and subsequent inflammation of the external ear canal. A complication of otitis externa is development of an aural hematoma. Dogs will head shake and scratch to try to gain relief from irritated ears. The result can be fracture of the cartilage and a hematoma originating from the auricular artery within the fractured cartilage. Our squad ensured that the handlers understood the importance of checking MWDs on a weekly basis and cleaning their ears, if needed, to help prevent infections.

* Lameness. MWDs work long, hard hours jumping in and out of tall trucks in the search pit. Orthopedic examinations of lame dogs were usually unremarkable. Typically, there would be a grade I/IV lameness but a specific lesion could not be localized. Again, medical personnel from the clinic were very cooperative and allowed us use of their radiographic equipment, which enabled us to rule out orthopedic injuries such as fractures. Muscle injuries were presumed and 3 days cage rest with nonsteroidal anti-inflammatory drugs were curative in most cases.

* Dental disease. Two dental surgeries were performed. The first was extraction of a carnassial tooth, which had developed a root abscess. The second was a root canal on a canine tooth that was fractured at the gum line during training.

Stray Animal Control/ Rabies Bite Control Program

Excessive numbers of stray animals (mostly dogs and cats) come onto bases looking for food. Strays can carry disease and parasites to the human population. Rabies virus is transmitted in saliva via a bite to humans and is fatal unless treated with post exposure antibodies. The Department of Public Works had the responsibility of trapping stray animals on base and bringing them to veterinary services for euthanasia. Unfortunately, this was an almost everyday occurrence and was difficult at times for the veterinarian and technician to euthanize so many animals. There were several instances of Soldiers bitten while handling stray animals. These Soldiers were given post exposure antibody treatment as a precaution. The animals were captured, decapitated, and specimens sent to Veterinary Lab Europe in Landstuhl, Germany, for rabies testing. In all of our cases, the specimens were negative for rabies. It was important to obtain this information so the Soldiers who were bitten could discontinue the post exposure treatment.

Health Checks on Local Animals

Periodically, camels or falcons were brought on base to entertain Soldiers. Our squad did health checks on the animals prior to Soldiers handling them to look for any obvious signs of disease that could potentially be zoonotic.

CONCLUSION

Several trends in both the food and animal missions were noted. The 3 most common problems with food were temperature abuse, unapproved sources, and insect infestation. These were mostly due to lack of compliance to US standards by the prime vendor. By vigilant inspection and recommending rejection of food to facility managers, the prime vendor began complying and the food quality improved dramatically. The 3 most common reasons our squad saw MWDs were otitis externa, lameness, and dental problems. These were mostly related to the environment and working conditions the MWDs were experiencing. In Qatar, the treatment room was almost complete when we rotated from theater. While we did not get to use the facility ourselves, our successors benefited from it. Our experiences, challenges, and accomplishments are typical and similar to other Veterinary Service units deployed in support of Operations Iraqi Freedom and Enduring Freedom.

REFERENCES

(1.) Army Regulation 40-905: Veterinary Health Services. Washington, DC: US Dept of the Army; August 16, 2004.

(2.) Army Regulation 40-657: Veterinary/Medical Food Inspection and Laboratory Service. Washington, DC: US Dept of the Army; November 6, 1997.

(3.) Worldwide Directory of Sanitarily Approved Food Establishments for Armed Forces Procurement. Fort Sam Houston, Texas: US Army Veterinary Command; June 4, 2008. Available at: http://vets. amedd.army.mil/VETSVCS/appro ved.nsf/ a33b0b8376c838f586256f82007bf7b7/a981a3522fa3 217e86256f960052191f?OpenDocument.

(4.) The Handbook of Veterinary Care and Management of the Military Working Dog. Lackland AFB, Texas: Dept of Defense Military Working Dog Veterinary Service; March 5, 2004.

(5.) Army Pamphlet 190-12: Military Working Dog Program. Washington, DC: US Dept of the Army; September 30, 1992.

CPT Marla Brunell, VC, USA

* Military occupational specialty

([dagger]) Army and Air Force Exchange Service

** A secure area outside and away from the entrance gate of a base where guards and bomb dogs search vehicles for explosives before allowing them to enter.

AUTHOR

CPT Brunell is Chief, Wiesbaden Branch, Northern Europe District Veterinary Command, Wiesbaden, Germany.
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Author:Brunell, Marla
Publication:U.S. Army Medical Department Journal
Article Type:Report
Geographic Code:7IRAQ
Date:Jan 1, 2009
Words:2135
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