Veterinary student Amber Roudette broadens her horizons with Maui clerkship

Amber Roudette of Richmond, Virginia, is a fourth-year veterinary student pursuing the mixed species track at the Virginia-Maryland College of Veterinary Medicine. She is the past president of Veterinary Students as One In Culture and Ethnicity (VOICE) and previously wrote about her reflections on the Iverson Bell Symposium and her 2015 summer exchange in India.

Amber Roudette at a goat dairy in Maui.
On the weekends, Roudette spent time road-tripping through the island, spending time on local beaches, Haleakala National Park and Crater, waterfalls, and a goat dairy.

As I planned my fourth year clinical rotations, I decided to seek an opportunity that would allow me to explore someplace new. I made a list of the cities where I had friends who could host me, and out of Nashville, Philadelphia, Indianapolis, Seattle, and Maui, the obvious winner was Maui. I did a quick Google search and called eight small animal clinics within an hour radius of my friend Christopher, who had moved to the island in 2015. One clinic called me back to offer an externship. I was ecstatic.

My last major trip was a veterinary study abroad program in India in 2015, and it was an incredible, eye-opening experience. It pulled me way out of my comfort zone and ignited my desire to keep traveling the world. That trip was made possible thanks to extensive organizing by the late Dr. Elankumaran Subbiah, as well as financial support from the Young Fund International Travel Scholarship. For my Hawaiian trip, I was fortunate to receive a domestic travel scholarship from VMCVM, which covered my plane ticket. To keep my expenses low, I rode the bus to the clinic every day and bought groceries every week.

The externship took place at a five-doctor, small animal private practice in northern Maui. Founded in 2008, At Home Animal Hospital started as a mobile practice but eventually grew to include a freestanding hospital. During weekdays, I performed physical exams, drew blood, placed catheters, monitored anesthesia, and observed surgeries. On the weekends, I was able to spend time at local beaches, Haleakala National Park and Crater, wineries, waterfalls, and a goat dairy, as well as take a road trip around the entire island.

Island Medicine

Even though Hawaii is part of the United States, it sometimes felt like a whole new world, and being there broadened my fourth year education. Because there are no veterinary or veterinary technician schools in Hawaii, the veterinary professionals there tend to come from all over the country. This hospital had vets from Auburn, Cornell, University of California, Ross, and New Zealand, which exposed me to several different ways of practicing medicine.

Amber Roudette with a 10-week-old puppy.
Roudette's most memorable case during the trip was a 10-week-old puppy with an acute onset of lethargy and ataxia.

For example, I learned about quarantine, vaccination, and health certificate procedures, as Hawaii is a rabies-free state. I also gained an even greater appreciation for boarded specialists, as there are very few in Hawaii and virtually none on Maui. It’s easy for general practitioners in Virginia to refer their clients a few hours down the road to VMCVM. It’s much more difficult and expensive when your clients have to pack up their pet and fly to another island for specialty diagnostics and treatment.

One of the most memorable cases I saw in Maui was a 10-week-old puppy with an acute onset of lethargy and ataxia. The owners had just adopted her a week before, and suddenly their playful puppy wasn’t acting like a puppy anymore. The physical exam revealed severe neck pain, blood work showed eosinophilia (elevated eosinophils, a type of white blood cell), and radiographs were unremarkable. We learned that other puppies from the same litter had similar clinical signs.

The vet considered performing a spinal tap, but given the puppy’s young age, she opted for a working diagnosis of parasitic meningitis. The vet treated the puppy empirically with a dewormer, a corticosteroid, and an antibiotic, as well as hospitalization and supportive care. Within 24 hours, the puppy had a remarkable improvement, and she was sent home two days later. The vet contacted the other clinics with the puppy’s littermates and shared her treatment plan. Thankfully, all of the puppies recovered.

Cultural Diversity

During the trip, I strived to appreciate as much as I could about another culture, and to learn new ways of practicing veterinary medicine. My years with Veterinary Students as One In Culture and Ethnicity (VOICE) helped me keep an open mind when meeting and connecting with new people. I met people on the bus, on the beach, at the hospital, and in the neighborhood, all hailing from different parts of the world.

At the hospital, most clients were native Hawaiians who had long held cultural beliefs about pet ownership. For example, most native Hawaiians consider pets unclean and keep them outside or in a separate part of the house. By contrast, some Hawaiians see their pets as children and take them almost everywhere they go. I became quite used to seeing dogs on the bus as well as in the grocery stores and bars.

I was also surprised by the level of sympathy I saw given to feral cats. Due to an absence of natural predators, the feral cat population on Maui is massive, both in number and in stature. People regularly feed them, and some even brought them into the hospital. Local shelters also hold monthly vaccination and spay/neuter drives specifically for feral cats.

I am incredibly thankful to have spent three weeks in beautiful Maui. I want to sincerely thank VMCVM for the travel scholarship, which made my externship financially possible, as well as At Home Animal Hospital for hosting and mentoring me. I also want to thank my friend Christopher for his wonderful hospitality.

Amber Roudette poses with colleagues at the clinic
Amber Roudette shows her Hokie pride while posing with colleagues during her externship with At Home Animal Hospital, a small animal private practice in northern Maui.