Ralph waited next to the tray of unsettling stainless steel instruments. One looked like a pick and a few like wicked sets of pliers. He eyed them nervously as the doctor prepared a needle.

A few minutes after the injection, he began to relax. The doctor opened Ralph’s mouth and inserted a metal brace to keep it open.

Through a haze, he watched as she inserted a long tool in his mouth. Then he felt the vibration on his teeth and the grit landing on his tongue. Smoke appeared to rise out of his mouth, but it was just enamel dust.

“There ya go, Ralph, good for another year,” Dr. Melinda Roche said as she removed the brace from the horse’s head. Ralph’s head drooped.

“He’ll feel the sedative and be wobbly for about an hour,” Roche said. “He’s a bit of a lightweight but that’s why you don’t want unqualified people doing this.”

Most people wouldn’t have anyone other than a doctor operate on them. But not everybody is as protective of their animals. Idaho veterinarians are seeing signs of unqualified people working on animals — and though it’s mostly large animals, they’re worried the problem could also grow in small-animal practices.

But convicting the lawbreakers isn’t easy, made even harder by an old struggle over horse teeth.

Why you want a veterinarian

Roche, a licensed veterinarian for 10 years, knows what to do if something goes wrong with Ralph. Animals can have bad reactions, especially if drugs are involved. But some animal owners might not think about that when they just want a quick procedure and someone offers to do it.

Karen Ewing, executive director of the Idaho Board of Veterinary Medicine, said the frequency of people practicing veterinary medicine without a license increased nationally in the early 1990s after the Florida hurricanes. People were left with little money and urgent need, and vets were harder to find; pretenders took advantage of the situation.

Then problems started showing up in Idaho, particularly in feedlots, Ewing said.

One of the better-known cases in Idaho involved James Gary Boldt, who was charged with practicing without a license in 1996 and 2002 in Blackfoot. He surfaced in a Nampa clinic and was charged in 2006 after a horse and three dogs died in his care. He was never convicted because he presumably fled the state.

“We’re seeing it more with the economy the way it is,” said Vicki Smith, executive director of the Idaho Veterinary Medical Association. “People think they’re saving money.”

Veterinarians put in years of effort to be licensed by the state and can be held accountable for their mistakes by the Idaho Board of Veterinary Medicine, which issues licenses. If they are found negligent, vets can have their licenses suspended or revoked.

So, vets have a lot to lose if they don’t care for animals properly. They also carry liability insurance in case something unforeseen occurs.

The same cannot be said for lay people. The board is somewhat limited when attempting to punish those who practice without a license.

Tough and time-consuming

Case in point is an investigation playing out in Jerome County.

Often, animal owners don’t check for veterinary licenses and don’t discover problems caused by poor care until after the fact. When problems occur, animal owners often don’t know they can file complaints with the veterinary board. But the board can’t investigate anyone without receiving a written complaint.

This summer, the board received complaints of someone performing surgery on dairy cattle — reaching into the gut to move dislocated stomachs — without a veterinary license and providing artificial insemination without an Idaho State Department of Agriculture license.

“A big concern is, where is this guy getting the prescription drugs to sedate the animals?” Ewing said. “And what happens if an animal has a reaction?”

On Aug. 13, the board took step 1: It asked the state attorney general to write a cease-and-desist letter to Miguel Angel Brito Najera of Buhl.

Board members have since been notified that Najera allegedly hasn’t stopped.

Idaho law allows the board some further options: It can hold an administrative hearing and assess a penalty of up to $5,000 or it can file for an injunction in civil court. Both actions may mean little to those already flouting the law.

“It’s a slow process and in the meantime, the state wastes time and money and animals may be injured,” Smith said.

The final option may be criminal charges. Based upon the outcome, Najera could be charged with the unlicensed practice of veterinary medicine and maybe animal cruelty, neither of which is a felony.

“The problem is that county prosecutors have to be willing to take the case,” Ewing said. “Since it’s just a misdemeanor, prosecutors are sometimes too busy to bother.”

Even if prosecutors press charges, Ewing said it’s sometimes impossible to get the level of evidence needed to make a successful case. Sometimes only one person has seen enough to make a complaint, but prosecutors need affidavits from multiple witnesses.

Dr. Todd Wells, Magic Valley Veterinary Board Association representative, said he’s seen animals that he suspected were subjected to unlicensed work, but he never had the proof. Proof is hard to come by unless someone makes a lot of big mistakes.

“In talking to board members in other states, unlicensed practice is the No. 1 frustration,” Ewing said.

In an effort to prevent more unlicensed practitioners from taxing their resources, the veterinary board voted to record some public service announcements this August warning animal owners to use licensed vets.

“Most of what we’re trying to do is head off any more problems,” Wells said.

Taking the bite out of enforcement

Upgrading unlicensed practice to a felony might get more cases into the courtroom. But it may also cause a backlash the board would rather avoid.

Horses have long teeth that continue to push up during their lifetime, a helpful adaptation because horses grind down their teeth while chewing grass.

Chewing grass alone doesn’t do it for domestic horses that have to hold a bit in their mouth. If their teeth aren’t filed flat, points develop that can cause painful wear. Horses that are ridden often need to have their teeth filed once a year.

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Historically, people who shoed horses or performed other animal husbandry would often file horses’ teeth but there was little to go wrong. Until about 20 years ago, people filed horse teeth manually with long-handled files or “floats.” Most didn’t consider it a medical procedure.

Roche was a veterinarian’s assistant in the early 1990s when she remembers power tools first being used. With such equipment, all horses must be sedated and there’s a greater chance of filing the teeth down too far or causing heat damage by holding the tool in one place too long. That’s when vets started to question whether unsupervised laymen should be doing the work.

“It’s a hot topic,” Roche said. “Each state has made different rules about whether laymen can do (equine) dentistry.”

Unlicensed practitioners who’ve done equine dental work for decades are fighting laws making it illegal for them to continue it now.

In November 2008, Oklahoma made it a felony to practice veterinary medicine without a license. A few weeks after the law passed, a popular rodeo star, Bobby Griswold, was arrested after being warned four times to stop filing horses’ teeth. Griswold fought the charge and was joined by others.

The negative publicity resulted in Oklahoma passing a law this April declassifying equine dentistry as medicine and allowing unlicensed people to work on horses’ teeth as long as they have 80 hours of training. The American Veterinary Medical Association opposed the move.

This came after groups such as the Institute of Justice sued the states of Texas and Minnesota for arresting laymen for doing equine dentistry. It’s illegal in Idaho for unsupervised laymen to work on horses, but making it a felony could loose similar lawyers on Idaho.

In Idaho, technicians can do dental work under a vet’s supervision. Dr. Bernie Fletcher heads the Academy of Equine Dentistry in Glenns Ferry, which trains both veterinarians and technicians.

Fletcher said equine dentistry has become more sophisticated in the past decade with advanced procedures requiring much more training, but only in some schools and facilities. He said some veterinary schools don’t teach dentistry because many vets don’t consider it a specialty. Fletcher said that’s why unlicensed people got such a foothold.

“Part of it’s our fault,” Fletcher said. “Vets let it go because we didn’t want to do it. But vets should be involved in every case.”

If equine dentistry was somehow taken out of the veterinary medicine equation, unlicensed practice could be made a felony with no opposition. But vets aren’t agreed on how best to do that or even whether it should be done.

Ewing said the veterinary board has considered allowing laymen to do unsupervised dentistry if a special license was created so it could be regulated. But when surveyed, half of vets disapproved of the proposal.

“It’s a big fight between vets,” Ewing said.

Fletcher and Roche both said some laymen do good work, and some of the bad work they see is done by vets who haven’t been trained or who don’t do the work regularly.

So, even a license doesn’t guarantee good work. But it does mean a vet, or potentially a licensed equine dentist, can’t get away with bad work.

Until the dentistry question is worked out, it’s a lot easier for unlicensed people to get away with just that.

Laura Lundquist may be reached at llundquist@magicvalley.com or 735-3376.

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