Veterinarian Tom Furman is a dying breed.
With no conventional work schedule in place, he may spend one day dressed in a white lab coat, neutering dogs and tending to vomiting cats in an office. And the next day, he's dressed in a pair of green coveralls driving 120 miles in a dusty gray Dodge Ram pickup truck to perform an emergency C-section on a cow and test the semen of a two-ton bull.
"When you sprinkle the small-animal medicine in with the large-animal medicine, you can get a big variety of responsibilities for the day," Furman said.
As both the emergency and primary caregiver of all breeds of animals in the area, Furman, 33, is the lynchpin of Alliance, Neb., a small town on the western edge of the Sand Hills with a population of just less than 8,500 people. But he could be the last. Furman is among the ever-shrinking pool of rural veterinarians.
"This has been bad and getting worse for a number of years," said Dr. Ron DeHaven, CEO of the American Veterinary Medical Association (AVMA). "There has not been a time when it was worse than it is now."
Today, more than 1,500 counties in the U.S. are without a single veterinarian to treat animals, estimated by the AVMA. That amounts to 44 states with at least one shortage area, designated annually by the U.S. Department of Agriculture (USDA).
The shortage is most acute in states with the most food-producing animals, such as cows, chickens and pigs.
In Idaho, 33 of its 44 counties are in need of rural veterinarians; in South Dakota, more than a dozen counties have more than 25,000 food-producing animals but no food-animal veterinarians.
Last year, Secretary of Agriculture Tom Vilsack designated 187 veterinary shortage areas nationwide. Colorado, Iowa, Kansas, Nebraska and Texas top the list.
The problem extends beyond protecting animals. Nearly 70 percent of human diseases have an animal origin, DeHaven said, and are often caused by bacteria such as salmonella and E. coli transmitted to humans from animals.
Gary Sherman of the USDA's National Institute of Food and Agriculture (NIFA) said rural veterinarians are the eyes and ears of today's farms.
"Ultimately, to keep the food supply healthy and safe, it must begin with healthy animals." he said.
In one county in Iowa, there's only one veterinarian to care for more than half a million head of livestock, according to Dr. David Schmitt, the state veterinarian.
The numbers are similar in Texas. And Dr. Dee Ellis, the state veterinarian, attributed the shortage to cold hard economics.
"A vet charges what he thinks the animal is worth, but because a producer doesn't think treating a chewed-up sheep is worth $2,000 an hour, he can't make enough money to stay in business," Ellis said. "Either lower your fees or don't practice."