Feb. 27, 2023
Words & Photos by Jens Odegaard

A decade ago, Dr. Brea Sandness was gowning up to take a hands-on role in her first surgeries in veterinary school. Today, Sandness spends her time performing surgeries with her one-time mentors and teaching new classes of students at her alma mater, Oregon State University's Carlson College of Veterinary Medicine. 

Sandness, DVM ’15, returned to Oregon State as an assistant professor of small animal surgery in the fall of 2022.  “When I was finishing my residency at Michigan State University’s College of Veterinary Medicine and it came time to think about my professional goals, academia was where I felt I would be able to impact the most lives possible,” Sandness says. “Not only patient lives, but students, future veterinarians and surgeons. You are able to train and inspire the next generation.”

Molded by ‘Klay’ 
Like many veterinary stories, this one begins with a special pet.    

Sandness’ childhood dog Klay “embodied the animal-human bond,” she says. “He would just lay on you for hours to snuggle and just put his weight on you – like a weighted blanket helps you relax. He was just an all-around amazing family dog.” 

In addition to being a cuddle buddy, Klay was the family hunting dog. During one hunting trip, Klay injured his shoulder. Though Sandness doesn’t recall exactly what the diagnosis was (she was pretty young at the time), it left Klay with a “very distinct abnormal gait in his front end,” she says.

Photo: Dr. Brea Sandness (left) and Dr. Bianca Reyes, small animal surgical resident, perform a procedure on a kitten — more details later in the story.  

Sandness’ parents, Mark and Sheila Sandness, took Klay to their local veterinarian in Bismarck, North Dakota. Their primary veterinarian recommended consulting with a surgeon at the University of Minnesota’s College of Veterinary Medicine. “He told us this was the closest place we could consult with a specialist to potentially have surgery done as he wasn’t as comfortable with these injuries,” Sandness says. “While Klay was an integral part of the family, this was a lot financially in addition to time required as it was an eight-hour drive for the consult, potential surgery and recovery. Thankfully the injury wasn’t life threatening and while specialty care wasn’t pursued our primary veterinarian did a great job at managing his injury.” 

“It was these experiences, with my family pets, that ignited the initial dream of becoming a veterinarian,” Sandness says. This led her first to the University of North Dakota where she obtained a bachelor’s degree in biology.  With no veterinary school in the state of North Dakota, the next step to obtaining this dream would take her out of state. 

Initially, Sandness didn’t have a strong preference for where she’d like to pursue her veterinary degree. However, her boyfriend (now husband), Dr. Tyler Rose, was applying for optometry school and had his sights set on Pacific University in Forest Grove, Oregon. The Carlson College of Veterinary Medicine in Corvallis is only an hour-and-a-half drive from Forest Grove through the rolling vineyards, oak groves and farmland of Oregon wine country.  

“After looking into the college and learning more about the state of Oregon, I thought: ‘Oregon seems neat! I'll put my application in and we'll see what happens,’” Sandness recalls. 

It happened. Sandness got into Oregon State and Rose was accepted into Pacific University.  

A thrill of the heart 
In 2012, at the beginning of her second year in vet school, Sandness was accepted into the Merial Summer Research Program at the college. Through this opportunity, she was connected with Dr. Jennifer Warnock as her mentor for the program. Warnock is a board-certified surgeon and associate professor of small animal surgery. 

Warnock invited Sandness to stand and observe surgeries in her down time between work and research, an opportunity that usually comes later in in school. It was an invite that would change her life by further focusing her veterinary aspirations. 

Growing up in North Dakota, Sandness was only familiar with veterinary primary practitioners. “I actually didn’t know you could specialize in veterinary medicine, because in North Dakota we have zero specialists – still to this day,” Sandness says. 

In the operating room, Sandness got to observe and learn from a master of the surgical craft. Warnock is an American College of Veterinary Surgeons founding fellow of minimally invasive surgery in small animal orthopedics. “I thought her procedures and technique were the coolest things I’d ever seen,” Sandness says. “This experience not only exposed me to the importance of surgical specialties within veterinary medicine, but that a female could obtain these types of credentials. So really it was Dr. Warnock, and working with her, that turned me to finding surgery specifically.” 

Along with Warnock, Sandness got to work closely with Dr. Katy Townsend, another board-certified surgeon, during her fourth and final year of veterinary school. It was with Townsend that Sandness participated in, rather than just observed, her first surgery. The surgery was a patent ductus arteriosus or PDA on an Alaskan klee kai. 

The ductus arteriosus is a blood vessel in the heart that normally closes soon after birth. Its purpose is to prevent unnecessary blood flow to the lungs during fetal development. Normally, this vessel closes soon after birth to allow normal blood flow to the lungs. But, if it remains open (patent), the patient will suffer from life-threatening abnormal blood flow as the heart pumps. “It creates this vibration murmur,” Sandness says. “It’s very obvious and you can often feel it just holding the animal.” 

Veterinary surgeons and cardiologists can close off this vessel either through minimally invasive or open-chested surgery, depending on the characterization of the abnormality and the patient. “During this open-chested procedure, Dr. Townsend would allow us to gently touch the live beating heart and feel this thrill,” Sandness says. “She then ligated this abnormal vessel – it’s an incredibly intricate and delicate surgery. Following ligation, she would then allow us to touch the heart to feel the traditional beating instead of the whooshing murmur. It's a truly amazing feeling and immediately gratifying: seeing a surgeon perform a procedure on something that is considered fatal to this pet as they would develop heart failure and now they can go on to live very normal lives.” 

Photo: Dr. Jen Warnock (left) and Dr. Katy Townsend performing a surgery together in the operating room. 

Dr. ‘__________’

The thrill of surgery was one reason Sandness decided to pursue a residency in veterinary surgery to become a specialist. The other was the belief and encouragement from her mentors throughout her training. “If it weren't for people like Dr. Townsend and Dr. Warnock, I wouldn't have done it,” she says.

Securing a veterinary residency is extremely competitive. Sandness felt behind as she didn’t realize her passion to pursue specialty training until late into veterinary school. “I felt as if I was trying to catch up.  I spent a lot of time in the operating room with Dr. Warnock when I could,” Sandness said. She was, and still remains, one of the most uplifting surgeons. She would always greet you as a doctor, and on her tests she would have ‘Dr.’ and then a line for you to put your name. She always really treated you with genuine respect and was very encouraging. She made me feel capable of pursuing this passion by finding ways to help me catch up, improve skills and knowledge, and made me feel like part of the team by offering me the opportunity to practice skills with the surgery residents.

After graduation, Sandness completed a rotating internship in Boise, Idaho and then a surgical internship in Reno, Nevada – both at private practices. 

After her surgical internship, she applied for a surgical residency program. Unfortunately, she was unsuccessful in obtaining one of the coveted residency positions. This is not uncommon as the match rate for this specialty for applicants is only about one in four or five. For example, in 2022, there were only 54 total positions for a small animal surgery resident through the Veterinary Internship and Matching Program while there were 238 applicants, according to the program’s statistical data.

In order to try and improve her application, she completed another surgical internship at a private practice in San Antonio, Texas. However, when it came time for the next round of surgery residency applications she found herself unsuccessful yet again at being offered a position. 

“At that point, I had spoken with a surgeon from Michigan State, and she invited me to do a third surgery internship with them in the hopes that if it went well, then hopefully I would match with their program the next year,” Sandness says. “My husband and I had talked about it, and if I didn't match after this third surgery internship, then I would need to consider redirecting my professional goals.” 

Match results were emailed at 8 a.m. eastern time that February in 2018. “My husband and I were on the West Coast visiting friends and so I was up at five o'clock that morning just hitting refresh over and over on my email and just praying: ‘This has to be the year.” Just like that, there was the email. “Congratulations, you matched to a program.” 

The perseverance paid off. “I ended up matching at Michigan State University where I was completing my surgery internship, so even better was that we didn't have to move for the fifth time in six years!” Sandness laughs. 

At Michigan State University, Sandness found another mentor that instilled a passion for teaching to go along with her love for surgery and passion for her patients. "I really do attribute my love of academia to my mentor: Dr. Karen Perry. She is amazing. She's so wonderful with the students, and the way she teaches in and outside of the operating room, the students just gravitate towards her," Sandness says. "She focuses on molding their confidence and offering tools for them to be successful in being day-one ready. I was incredibly lucky to work and train with her. It was the opportunity of a lifetime and she still offers guidance and assistance on cases. She is ultimately the reason why I looked to continue my profession within academia." 

Stitching it together

On a recent weekday in the college’s Lois Bates Acheson Teaching Hospital, Sandness gloves up for a procedure on a kitten that was born with an abnormal sternum. The kitten’s sternum curves inward, a condition called pectus excavatum, which is putting pressure on her heart and lungs. 

To help alleviate this pressure, Sandness will suture the kitten’s sternum to a molded plastic splint on the outside of the kitten’s chest. She’ll have to suture very precisely to avoid hitting the heart or lungs as she runs the needle down through the skin, underneath the sternum and then back out through the skin and through the splint before tying the sutures off snugly to pull the sternum away from the heart and lungs and into proper shape.

This condition is rare, and so while Sandness knows of the disease, she has never performed the procedure before. She calls upon a new mentor, her colleague Dr. Ingrid Balsa, for collaboration. Balsa is a board-certified surgeon with prior experience on the faculty of the UC Davis School of Veterinary Medicine and has also completed a fellowship in small animal minimally invasive surgery (soft tissue). In turn, Dr. Bianca Reyes, a current small animal surgery resident, is working with and learning from Sandness and Balsa. Also assisting and observing are fourth-year veterinary students Astrid Reyes and Selah Green and second-year student Marissa Patton. 

Suture by suture, Sandness and team work their way to a successful attachment of the sternum to the splint. Now just to wait and see how it heals up.  

Photo: Dr. Brea Sandess (left) and Dr. Bianca Reyes suture the splint to the kitten's sternum.
 

Sandness tries to connect with each student she interacts with on the clinical rotation, and to give them something to take away even if they don’t go on to become surgery specialists. “I ask each of them: ‘What are your career goals?’ So we can try and figure out what is the best way for them to pull something out of their surgical rotation that applies their career goal. Even within the most technically challenging surgery, you can find something what is integral to a general practitioner in either small or large animals on a daily basis. For example, suturing – there's suturing involved in every surgery – or there's pain management and case management,” Sandness says. “I think just finding what they're passionate about and then trying to bridge that with what we’re doing is important.” 

And Sandness is always on the lookout for the next surgeons. Especially if, like her back in vet school, they don’t know it yet themselves. “If you find somebody who seems more naturally inclined, they might not even know that they're natural in surgery,” Sandness says. “I think telling them that they function naturally in a surgical setting, such as being astute and anticipatory to the surgical team and patient’s needs, is helpful, and then that we would love to support them if they wanted to consider advanced training.’” 

Maybe in another decade or two, there will be a student looking back on their time with Dr. Sandness at Oregon State, the same way she recalls Dr. Warnock, and Townsend and Perry.