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After a long and winding career journey, highly respected veterinary cardiologist Dr Arianne Fabella has come full circle. By Rachel Smith
Dr Arianne Fabella was sitting in a lecture hall as a first-year veterinary student when she realised her passion would always be focused on heart health.
“Did I have a lightbulb moment? I guess so. It was in first year, I was in one of our physiology classes and it just sort of dawned on me that cardiology was the kind of medicine I liked thinking about,” she says. “The field of cardiac physiology is incredibly interesting, and once you learn some of the basic concepts, you build on it more and more and only get better at it.”
Dr Fabella’s first role out of university was in a busy general practice followed by that as a rotating intern at multidisciplinary referral hospital, SASH (Small Animal Specialist Hospital), in North Ryde, in 2018. “During the internship you’re exposed to all aspects of veterinary science—but for me, I went in knowing I wanted to do cardiology and had the intention to specialise, through residency or a specialty internship.”
Why heart health? One of the most interesting aspects is the variety of solutions different species have evolved for circulation, and that’s fascinating, she says. “And, some animals are embryonically less advanced, say, a fish heart compared to dog heart, but they’re functional solutions nonetheless. My favourite part of veterinary cardiology is interventional cardiology because you can do something about their condition, and that’s incredibly rewarding for me.”
Moving to the US
Working and studying overseas was always part of Dr Fabella’s plan and she set her sights early on landing an overseas residency. “I did a specialty internship at the University of California, Davis, in emergency critical care, and then I went into the VIRMP match system as an international candidate for a residency, which I completed at the University of Georgia,” she says.
The VIRMP algorithm ‘matches’ you to a facility based on your interview scores, transcripts and how institutions rank you, as well as how you rank them—and there’s a rigorous interview process, too. “As an international candidate, you’re a bit of an underdog compared to the American candidates,” says Dr Fabella. “Coming from Australia, I had to tour the facilities, introduce myself [to the right people] and be academically strong, to stand out from the crowd.”
But stand out she did. Dr Fabella was offered a three-year paid residency at the University of Georgia in 2020. “It’s hard leaving your family and starting over in a whole new country, especially in a high-stress environment—but I built my own little family in the US made up of other veterinarians and friends,” she says. “And I also knew while the position would be challenging, I’d be happy to be doing exactly what I wanted to do every day.”
Even so, American residencies are gruelling, she admits. You’re on call for long stretches of time, and your working day starts very early and “doesn’t finish until it’s finished”. Plus, you have to keep up with the requirements for didactic learning at home. “You’re studying quite a lot and it’s all-encompassing—but when you’re doing something you love, it’s so much easier to go to work.”
While in the US, Dr Fabella also spent four weeks with human heart physicians at both children’s hospitals and electrophysiology labs. “There was some profound learning from one another. The dog, cat and human hearts are very similar in terms of structure and function but there are also some cool anatomic differences. That was one of the best experiences I had there.”
Bears, tigers and otters
Exotic animal cardiology was part of the job during Dr Fabella’s residency at the University of Georgia, where she got to do echocardiograms on Native American animals such as hog-nosed skunks, striped skunks, North American river otters and even an American black bear.
The otters—which usually pop up looking cute on Instagram reels lying back in the water ‘holding hands’—were an experience in more ways than one, she recalls.
“They’re sweet but also quite vicious with big teeth, and very wriggly!” she laughs. “We tried to train one of the otters to be able to do an awake echocardiogram, but he was pretty savvy and wasn’t even getting in the shute anymore at the end.”
After many great experiences in the US, Dr Fabella was tempted to stay—and was invited to apply for a number of faculty positions. But she decided it was time to go back to Australia, returning in 2023.
“I couldn’t see my life being in America long-term, and returning to SASH after my residency has been like coming home,” she says. “It’s been a very easy transition into clinical life post-residency—the hospital has all the bells and whistles, all the different types of specialties and I love practicing medicine with a multi-disciplinary approach.”
A new chapter
This year, Dr Fabella celebrated a big milestone: becoming recognised as a Diplomate of the American College of Veterinary Internal Medicine in cardiology. This places her among the few veterinary cardiologists in NSW. That said, passing the exams was no walk in the park.
“It’s a total of six examinations, anywhere between two and a half to four hours long, over the course of a week,” she says. “It examines every part of cardiology, with physiologic recordings, case studies, essays, multiple choice and a video and pathology component—and it’s probably the hardest set of exams [I’ve ever done],” she says.
Dr Fabella is now considered a specialist in veterinary cardiology in the US, and a ‘boarded’ cardiologist in Australia. “I can’t call myself a specialist in Australia yet. That requires some paperwork and a fee, but it’s on my list to do that,” she says.
She can, however, provide the highest level of expert heart health care for pets across NSW—and she’s also an integral part of SASH’s new cardiology unit. “We accept phone calls from veterinarians needing advice, we interpret ECGs sent through, and often dual-manage cases with other vets out in practice,” she explains.
Back in the clinic
What does a typical week look like for Dr Fabella? “We have a four-day week, and that involves examining patients. chatting to referring vets and doing some form of didactic learning with the interns here,” she says.
Procedures are also a part of her work—from placing pacemakers to minimally invasive catheterisations such as balloon valvuloplasty for pulmonary valve stenosis. “We’re also considering some other more rare procedures that’ll give congenital dogs more quality of life. We’re always open to talking about all the weird and wonderful things we could do with heart disease, particularly in the congenital and acquired sphere.”
And given her love of exotic animals, which hearts would she like to treat in Australia if she had the chance? “I’d love to echo monotremes; platypus and echidna hearts would be pretty incredible to see,” she says. “I’d also like to work on more fish hearts, some native birds …and dip my toe into some zoo work in the future, too.”