When that didn’t work, she climbed onto the horizontal bars of an attached metal gate and sidled around the side of the cow’s rump. She stood on the wall and leaned against the pregnant animal as she kept her balance.

With a gentle but strong push from Flanagan, the cow stepped to the side, giving Flanagan the room she needed to step down. Flanagan, a young veterinarian who provides medical care to large farm animals three days a week, listened through a stethoscope as she flicked the cow’s flank with a finger to hear if one of its stomachs had migrated uncomfortably out of place.

Only 28 years old, Flanagan has been a practicing vet in Maine since 2010 and so is used to having large obstacles to contend with. Her student loans for getting her veterinary degree from Cornell University, which she said add up to around $165,000, could easily count as one of them.

Flanagan belongs to a rare breed in Maine, where state officials estimate that there are only about 35 veterinarians statewide who treat large farm animals.

There was a nationwide shortage of farm animal veterinarians in the 2000s that led to the creation of federal and state tuition loan reimbursement programs for veterinary students who pledged to treat large farm animals. The shortage in Maine has become less acute since then, according to some vets and others with connections to farm animal care, but still there are parts of Maine that the state labels as underserved.

Young veterinarians are graduating from school with heavy debt loads that make it difficult for them to treat farm animals in some parts of the state where older vets are retiring, industry officials say. Vets are traveling longer distances to places where veterinary care for farm animals is hard to come by, and as a result are charging higher rates that farmers find difficult to absorb.

Farmers, faced with increasing feed and fuel costs, have opted to limit their expenses by treating certain conditions on their own instead of calling a vet. Veterinarians, who often provide phone consultations to regular customers, try to focus their practices in areas where there are relatively large concentrations of farm animals in order to compensate for the decreased demand.

All of this applies to Flanagan, who lives and works in Androscoggin County but makes regular calls in Franklin, Oxford, Sagadahoc and York counties, often traveling more than an hour to get to a farm. And it applies despite the fact that she is getting her student loans forgiven through two veterinary school tuition reimbursement programs — one with the Finance Authority of Maine and the other with U.S. Department of Agriculture.

Because she has agreed to devote a significant portion of her practice to treating large farm animals, the programs are paying off tens of thousands of dollars of her student debt each year.

With the FAME program, she has to provide such services to large farm animals in underserved areas, which the state has identified as Cumberland, Hancock, Knox, Oxford and Waldo counties. With the USDA program, she has to spend at least 80 percent of her work week treating animals that are cultivated directly for food or fiber such as cows, llamas, alpacas, pigs, goats and sheep. Under federal rules, horses are not counted as food-and-fiber animals because they are not cultivated for meat, dairy products or their hair.

“I haven’t paid a dime on the loans,” Flanagan said. “The whole thing is going to go away this year or next year, which is great. Basically, I’m going to pay off all my student loans within five years of graduation because of those two programs.”

Clint Harris, whose family has been operating Harris Farm in the York County town of Dayton since the 1940s, is one of Flanagan’s clients. He said recently that in the 1980s there were veterinarians 15 or 20 minutes away who would come treat their cows. But the steep decline in Maine’s dairy farms has made vets harder to come by, which is why Flanagan drives to his farm from more than 60 miles away.

He said Harris Farm has about 40 milking cows and about 120 cattle total, including those raised for beef. He said employees at the farm have become more accustomed to doing some simple medical procedures themselves — administering shots, setting up intravenous treatments, tending to infected hooves — that only vets used to do.

“We used to have emergency veterinary services nearby,” Harris said. “We’ve been able to make it work.”

And yet York County, which by the state’s most recent estimate had five full-time farm animal veterinarians, is not considered one of the two underserved parts of Maine. Cumberland and Oxford counties, which together have an estimated two and a half farm animal vets between them, comprise one area that is deemed underserved. Knox, Waldo and Hancock counties, which have a total of fewer than five farm animal vets, make up the other.

Michele Walsh, Maine’s state veterinarian, said that the USDA issues guidelines for determining areas that have insufficient farm animal veterinary services. The formula includes data on the amount of livestock, the total value of livestock product sales and the amount of land in a given area that may be underserved, she indicated. In Maine’s case, she added, state officials also considered areas where older veterinarians were expected to retire in the relatively near future.

Walsh said that while enrollment at veterinary schools nationwide has increased in recent years, many of the new animal doctors are electing to treat only pets, which generally is more lucrative and less physically demanding. The number of small farms in Maine has gone up, she said, but they are dispersed over large areas and tend to have few, if any, large animals.

This may explain the lack of interest last year in Maine for the USDA veterinary student loan repayment program, she said.

“Nobody applied for the (federal) awards,” Walsh said. “I think it is a lean time at a lot of (farm animal) practices.”

Maine is expected to get a handful of newly minted farm animal veterinarians in the coming years, however. According to officials at FAME, since 2011, when the agency’s new vet school reimbursement program went into effect, five students have been awarded FAME grants. All are still in school, with the first expected to graduate in June 2015.

But Simon Alexander, a large-animal vet in Exeter in Penobscot County, said he thinks Maine already has enough veterinarians who treat farm animals — and he’s worried there may be too many in the near future. There always will be areas where veterinarians are scarce, he added, just as there are some rural locales where there aren’t any doctors or dentists nearby.

“We have about as many veterinarians as the state can support,” said Alexander who, like Flanagan, has benefited from veterinary school reimbursement programs. “The pie is shrinking. It’s all a matter of margins for everybody. It’s a conundrum, for sure.”

Glendon Mehuren II of Faithful Venture Farm in Searsmont in Waldo County said several large animal vets in the area have hung up their hats in recent years or decided to go solely into small animal practice. He said he’s been a regular customer of a vet in West Gardiner for the past five or six years, and has been able to get treatment for his herd of 100 or so dairy cows when he needs it.

But, like Harris, Mehuren said he does more doctoring on his own now, treating problems such as inflammations or calving paralysis. He said that when he does call for assistance, he has to make sure it’s worth the price.

“It’s not to the point that you can’t get them,” he said of dairy cow vets. “It’s to the point that it’s expensive to get them. It makes me use the service less.”

Don Hoenig, a former Maine state veterinarian, said the decline in paying customers is significant. When he first started working for the state department of agriculture in 1986, there were approximately 1,000 dairy farms in Maine. Now, he said, there are fewer than 300.

The statewide quantity of cows in Maine hasn’t changed all that much, but the decline in the number of farms still affects the demand for vets, he said. It’s more efficient for one vet to treat 400 cows at one farm than it is to provide services to four farms miles apart with 100 cows each. The more the animals are concentrated in one place, the fewer vets are needed, he said.

“The profession is changing,” Hoenig said. “We don’t have a food animal practitioner in every town now.”

Turner, just north of Auburn, is in an area heavy with farms and where Flanagan works with four other vets at Turner Veterinary Service. During her recent weekly visit at Brigeen Farms, some farm workers helped her roll the cranky Holstein onto its back so she could secure its wayward stomach by stitching some plastic twine through its belly.

Flanagan, who grew up in Solon, said she plans to make a career of treating farm animals in Maine. She said she knows not to expect to work normal hours or to make a lot of money, but she still has to be sensible. It just isn’t practical to serve remote customers who might need help birthing a calf once every few years, she said.

“If you want to be a solo practitioner that treats every single animal under the sun, you could live in Rangeley and probably make it,” Flanagan said, using the remote Franklin County town as an example.

But, she added, a vet who does that probably will be on call round the clock, be a solo practitioner and never take a vacation. And for new vets coming out of school $200,000 in the hole, she said, “it’s not really a lifestyle most people want to go into.”