Bhutan is a small country located on a Himalaya mountain range sharing borders with India and China. It has a small human population (800,000 in 2017), a small economy and a government focus on Gross National Happiness. In Bhutan, veterinary care is free and only available at Government veterinary hospitals. There are 20 government hospitals; one in each district of the country serving all animals within just that district. Since there is no veterinary school in the country, veterinarians are educated in foreign countries.

In 2009, at the beginning of the National Dog Population Management and Rabies Control Project, all the veterinarians were provided with small animal medicine and surgery training by HSI veterinarians from India. As a part of strengthening the veterinary hospitals in the country the Department of Livestock, Royal Government of Bhutan, appointed one veterinarian as a District Veterinary Officer to undergo the highly skilled spay/neuter training program organised by HSI. Upon completion of the spay/neuter training program all the 20 districts were provided with a complete set of necessary equipment and tools to create a sterile and humane spay/neuter facility in the local government veterinary facilities. By 2012, HSI had trained around 30 veterinarians who work as District Veterinary Officers, making sure that all veterinarians in the country have the same surgical skills and facilities necessary to provide high quality, minimally invasive and community based veterinary clinics for companion animals.

The Bhutanese government supported a change in veterinary care in their country by letting HSI help them develop new standards and protocols for small veterinary medicine. It has positively impacted companion animal veterinary treatment in Bhutan and Bhutanese veterinarians still report what a difference the training and facility changes have made to their work and to how they provide services to the animals.