Battling degenerative arthritis, the 56-year-old large animal veterinarian can't do the physically challenging work any more. Worse, he can't find anyone who will, having already tried to recruit a bovine veterinarian to join his practice. He has advertised for help and trained new graduates - only to have them leave after short stays.
Now, three vet trucks sit idle in his parking lot.
"Believe me, I've looked under every stone, there is no one out there," he said.
The shortage of large animal veterinarians isn't limited to Vermont. In New England, there will be 1,036 vet vacancies in the next six years, according to a June study by the Cummings School of Veterinary Medicine, at Tufts University. In the same time period, over a quarter of the more than 100 specialized food animal veterinarians will reach retirement age, the study found.
Fewer people are interested in large animal veterinary medicine, said David Kirkpatrick, a spokesman for the American Veterinary Medical Association. With a decline in the number of family farms, fewer children are getting exposed to agriculture, he said.
The first years on the job, too, can be daunting. Saddled with an average of $106,000 in school debt and an average starting salary of $53,000, large animal vets don't make what small animal doctors do - about $60,000 a year to start.
Last year, 60 percent of vet school graduates went into private practice, with just 5 percent in large animal veterinary medicine exclusively and 41 percent in small animal practice, according to Kirkpatrick.
The trend isn't just bad news for farmers. It's potentially bad for consumers as well.
"With the critical role that food animal veterinarians play in protecting the nation's food supply, this shortage is especially alarming," the Cummings study said.
The American Veterinary Medical Association and Association of American Veterinary Medical Colleges have urged Congress to pass bills aimed at boosting the number of new vets through a loan forgiveness program for those who work in underserved areas and a competitive grant program for colleges to bring in more students.
At least 13 states - most recently New Hampshire - are starting or have started loan forgiveness programs.
But Kirkpatrick says without a federal program, the improvements will be incremental.
Sanford thinks there's more to it. Since 2000, he's noticed a change in attitude and work ethic of new graduates he's hired.
"The reality is that the romanticism of James Herriot no longer exists," he said, alluding to the late English veterinarian who wrote "All Creatures Great and Small" about life as a country veterinarian.
Kirkpatrick has heard similar laments.
But veterinarian Stephen Major said more recent graduates are simply seeking to balance work and life.
Many new graduates are older than their contemporaries were when they started their careers and have families.
"They may actually have other things to do," said Major, owner of Green Mountain Bovine and Equine Clinic in West Chesterfield, N.H. "We, as employers, need to keep that in mind, to allow for other facets of life, days off and weekends off."
To lessen the load or make up for shortages, some practices are collaborating with neighboring vets to share emergency and weekend duties, he said.
In Derby and Greensboro, where Sanford practices, there's just one vet in the county besides him.
Farmers are having to look farther away for a vet and that could be a problem if there's an emergency like difficult calving or a cow with a twisted stomach. They may also chose to forego things like pregnancy checks, which could be costly later, Sanford said.
During the last two months of pregnancy, a cow is dried off or not milked, he said.
"If you dry her off too early, then you lose that many days of milk that you could've put in the tank," he said.
He thinks technicians, perhaps farm hands, could be trained to do these exams and other common procedures to alleviate the shortage.
When Westfield dairy farmer Jacques Couture got the letter from Sanford telling him he could no longer serve his cows, he called the other vet in the county to ask if he could take in Couture's cows. He couldn't, and referred Couture to a practice in Enosburg, which is about 30 miles away.
Couture's grateful he found someone, but worries about his new veterinarian's ability to get to his farm in winter, when snow and road conditions can make travel difficult.
Sanford, who continues to treat backyard animals and pets, said giving up on his cow patients has been heart wrenching.
"I felt tremendous guilt, I felt tremendous responsibility, I overworked myself, it was a stress on my family," Sanford said. "Now, finally, I've come to a point where I'm at peace with my decision, because it's not my fault."