Monday, October 1, 2012

When the patient is a shelter: week one

The next question I get after “what do you do?” is always “what’s shelter medicine?” I have been playing around with different ways to sum up a complicated veterinary specialty in a few sentences, suitable for cocktail party conversation. (No, I do not actually go to cocktail parties.) Recently I found an answer I liked: shelter medicine is where the patient is an animal shelter, not an animal.

For the next four weeks, my shelter medicine program will be working on a consultation with a particular animal shelter. This week, we are analyzing data from the shelter, which is a large municipal animal care and control facility in the South. As such, it will be open admission (take in almost any animal offered to it) and therefore likely to perform euthanasia of potentially healthy animals to free up space for more animals, rather than solely for behavioral or medical purposes.

Step one: analyze what this shelter takes in. I have received spreadsheets of data from the last five years. I will be building data tables to tell us how many animals of each species it accepted (we’re only looking at cats and dogs); how many animals of each age category it accepted (kitten/puppy, adult, and the always dreaded “unknown,” of which there are more than you would expect at most shelters even though it isn’t hard to tell if an animal is an adult or not); why the animals came to it (surrendered by owner, stray, confiscation, returned by an adopter, return from foster care, other). This will help us understand where most animals in the shelter have come from, which will be key data in making recommendations to the shelter about how to work to reduce their intake numbers.

One of the residents in my program is simultaneously looking at what happens to the animals who are in the shelter, by age and species: euthanized? Died in the shelter? Adopted out or transferred to a rescue (“live release”)? This will help us make recommendations about how to increase live release. For example, which kinds of animals are most at risk of euthanasia: feral cats? (Does the shelter have a trap-neuter-return program?) Adoptable puppies? (Do they have a program to transfer to other groups which might have more resources to put towards finding homes?) Adoptable kittens? (There are always too many kittens!) Sick animals? (It may be acceptable to euthanize sick animals, but why did the animal become sick? Does the shelter have a problem with communicable disease?) And, of course, we will look at how many animals died in the shelter. (That is the worst outcome. That should rarely happen. If it happens too often, it is a huge red flag.)

So wish me luck with all my spreadsheets. Luckily, I used to be a computer programmer. I may call on some old skills to help me out this week.

Saturday, September 29, 2012

Cuteness interlude

You all like photos of foster kittens, right?


You can only see four of them there. For some reason one is always off doing something else (always a different kitten).

They are probably around three weeks old. They had not quite gotten the concept of solid food yet and were not eating well in the shelter where I was working last week, and were underweight. One of them had a bad upper respiratory infection, which was manifesting as bad conjunctivitis (inflammation around her eyes). She looks much better today after meds and someone willing to mix up juuuust the right concoction of milk replacer plus canned food.

 

It’s hard to tell in this photo, but her eyes are still pretty red. I’m not worried about her any more, though. She will do fine.

Monday, September 24, 2012

The Feral Freedom program: leave outdoor cats where they are!

Even in parts of the country in which the dog overpopulation problem is mostly under control, the cat overpopulation problem is still rampant. Cats entering shelters often have a less than 50% chance of adoption, down to 10% or less in many communities. Certainly, unfriendly feral cats coming in to shelters have a miniscule chance of adoption, so small that most shelters euthanize them rather than trying to find them a barn home.

On the other hand, cats living outdoors often do very well for themselves. Contrary to the popular assumption that the life of an outdoor cat is nasty, brutish, and short, most of the cats coming through trap-neuter-return (TNR) programs are healthy. They may not live as long as indoor cats, but they are not miserable. To some people, the idea of euthanizing a cat rather than run the risk of its being hit by a car in a year seems silly or even a little mean.

The city of Jacksonville, Florida, recognized that the choice for outdoor cats, feral or not, was either to be spayed/neutered and returned to their territory, or euthanized. That was it. Certainly feral cats stood no chance of adoption, and the influx of friendly cats was so great that their chances weren’t much better. That realization was the seed of Jacksonville’s Feral Freedom program. This program facilitates the sterilization, vaccination, and return of all healthy outdoor cats that are presented to the shelter. These cats come from the surrender of “stray” cats and from active trapping. Rather than become shelter inhabitants, they are returned to the location where they were originally trapped or picked up.

Does it cost a lot? Because the city was holding all cats for five days in case an owner came to reclaim them, and paying for euthanasia and disposal of the body, the program costs the same as the previous policy, or a little less.

Do owners fail to find actual stray cats when they are not held in a shelter? Research has shown that stray cats are less likely to be reunited with their owners in shelters than if they are left outside to find their own way home. Many owners do not expect to see their outdoor cats daily, and may not start looking for a missing cat until after it has already been euthanized in a shelter.

Are outdoor cats nuisances? Some certainly can be, although sterilization does reduce nuisance behavior, and vaccination reduces disease. (Cats are much more likely to get sick in a shelter than outdoors.) Feral Freedom provides assistance to people with complaints about individual cats. They will trap, sterilize/vaccinate, and return the cat, and then suggest that people who want it off their property try methods like motion-sensitive sprinklers. (And hilarity ensues.)

Do the good citizens of Jacksonville approve of this program? Jacksonville initially implemented the program on the sly without a lot of publicity, but did publicize it once it had proven to reduce cat euthanasia rates in shelters. The city receives complaints about individual cats, but rarely about the program as a whole. Most people, when they understand that the cat’s choice is euthanasia or return, accept that putting the cat in a shelter is not a humane option. (Some people do disagree. That will be true of almost any public policy, except maybe the one where every new baby gets a chocolate eclair.) But cats will not be relocated, even problem cats. Aside from the question of how well a cat will do when dropped down into a new territory, there is nowhere for them to go. There are no places that want more outdoor cats.

And, of course, the ethical questions. Isn’t it the job of a shelter to provide care for homeless animals? Of course it is. But if the shelter does not have the resources to provide for all of them, does it become the job of the shelter to kill them when they are not otherwise suffering? And aren’t cats better off in a good home? Of course they are. But if there is no good home available (or even bad one), are they better off dead?

I certainly recognize that this approach to cat overpopulation is a controversial one and that many will disagree with it. (If there is interest, I may blog later about the questions of communicable disease in outdoor cats, or predation of wildlife by outdoor cats.) But I think we have reached the point in dealing with the pet overpopulation problem where revolutionary ideas are worth trying, because we have tried almost everything that is non-revolutionary. Don’t get me wrong: euthanasia of healthy domesticated animals has certainly decreased in the past decades. But there is still a long way to go. As one of my faculty advisors said to me recently, “It’s an exciting time in shelter medicine. Everything’s on the table.”

For more information:


Monday, September 17, 2012

Hey, want to get rid of those ovaries, cheap?

A few months ago I was watching a general practice veterinarian perform a dog spay. And I was surprised by how slow he was. He seemed hesitant, not confident in his technique, and he took a good forty minutes to finish the surgery. He commented to me, “I only do about one spay a month. Most of the animals we see these days were spayed before they left the animal shelter.” This made me wonder: if I had a dog that I wanted to have spayed, where would I take her? To someone who only performed this complicated surgery once a month? Or would I actually rather have her spayed at a shelter, by someone who does multiple surgeries a day, even though she is less likely to have high quality anesthesia management and individual attention there?

The answer to the question of how to offer high quality, high volume spay and neuter services to the general public is veterinary clinics focusing entirely on spay and neuter, and not offering general health care. One model clinic of this type is Humane Alliance in Asheville, NC. This sucessful non-profit clinic was founded in 1994, before much of the rest of the shelter community had woken up to the fact that high volume spay/neuter is an important component of reducing pet overpopulation. Today, 25% of the animals they surgerize are privately owned and come in on appointment. The other 75% come from shelters, rescues, and feral cat trap-neuter-return operations within a sixty mile radius of the clinic (transportation is provided by the clinic). On any given day they may have 100-125 animals in the building receiving surgery.

The Humane Alliance model was so successful that other clinics began coming to them for help. In 2005, Humane Alliance began accepting applications for National Spay/Neuter Response Team (NSNRT) members, member clinics designed on the Humane Alliance high volume model. They define “high volume” as at least 5,000 surgeries per year, though they note that most clinics perform at least 7,000. With a profit margin of about $2-3/surgery, this nets the clinics a profit of about $10,000/year, which is enough to keep them afloat. Today, there are 110 NSNRT clinics, and five more are expected to be operational before the end of the year. Humane Alliance helps the clinics every step of the way, from the design of their business plan, to the list of medications to have on hand on opening day, to sending staff members out to work on site at the new clinic for the first week.

Do these clinics provide spay/neuter surgery in the style of shelter surgeons? In some ways, yes, because their protocols are very much oriented to high volume, with the expectation that one surgeon will handle up to dozens of animals a day. But the quality of the care is extremely high. Arguably the most dangerous part of surgery is going under general anesthesia, and these clinics do not skimp on their management of this aspect of surgery, down to the details of keeping the animals extra warm on a heating blanket while they wake up.

I like this vision of the future: veterinarians who are specialists in spay/neuter surgery, working in clinics that are focused on this one complicated procedure, providing services of higher quality and for lower cost. Making spay/neuter more affordable and more accessible can only be a good thing for pet overpopulation. Unfortunately, the reaction of many general practice veterinarians is not so enthusiastic. Because these types of clinics charge much less for surgeries (often well under $100), veterinarians at full service clinics often fear that their clients will be stolen from them by clinics offering less expensive services.

Is it a realistic fear? I don’t think so. Full service veterinarians offer full service: wellness care, and management of sick animals. Spay/neuter clinics offer a one-time interaction with the client. Full service veterinarians may indeed lose spay/neuter business, but I contend that those services don’t comprise a large part of their income to begin with. The rest of their services aren’t threatened.

I think these clinics are going to continue to expand, and become an accepted part of the way veterinary medicine is practiced. The old adage “good, cheap, fast: pick two” is disproven here. This is the place I would take a beloved animal to have surgery.

Monday, September 10, 2012

What breed is my shelter dog?

I am weekly asked the question “so what kinds of dogs do you have?” People don’t ask this about cats. But it is the first question they ask about a dog. We use a dog’s breed as shorthand to tell us the dog’s size, color, build, and to make predictions about its temperament and energy level.

I usually describe my dogs as a “golden” (one word) and a “32 pound something or other, probably a border collie/retriever mix“ (11 words, and I didn’t even get her color in there). Some dogs, like my golden, can easily be pointed to and called a purebred, even if they aren’t registered (which is the technical definition of a purebred). But once you start mixing purebreds, it rapidly becomes surprisingly difficult to predict the heritage of the puppies. Traits that you think of as the defining characteristic of a particular breed, like that rich golden color, are often recessive and disappear in the first generation of mixed breed puppies. Look at pictures of puppies of known mixed breed heritage and you’ll be surprised again and again at how impossible it is to guess the parents’ breeds.

Now, I do make guesses about breed heritage when I describe my little mutt. But is she really a mix of breeds? Is it possible that there are a lot of dogs out there that owe more of their heritage to a pool of dogs that never got sucked into the closed breeding groups of registered breeds, and were always just something or others?

So why do I persist in making up breeds for her? Because it is shorthand. People understand it. It gives them a handle to use in building their imaginary picture of this dog I’m describing: her general size and shape and, of course, temperament. Of course, what a dog looks like does not predict very much about its temperament (except maybe that little dogs often have Napolean complexes — and that is nurture, not nature!).

As for the rest of it, we don’t have to say that a dog is a breed. We can say that it is a type. This is really what we are doing in a shelter when we guess the breed of a dog to write on its adoption card. No one really thinks that all those “lab mixes” definitely have Labrador Retriever in them, but it lets potential adopters browsing on the internet to know what to expect and to make a decision about whether to come in to the shelter meet the dog.

So what is my little mutt? Maybe next time I will say she is a “collie type” dog. As for the rest of it, describing her exact color and personality always makes for a fun conversation.

Tuesday, September 4, 2012

Team Dog Zombie shirt

As requested, shots of the Team Dog Zombie shirt. Every team member had a shirt which had some variation on this theme. My husband kindly offered to edit out any identifying information (my name and my team members’ names) from the photos.

The front of the shirt has a stylized cat face on it and says “have you seen my cool tattoo?” This is a reference to the habit of shelter veterinarians of tattooing any animal whom they spay/neuter, to avoid later unnecessary surgeries if the animal is later lost and ends up back in a shelter. (All vets should do this! You never know who will get lost! Dude, I lost my dog the other day. But found him again in two hours.) You can see the little green line down by my belly area, which is the cool tattoo. Yes, I have considered giving myself this exact tattoo, but have decided it is not as cool on girls as it is on cats.



The back of the shirt has the team name, and all the team members signed it (my husband blurred out their names). We were originally Team C, and you can see a reference to this on the shirt.

Me: Don’t include my whole butt in the picture!
My husband: Don’t worry, there’s no way that could happen.

We have such a healthy relationship.


Monday, September 3, 2012

Felicia Day and dog training

I was a geek before I was a dog zombie. I am a fan of The Guild, which is a web-based show produced by Felicia Day. Day also has a YouTube channel called Geek and Sundry (I am a geek and I am sundry!) and on a recent episode of The Flog (which is a video blog type thing — Felicia’s Blog, Flog, get it?) she has a professional training session with her dog, Cubby. Who is super cute, but not the cutest dog ever. 




It was a nice segment. The trainer did some basic agility work with Day and Cubby, a good choice for a dog who looks like he has the genetic background (herding breeds) to have some smarts. She instructs Day to do a lot of luring with Cubby — using a food reward to guide him where she wants him to go. A lot of agility trainers use shaping instead, in which they set the dog up to do the right thing, let him figure it out, and then reward the right choice. This method can be a little slower up front, but produces a dog who learns how to learn, learns how to experiment in order to figure out what you want him to do, and in the end gets the concept you’re trying to communicate a little better. (Theoretically, anyways. Every trainer has their own opinion about what’s the best way to train.) One reason to choose luring over shaping for a YouTube show is that you need to have quick results. As fun as I think a shaping demo would have been, that wasn’t what this show was about.

The trainer concludes by saying that Cubby needs some mental stimulation every day. She had to pick one message to get across in a short segment, and I think she picked a great one. Yes, mental stimulation is important, especially in dogs who have to sit home all day when their owner is out working! Agility is loads of fun and I highly recommend it as a great partner sport that works your dog’s brain and muscles. In Cubby’s case, since Day described him as an older dog, he might benefit from a quick vet check to make sure he is up for the exertion of an agility class. In fact, it is always a good idea to check with your vet before starting a new exercise program for your dog, to make sure your dog is up for it. Some dogs need to lose a little weight before embarking on jumping over obstacles, for example.

If you want to get involved in agility, look up your local dog training clubs and schools and ask about local agility organizations, and take a class. When I was getting into agility, I found a local agility trial and volunteered at it. Then I asked all the competitiors what school they recommended locally. They all said the same one, so my choice was easy.

If your dog isn’t up for that kind of activity, you can give him mental stimulation other ways. Train him tricks. Leave him with toys stuffed with food for him to work out during the day. When you feed him kibble, scatter it in the grass for him to hunt for it. Everyone needs a little brain exercise from time to time, even dogs.