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| Dr Miller examines a young patient. |
Dr Lila Miller is best known internationally as co-author of Shelter Medicine For Veterinarians and Staff (you can check out the second edition and download an exerpt from Wiley here) and more recently Infectious Disease Management in Animal Shelters (order a copy or download exerpts from here). She was also the first African American woman to graduate from Cornell's veterinary program and has witnessed massive diversification of the profession.
Dr Miller has more than 30 year experience working in animal shelters for the ASPCA and is Vice President of the organisation's Veterinary Outreach. She taught the first course in shelter medicine in the US, co-founded the Association of Shelter Veterinarians and has recieved a swag of awards in what many consider the toughest field in vet-land.
One of the most fascinating things about Dr Miller is that she almost quit vetting. She spoke candidly with SAT on the eve of her visit to Australia this month to speak at the 5th National Getting to Zero Summit (you can register here - the program looks amazing and its running next week, 10-14 September).
[NB Dr Miller was apologetic that she writes "like she talks - a lot"...but I think you will agree that this interview needs to be run in full].
Tell
us about yourself.
I
have a bachelor’s degree in animal science and a veterinary degree. I grew up
in Harlem, New York, where I still reside. My father worked in a clothing store
as a tailor and pressing clothes and my mother sold tokens in the subway. I
went to Cornell University as an undergraduate majoring in animal science and
then went onto the veterinary school, where I graduated in 1977. To give you an idea of the times, I was the
first African American woman to graduate from Cornell’s veterinary college, and
was a member of the first class to admit more than just a handful of women!
(How things have changed!)
At the urging of my mentor, Dr. Joseph Tait, who was providing veterinary
oversight of the shelter system in New York, I went to work at the ASPCA right
after graduation to help the organization develop a health care program for the
shelter animals. The ASPCA had the contract for animal control for New York
City, operating 5 shelters that were open 24 hours a day, 7 days a week. The
vast majority of the animals were euthanized by lethal injection or
decompression chamber.
After helping convert to
all euthanasia by injection, setting up health care and spay neuter protocols and
helping implement adoption criteria, working both hands on and supervising the
program for about 5 years, I became director of a clinic that provided low cost
veterinary care to the community as well as the shelter animals. The clinic
underwent several physical and staff expansions to meet the demand, but after
15 years, when the ASPCA finally decided that operating a municipal animal
control program did not fit the mission of a national animal welfare
organization, the clinic was closed by the agency that took over animal control.
I then went on to teach shelter medicine at Cornell and write about what I had
learned about caring for shelter animals. I then became director, senior
director and vice president of the ASPCA’s Veterinary Outreach department,
which had a staff of 3 other veterinarians dedicated to teaching shelter
medicine to veterinary and shelter professionals, providing consultations and
grants to shelters to help improve the lives of shelter animals, decrease euthanasia
and increase the live release rate. My current job is vice president of shelter
medicine, where I continue to focus on teaching and training veterinary and
shelter professionals about shelter medicine. I also lecture extensively to
veterinarians about their role in handling animal abuse, whether through
education or participating in investigations and prosecutions.
In
addition to co-editing the three shelter medicine textbooks, I co-founded the
Association of Shelter Veterinarians and have been actively involved in
veterinary regulatory medicine. I was a member of the New York State board that
regulates veterinary medicine and on the National Board of Veterinary Medical
Examiners that creates veterinary examinations for licensing boards.
What motivated you to become a veterinarian?
I
always wanted to be a veterinarian from the age of about 5. I don’t recall what
my initial motivation was, but as I got older I never wavered from it. I liked
animals but wasn’t overly involved with them-I had a dog, parakeet and hamster
over the years as a young child-and as I got older I found I liked biology so
it seemed like a good match. All my education through high school was focused
on attaining that goal.
Shelter medicine is a tough area to work in. What attracted
you to this area and what sustains you in it?
I was never “attracted “to
shelter medicine. It didn’t exist when I was in veterinary school or even after
I graduated. As a student, I disliked visiting the shelter with Dr. Tait,
thinking it was a depressing place and that I would never work there. But Cornell
was very grueling and when I graduated I was drained and didn’t feel qualified to
go into private practice and didn’t want to undergo the rigors of an internship
either. In fact, I wasn’t even sure I
wanted to be a veterinarian any more.
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| Adult dogs with parvovirus, a common affliction in unvaccinated populations. |
When Dr. Tait asked me to work at the shelter and help him improve conditions for the
animals I hesitated but thought it would be a good place to get hands on experience
with animals for a couple of years without the pressure of private
practice. I also saw it as an
opportunity to make a big difference in the lives of hundreds of homeless
animals who didn’t seem to get much attention from veterinarians, and realized the
impact of any improvements I could make would be far greater than I could make for
the individual animals I would treat in private practice.
I thought I’d stay at
the ASPCA just long enough to help set up a program and train staff. After
about 5 years, when the program was established and running well, I was asked
to run a clinic in an underserved area of New York as well as continue to
oversee the shelter program. I saw
another opportunity to help animals who would otherwise be neglected because
their owners could not afford the cost of care. When the clinic closed, I was
offered the opportunity to help teach others what I had learned over the years
and it was another chance to make a difference. So what started out as a short
term commitment borne of uncertainty about my future turned out to be my life’s
work.
How
have shelters changed since you graduated?
Shelters have changed
dramatically over the last 30 years. When I started working in New York City, animals
were essentially warehoused and most were killed after being held for a few
days, sometimes only 48 hours. All
animals were admitted to the shelter regardless of their medical condition or
conditions in the shelter, often leading to overcrowded conditions and some
long term stays that sometimes lasted for months for legal and cruelty cases.
The influx of animals far exceeded the adoption and return to owner rate. The
focus was on animal control and nuisance complaints, not animal welfare. But as the human animal bond increased and more
was and is being learned about animal behavior and emotions, the focus has been
shifting to rejecting euthanasia as the primary method of animal control.
Other ways shelters have changed?
Providing
for quality of life, reducing euthanasia and increasing the live release rate
have become an increasingly important goal for shelters. In addition to paying
more attention to the physical health and behavioral needs of shelter animals, shelters
are engaging the community in the struggle to end euthanasia of healthy but
unwanted pets. Foster care, rescue groups and volunteer programs are much more
common than 30 years ago.
Shelter
staff are becoming more professional, receiving training in animal behavior and
handling, and research is being conducted to debunk the myths surrounding
adoptions and determine the best ways to get more animals into loving, long
lasting homes. Research is showing that fee waived adoptions, adoptions as
gifts and during holidays can result in good, long lasting placements. Behavior
assessments are being used to match an animal’s behavior to the lifestyle of potential adopters, and
to make their stay in the shelter while awaiting adoption less stressful.
Early
age desexing and high quality, high
volume sterilization techniques and protocols were pioneered by shelter
veterinarians in an effort to decrease the births of unwanted litters that were
finding their way into the shelters, swelling population numbers and making the
job so much more difficult.
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| Early-age desexing is a safe and effective means of controlling the number of unwanted animals. |
Shelters
are being retrofitted and designed with the welfare of the animal in mind, and as
inviting, cheerful destinations for the family to visit to acquire a pet.
Shelters
are also seeking alternative and more innovative ways to deal with free roaming
cats, instead of the traditional method of just trapping and/or killing them.
Shelters
are also starting to work together collaboratively, transporting animals at
risk of euthanasia to areas of the country where they can be rehomed due to
shortages. In some communities, shelters with greater resources are working
with shelters with lesser means to save the lives of adoptable animals who
would otherwise be euthanized because of minor health problems or overcrowding.
How
do you think shelters need to improve?
One of the biggest areas
we need to work on is the management of cats. The number of free roaming cats
is unknown but estimates are over 50 million in the US alone. Bringing healthy cats into the shelter ends up
often being a death trap for them-so much so that some shelter professionals
are recommending not bringing them to the shelter at all, and redesigning cat
housing to meet their needs when they must be brought in. We need to improve
getting the message out to the public about desexing, humane care and
responsible pet ownership. We also need to improve customer service and
outreach.
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| Shelter cats need our help! |
You’ve
written extensively about infectious disease control in shelters. Why is the
shelter context different?
Disease control in
shelters is problematic for a number of reasons. Shelters are often
underfunded, understaffed and overcrowded, which creates a perfect storm for
disease transmission.
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| This puppy is suffering from parvovirus. Affected dogs are extremely flat and depressed, and display gastrointestinal signs including vomiting and haemorrhagic diarrhoea. It is treatable but requires intensive care. |
Animals are admitted from varying sources with all types
of disease exposure that the shelter has no history about. Mandatory holding of
animals who may appear healthy but are incubating disease results in disease
spread. Shelters are inherently stressful, which contributes to disease
transmission. Many shelters were not originally designed to house animals so
poor ventilation and porous housing materials that are difficult to disinfect
may be used, contributing to disease spread. Many shelters are unable to
provide ongoing staff training and the very sanitation protocols designed to
prevent disease spread may inadvertently contribute to it. When disease does
occur, many shelters cannot afford diagnostic testing and don’t have proper
isolation and quarantine facilities for appropriate management. The list could
go on and on as to why it is more difficult to control disease in
shelters.
Can
you tell us about any non-human companions you share your life with?
I have a 10 year old
tortoise shell cat named Miss Coco. I found her as a stray outside my building
when she was about 6 months of age. I
had planned to turn her into the shelter, but she was very friendly and
insisted on rubbing and endearing herself to me and my mother, who insisted on
keeping her. As my mother can no longer
care for her she has been living with me for about 6 years now.
Burnout
and carer’s fatigue are commonly associated with many areas in veterinary medicine,
including shelter work. What are your strategies for dealing with these?
I don’t really have any
strategy for dealing with burn out. I have certainly experienced it over the
last 35 years but when I ask myself what else I could be doing that would have
the same impact, I draw a blank and feel renewed.
Do
you have any favourite resources that you can share on shelter medicine?
My favorite resources are www.aspcapro.org, www.shelter medicine.com, the shelter medicine and
forensics on- line courses offered by U of Florida’s shelter medicine program,
Maddies fund webinars, Humane Society of the US (HSUS) Animal Sheltering
magazine and the shelter medicine
textbooks I edited with Stephen Zawistowski and Kate Hurley. The Veterinary
Information Network (VIN) has a shelter medicine page, but the membership fee
is expensive. Of course, one to the best resources is the Association of Shelter Veterinarians (ASV) member’s list
serve.
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| Dr Miller with a puppy. |
Any
tips for veterinary students or veterinarians seeking to work in shelter
medicine?
Veterinary professionals
who wish to work in shelter medicine should try to familiarize themselves with
the resources that are available and join ASV. The practice of veterinary
medicine in a shelter is very different from typical private practice. Failure
to understand the differences often results in unsatisfactory interactions
between veterinarians and shelters. Students should select a veterinary college
with shelter medicine training available-there are several in the US- join the
student chapter of ASV and try to do a supervised externship program at a
shelter.
What
does “getting to zero” mean to you?
To me “Getting to zero”
would mean society had finally met its obligations to the animals it domesticated
and no more healthy adoptable animals would be euthanized for lack of a home.
